How to help children during a panic attack.

While it’s true that, age-wise, I am a full-grown (albeit petite) adult, I have never lost connection with the panicked child I once was.

In fact, without consciously choosing, I’ve dedicated my entire adult life to learning how to become less panicked by uncertainty, less anguished by the unknowable, and more comfortable with the sensations of dread signaling terror that cascade throughout my body.

I’ve done this with deep and relentless self-inquiry, consistent study, decades of therapy including psychoanalysis, Eye Movement Desensitization Reprocessing (EMDR), Somatic Experiencing therapy, and ongoing conversation.

All driven by an innate need to master my emotions so that I can live with more ease in the world without being sidelined by the darkest, scariest inclinations of my panic and anxiety, which once so interfered with my life that I couldn't leave the house to participate in or live my life.

It’s in this mindset, and from the point of view of a panicked child all grown up, that I offer the following advice.

When the child in your life is having a panic attack, do you know how to help them?

Do you tell them that they’re okay?

That they’re fine?

Do you tell them not to worry, or that they’re overreacting?

Do you reassure them that you’re not worried, that no one around you is worried, and if no one else is worried, then all evidence suggests that there is no reason to worry?

Yes?

Well then you are a wonderful parent/caretaker who means well, and I am now asking you—on behalf of all panicked children everywhere—to please stop doing this.

When your child is having a panic attack, they are not fine.

They know this.

You know this.

So when you tell them that they are fine, when that is very clearly not their experience, they feel more alone. Worse yet, they feel unsafe because what you are telling them and what they feel are in conflict.

In the throes of a panic attack, your child feels out of control, and that is terrifying.

What they need is someone who demonstrates to them that they are capable, reliable, and able to act as a liaison between their terror and reality.

In order to prove that you are in control and they are safe with you, the first order of business is to be honest with them and acknowledge that you can see and understand that they do not feel okay.

Anxiety gets worse when it’s denied or hidden. Telling someone, especially a child, that they are okay when they are not makes their anxiety worse.

Acknowledging that someone feels not okay does not trigger their anxiety; rather it allows the anxious person to relax a little, knowing that someone is completely there with them.

Getty Images / Peter Dazeley

A child having a panic attack is afraid of what’s happening to them.

When the person with them is calm and stable, unafraid, able to recognize the situation for what it is, and acting as steady ground, the child can begin to feel safer.

This is what's known as co-regulation.

Co-regulation is the ability of one person's autonomic nervous system to influence another’s autonomic nervous system.

This process is not only interpersonal, it's neurological and biological, facilitating an emotional and physical balance. (Stay tuned for a forthcoming piece on co-regulation in adult relationships.)

Panic can only be de-escalated and soothed when the anxious person’s experience is fully acknowledged.

When your words align with the truth of what’s happening, you are offering congruence, which automatically creates a safe place for your panicked child to land.

So, are you supposed to tell the panicking person they are NOT okay?

Sort of yes and sort of no.

A good approach is to tell the child you understand what’s happening, and convey to them that you’re there and will get through it with them.

Remind them that they have panicked before, and just like last time, they will get through this again.

Be conscious of mirroring back to your child the fear they are describing. Perhaps they will say they are unable to breathe.

Let them know that you can see their chest and belly rise and fall, that even though they feel like their body is shutting down, you—the person not panicking—are watching and can attest to the fact that it isn’t.

You are their witness, and you are assuring them that what they are feeling isn't factually happening—it's simply their fear making lots of noise. This distinction between feelings and facts is vital.

The person who is panicking (or having extreme anxiety) is experiencing their worries as somatic sensations inside their body.

These sensations trigger a heightened sense of danger, signal an ominous threat, a pressing on their chest of imminent doom.

These physical experiences of distress are very real, and because of it, those in the throes of panic have trouble distinguishing between what's real and what's not.

Yes, your child might be convinced that you’ll forget they exist after they’ve left for their school trip, but that’s just a feeling, some bad information their anxious brain is sending them. But it’s not a fact.

The fact is that you have never forgotten your child in the past. The fact is that your child has never forgotten they have a parent. So it makes logical sense that no parent could forget they had a child.

Separate their worries from reality with logical, evidence-based facts.

Getty Images / Klaus Vedfelt

Sit with your kid.

Do not be busy doing other things while your child is panicking.

Hold the anxiety with them.

If they are hyperventilating, breathe alongside them.

Show them how you would like them to be breathing.

Inhale for four counts, hold for seven counts, exhale for eight counts, and repeat this as necessary. 4-7-8 is a great technique for calming down an overzealous nervous system.

If they are not hyperventilating, having them breathe might actually induce hyperventilation, so do not tell them to breathe unless it’s necessary.

When I’m panicking, my older sister, Kara, will tell me to imagine that I'm inhaling blue, safe, clear and clean air and exhaling hot red, polluted, mad air.

Having a visual gives me a job that requires shifting my attention off what I’m feeling and onto how I’d like to feel. It gives me a sense of control over what’s happening.

Remind your child that panic attacks are false alarms.

That their alarm has gone off when it didn’t need to, and now you just have to sit and be patient until the alarm quiets down.

Their alarm is more sensitive than others’, so things that other people wouldn’t think are dangerous, threatening, or scary are all of these things to a highly sensitive human.

Whatever you do, do not deny their experience. Do not diminish what is happening for them. Don’t tell them they are being ridiculous or overly emotional. That's the equivalent of telling someone who was robbed at gunpoint that they're being too dramatic.

Just because you can’t identify with your child’s fears doesn’t make the experience of whatever they’re anxious about any less traumatic for them.

There are ways to acknowledge that the thing itself isn’t dangerous, that feeling afraid won’t kill you, while also communicating that you understand the fear is very real to them.

Be your child’s life coach, their mental-health advocate, their best friend. Treat them the way you want them to treat themselves. They are learning all of their behavior from you. Be their role model. It’s what they’ve always wanted from you.

You got this.

And in the event you'd like some resources to help with your child's anxiety, and your own, I highly recommend these books:

The Worry Cure: Seven Steps to Stop Worry from Stopping You. Robert L. Leahy, Ph.d

Freeing Your Child from Anxiety- Tamar E. Chansky Ph.D.

Freeing Yourself from Anxiety: The 4-Step Plan to Overcome Worry and Create the Life You Want by Tamar E. Chansky Ph.D.

You and Your Anxious Child: Free Your Child from Fears and Worries and Create a Joyful Family - Anne Marie Albano, Ph.D with Leslie Pepper

If you want to share some specific techniques that have worked for you and your child, please let us all know in the comments!

Until next week I am…

Amanda