The fine line between not accommodating and unconditional emotional support

[Anonymous]

Hopefully this post makes sense. I'll give a real world example from tonight. Five year old ds hates hair wash night due to sensory issues and severe anxiety. Normally he can do it and has been doing it on his own for the past six months or so. For some reason he had a complete meltdown tonight, screaming crying dry heaving in the shower. He has a communication delay so it's really hard to understand what he's upset or anxious about and when I suggest possibilities he says "yes"
so I never really know if that's actually it or he's just going along with what I say.

I try so hard an environment where he feels safe to feel his feelings and doesn't feel judged for them or only lovable when he's easy. At the same time I know that accommodating the anxiety is the wrong move and giving in only worsens it. So what do I do here? Let him get out of washing his hair? Or force him to do it even though it's clearly causing a lot of anguish? I feel like no matter what choice I make it's the wrong one.

[Anonymous]

I wonder if he was overtired. Also, do you read the Todd Parr books on feelings and have a feelings chart? Maybe even if he can't articulate his feelings he can point to them on the chart.

I think accommodating his feelings by asking if he'd like to wash his hair in the sink while fully dressed is reasonable. But once he picks a method, he needs to follow through on that one.

[Anonymous]

Are you getting him speech and ot help? I would try to talk to him why? Is the shampoo burning his eyes?

[Anonymous]

Have you considered making hair wash be an every night activity so that it doesn't seem variable/random to you DC?

[Anonymous]

This is OP.

He is in speech and OT though speech just started a few months ago.

He's worried about getting water and soap in his eyes. What's confusing to me is that he's been fine for the last six months and washing himself actually alleviated a lot of the anxiety. He does a great job of washing it himself. We always wash Sundays, all the kids.

I ascribe to the Eli Lebowitz SPACE model and try not to accommodate too much but sometimes I'm worried I'm too rigid. Hence walking the fine line. I just don't know.

[Anonymous]

Anonymous wrote:This is OP.

He is in speech and OT though speech just started a few months ago.

He's worried about getting water and soap in his eyes. What's confusing to me is that he's been fine for the last six months and washing himself actually alleviated a lot of the anxiety. He does a great job of washing it himself. We always wash Sundays, all the kids.

I ascribe to the Eli Lebowitz SPACE model and try not to accommodate too much but sometimes I'm worried I'm too rigid. Hence walking the fine line. I just don't know.

Can he wear swim goggles to wash his hair? It's an easy solution.

[Anonymous]

I think all the sympathy as well as cheerleading, but not getting out of washing the hair because of you do, you’re creating an anxiety beast that will only grow. Also big praise and reward for bravery after. Ideally the reward is set up ahead of time - like for next week. “I know how hard it was last week and I also know how brave you are…” Maybe set up tiers - one for if he does it himself, one for some crying, one for a meltdown but he gets through it. Let him help you pick the reward - and if possible have it be some kind of extra attention from you.

[Anonymous]

Anxiety is different from sensory issues. If I touch something hot, it's going to hurt every time -- I can't desensitize myself out of it hurting. Same for other sensory experiences, even if you don't understand why the sensory experience is painful -- it still is to the person experiencing it.

If he's normally ok with hair washing, I would want to know what made this time different. It's ok to model flexibility on particularly hard days.

[Anonymous]

Op, I have a child with severe anxiety, and there are going to be moments when the anxiety is overwhelming. When this happens, I scaffold — so with the hair washing, maybe you help wash their hair, or rinse it or talk them through it — something where they have to do it, but they are feeling supported.

An example from my DC is that they are quite scared of insects, and the red lantern flies are a trigger. So when DC sees them, DC isn’t allowed to not walk to wherever we were walking, but I will hold their hand, or they can run, or I can remind them the whole time that they can do it and that I know it’s scary for them. If they really won’t walk, we just stay as long as DC needs to calm down and figure out how they want to tackle it. Sometimes DC will have a meltdown and it will take us 20 minutes to manage it.

FWIW, DC started medication last year and it was super helpful. Panic attacks turned into meltdowns and better ability to cope.

[Anonymous]

He has autism right OP? A consultation with an ABA or OT therapist can help you develop plans at home to ensure your child continues to learn skills but not in an overwhelming way

[Anonymous]

Anonymous wrote:Op, I have a child with severe anxiety, and there are going to be moments when the anxiety is overwhelming. When this happens, I scaffold — so with the hair washing, maybe you help wash their hair, or rinse it or talk them through it — something where they have to do it, but they are feeling supported.

An example from my DC is that they are quite scared of insects, and the red lantern flies are a trigger. So when DC sees them, DC isn’t allowed to not walk to wherever we were walking, but I will hold their hand, or they can run, or I can remind them the whole time that they can do it and that I know it’s scary for them. If they really won’t walk, we just stay as long as DC needs to calm down and figure out how they want to tackle it. Sometimes DC will have a meltdown and it will take us 20 minutes to manage it.

FWIW, DC started medication last year and it was super helpful. Panic attacks turned into meltdowns and better ability to cope.

Have you consulted with therapists on this approach?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op, I have a child with severe anxiety, and there are going to be moments when the anxiety is overwhelming. When this happens, I scaffold — so with the hair washing, maybe you help wash their hair, or rinse it or talk them through it — something where they have to do it, but they are feeling supported.

An example from my DC is that they are quite scared of insects, and the red lantern flies are a trigger. So when DC sees them, DC isn’t allowed to not walk to wherever we were walking, but I will hold their hand, or they can run, or I can remind them the whole time that they can do it and that I know it’s scary for them. If they really won’t walk, we just stay as long as DC needs to calm down and figure out how they want to tackle it. Sometimes DC will have a meltdown and it will take us 20 minutes to manage it.

FWIW, DC started medication last year and it was super helpful. Panic attacks turned into meltdowns and better ability to cope.

Have you consulted with therapists on this approach?

PP here. Yes, this is the approach recommended by DC’s therapist.

Accommodating anxiety is the worst thing a parent can do - it signals to the child that the “thing” they are anxious about is actually something to be anxious about. Instead you support the child to face their anxiety and they learn that 1) they can do it, and 2) the thing is not something to actually be anxious about.

My DC does CBT and ERB to help them manage their anxiety - meds help, too. I also did SPACE therapy so I understand how to not accommodate the anxiety— it’s not intuitive to me to do that.

My DC has made a huge amount of progress, but still a ways to go. Anxiety can really be limiting if untreated, and even when I think DC has mastered a fear, it can have moments when it comes back.

[Anonymous]

I second swim googles. We have done that. The point is he needs to get clean. He can wear googles in the shower his entire life if he needs to. Or cover his eyes with a towel. So many things are going to be hard. If you can find a solution that works for everyone go with it.

[Anonymous]

My opinion is that you don't accommodate - he takes the shower. Otherwise, it's just worse next time, you're reinforcing that it's too scary and he shouldn't do it.

However, you offer lots of unconditional emotional support before, during, and after. You just don't budge on the actual doing of it.

[Anonymous]

OP, I disagree with the advice that you should force your kid to take a shower every night. I think too many people have a shallow understanding of what "not accommodating" means and how anxiety works. What you need to do is help your child face their discomfort in manageable ways. If your son has been taking showers without incident for 6 months and then one night totally freaks out about it, that tells me that, for whatever reason, completing the full shower was not "manageable" that night.

If it were me, I would give my kid some insight into how other people manage fluctuating stressors and say something like "Wow, you're really tired tonight. Lets just rinse your hair with water and tomorrow we'll be sure to start shower a little earlier." (or rinse his body with water or do a washcloth bath or whatever seems reasonable for the evening). You also try to figure out what might be going on (tired? sick? sensory overload from something else?) and address it so by the next shower your kid is able to succeed again.

As adults we all have times where we feel like we just can't deal with X even though we usually deal with X just fine, and we give ourselves a break. Kids have the same experience. It is totally appropriate to take that into account. I mean, if you knew he was hurting from an ear infection you wouldn't force it, right? You would offer some alternatives and return to the full shower when he was better.