When Children’s Separation Anxiety Persists

Answer to a Quora question about 10 year old twins with extreme separation anxiety

Please know that you’re being normal for your feelings; you have tried probably everything you can think of short of medicating your children, and so far, nothing has worked.

What caught my attention was your mentioning that your sons have already received counseling for many years. This caught my attention because it may not be the counseling itself that’s “not working”, but rather, what “root cause” may be missed by counseling.

Before going the medication route (I view psychotropic medication only as last resort for children this young), I’d recommend 3 options:

1. Examine other approaches.

There may be methods of counseling that could work well. If for example you have worked with the same counselor for several years and you have yet to see a tangible improvement, then it’s time to find someone else.

If the counselor is capable of other approaches, ask about these approaches: it is entirely possible that the counselor has already tried cognitive behavioral approaches or desensitization approaches. It is critical to know whether the counselor has already tried other approaches because this gives you an important data point about whether or not it is the methodology that is truly the problem.

2. Examine your reinforcement.

You may be unknowingly reinforcing your sons’ behaviors by your response. Let’s set aside the anxiety component (because right now, I’m not sure it’s “anxiety” as the core component instead of “anxiety” as a symptom of another core component that is undiagnosed) and look at your response to your sons’ behavior. Are they seeing “Mum lets me have my way if I do XYZ, then I’ll do XYZ to get what I want”?

I’ve done this before: I’ve unknowingly reinforced negative behavior when my son has a meltdown that was linked to anxiety. I could be going down the stairs and he’s screaming like I’m about to abandon him forever. What did I do when I heard him screaming? I scooped down to comfort him and soothe him. Result: my son sees the outcome and makes the association, “every time I scream bloody murder mum stops and holds me and says nice things to me: I’m going to scream bloody murder more often!”

3. Examine the true core component.

This is where you go to specialists. I recommend that you take your sons to receive a comprehensive psychological evaluation to rule out other factors before you accept the “anxiety diagnosis.” There may be other health conditions occurring that have anxiety as a comorbidity. Therefore, until you address the root cause, you are only treating a comorbidity and that can be a “hit or miss.” It sounds like so far there have been more misses than hits, which tells me that “anxiety” may not be a root cause but is in fact, a comorbidity to another condition.

In my child’s case, he was diagnosed with separation anxiety disorder. This was due to diagnosing the anxiety symptoms and missing the true root cause of his condition, for which anxiety is a comorbidity (and while this is a very serious condition, it is one for which I will not be using any medication for my child at his young age.)

I don’t want to “lead” you into thinking this may be what’s happening with your children. Instead, I hope that my answer can help you sort out options that can take you to the right answer and subsequently the appropriate approach to the solution.

My thoughts are with you.