As part of our recently launched Instagram Live sessions, we asked our Therapist in Residence, Saskia Joss, to share with us her tips and advice on how to help children with anxiety.

Saskia is a children’s therapist based in London. During her session, Saskia helped parents, caregivers and educators to understand the science behind anxiety, why children become anxious, and shared practical tips on how to help ease anxiety in children.

If you missed the Instagram Live session, we have put together a summary of Saskia’s insights and useful information.

Introduction to Saskia Joss

Hi, I’m Saskia Joss and I’m a therapist for children working in London. I was initially a primary school teacher, which I find very helpful because I better understand how children fit into the school system.

I was a teacher for a long time, for seven or eight years, before I qualified to become a therapist for children. I’ve now been a therapist for nearly three years, and I run a private practice in Mill Hill in North West London.

What Are The Reasons Anxiety Occurs In Children?

There are many reasons why people feel anxious, and some people have a natural tendency towards anxiety. You might say one of my children is so relaxed, so chilled, they don’t need anything extra.

Our natural personality will mean that some people tend to have anxiety that other people don’t have, which means that from a younger age, they’ll need more support to feel calmer and their body more relaxed, more of the time. We’re trying to remind the body to not be in a state of ‘fight’ all the time for anxious people, both adults and children.

Are There Any Typical Signs of Anxiety in Children?

Yes, definitely. I would say you know your children. And I think there’s an element of whether there’s been a shift in your child’s behaviour. Perhaps they used to do things with no problem.

But the other signs that you’ll see in anxious children are things like not wanting to go to sleep. Somatic pain is another one, which is when you don’t think they’re unwell, but they feel unwell. So they say, “Oh, I’ve got a tummy ache.” They actually do; cortisol makes children feel like they’ve got tummy aches and headaches.

Somatic pain is a massive side effect of having too much cortisol. If you imagine everything’s processing around your body and cortisol makes us feel sick and anxious, just like you feel before a job interview. 

You may also notice minor forms of self-harm to mitigate cortisol by making natural opioids. When you pull off a tiny piece of your skin from your finger, you make a small amount of opioid, which offsets your cortisol, and that’s why children do it.

Are There Any Tips For Helping Children To Feel Calm?

So inherently, the front part of the brain, called the prefrontal cortex, is precisely where your forehead is, and that is the calmest part of the brain. The reason it’s so complex, it’s not directly connected to any of your emotions.

But basically, it’s the part of your brain that does the most processing; it’s the bit where you do your organisational planning. And the idea is that if you can get your child to actively stimulate the prefrontal cortex when they’re very, very anxious, they’re getting to do some thoughtful, kind of rhythmic thinking.

The other thing you can do is anything very still and calm. For example, reading a book, jigsaw puzzles, colouring, listening to soothing music can also relax children. 

Is There a Link Between Child and Adult Anxiety?

You know, if you’ve got any different kind of physical condition as a child, you’re probably also going to have something similar as an adult. But obviously, there are things you can put in place for your child to help them be less anxious as adults. 

So if you’ve got a child that’s very kind of upbeat and happy, it’s easier for them to be upbeat and happy in adulthood. That doesn’t mean it’s the only way, and it doesn’t mean they can’t have a happy and fantastic life. But we make our chemical superhighways when we’re young — and helping children to make better chemical superhighways for all the chemicals, not just cortisol, but also serotonin, oxytocin, dopamine and opioids, lots of lovely things that our bodies can make by themselves without anything else, without alcohol or drugs. Anything else that the body can make it almost does everything itself.

Is Storytelling and Play Important In Reducing Anxiety?

I think there are so many lovely books to help children, for example, on Thinkably’s digital library. Using stories to have a conversation with your child, and talk them through thoughts and feelings will make a massive difference in how they see themselves. They might identify with a character who’s got a high level of anxiety or who’s having a challenging time and being able to discuss those feelings with children is invaluable.

This is known as “affect naming”— this ability to connect with the character. And then also, for example, with superheroes or Star Wars, there are characters that are both good and bad in themselves.

You know, there’s this possibility to connect with Anakin Skywalker and Luke Skywalker. You can be a good kid and a bad kid simultaneously. And you know that the Hulk has got this ability to let rip with his anger. And lots of children identify with that because they sometimes feel angry, and they want that to be safe and want it to be okay to feel that way.

When we read a book with a child, we can talk about a character. It’s less direct, less personal, and less vulnerable for the child and the adult. “Gosh, that bear is having a terrible time. I feel like he always feels like he’s left out. How do you think that feels? Have you ever felt like that bear?” 

But there’s an element of if you’re playing with a child and it’s very frustrating for both of you, that might be a thematic nature to that play. You know, for example, you’re playing with a child, playing in a play kitchen, and every time they bring over the food, they say, “I burnt it”, or “I ruined it.”

It’s not fun for anyone involved in play time. There’s no kind of enjoyable feeling to this play. A child might be feeling very frustrated or stuck. You know, they might be playing a game. “I’ll be the dog”, and then dogs very anxious, and the dog hides under the table. They might be showing you through their play they’re not doing as well as they would like to be, that the play is not frivolous, enjoyable or fun.

I was playing with a child recently who kept saying all the animals in the zoo were dying. We’re playing with these animals. And the child was saying, “The animals are dying,” and I’m thinking, this is not a fun game. Play is meant to be fun. And clearly, it’s not fun for us because if all the animals are dying, we’ve got to be anxious.

How Can You Tell If Your Child Is Anxious When They’re Not Vocal Or Unable To Talk Yet?

Oh, that’s a good question! So, I think with young children, they do make things very clear. They cry a lot, and they hold on to you. They don’t do things they usually do with ease, like falling asleep calmly in the evening.

With young children, it’s about a change and extended extreme emotion; lots of very big crying. For example, lots of wanting to hit a family member or bite somebody that’s not just once or twice, but over an extended period of this different behaviour where you think it doesn’t seem right … usually there is something else going on.

How Do Parents Know When Anxiety Requires Professional Intervention?

I think with all things, I would be judging something over an extended period of time. So, for example, the minimum I would tell you, as a parent, you should be assessing it for a three week window. You’ve noticed things are beginning to get a bit harder.

They don’t want to go to school. They do go in, but they don’t want to go in easily to school every day. And then also meal times – maybe they’re beginning to become complicated. If you notice that there are multiple places where things are complicated, and you haven’t got an idea of what to do to make it different, the first thing to do is have a conversation with someone with different skills to sort out and suggest ideas.

Parents regularly call me to ask me about their child’s behaviour, and their children don’t need therapy. As parents, we always worry that we’re not doing enough, and often we need to talk it through with other people who can share some of their own experiences. Our friends usually have very similar experiences to us.

Talking to a therapist outside your social group or your family can help you get a different perspective on whether something’s typical and manageable or difficult and problematic for you. And then they can work out whether there are things you can do at home without any actual therapeutic intervention, or whether you might need a few sessions or to understand what’s going on.

Do You Think More People Are Experience Anxiety Now, Or Do You Think More People Recognise The Signs And Understand That They May Be Experiencing Anxiety?

Yes, I think more people feel anxious and experience anxiety now. And because all of us have been shaken about in the last few years, it would be very irregular if you passed the previous two years without feeling anxious on any day of the last two years.

All of the events we have experienced can be very worrying. I think we’re all more aware of mental health issues than ever before, which I think is excellent. More people are having therapy, more people are talking about their feelings and emotions, and more people support their children’s mental health. I see more people thinking about their own mental health and that of their children, rather than assuming that kids are resilient. Maybe they are all fine, but perhaps they’re not.

How Can People Contact You?

You can get in touch with me on Instagram, @saskiajosstherapy, and you can also get in touch with me on my website saskiajosstherapy.co.uk, or email me at saskiajosstherapy@gmail.com.

I’m always happy to help. I’m happy to help parents and teachers or people looking for parenting support rather than therapy.