Ep 140: Managing summertime anxiety! Sleepaway camp, bees, swimming and more! with Dr Dawn Huebner

Ep 140 with Dr. Dawn Huebner, a clinical psychologist and author of mental health books for children (including the best selling "What to do when you worry too much") discusses her newest mini book series: Mini Books About Mighty Fears. This series addresses specific fears that commonly affect children.  In this conversation we discuss 2 of her mini books “Facing Mighty Fears about Being Apart from Parents” and “Facing Mighty Fears about Animals” and review strategies to help with these common summer time stressors. Dr. Dawn Huebner discusses the step-by-step method for helping kids overcome fears, emphasizing empathy, understanding, and encouragement.

Takeaways

• Cognitive behavioral therapy (CBT) is an effective approach for helping children manage anxiety by addressing thoughts and behaviors.
• Validating children's fears and practicing exposure therapy are important strategies for helping children cope with anxiety.
• Parents should avoid common mistakes such as dismissing anxiety, overly accommodating, and trying to talk their child out of their feelings of anxiety.
• Strategies for helping children cope with anxiety related to summer camps and fear of the dark include normalization, exposure, and building familiarity with the situation.
• Gradual exposure and facing fears with empathy and encouragement can empower children to overcome anxiety and build resilience.

Quotes:

• "The goal is to teach children to change their relationship with that uncomfortable feeling of anxiety and to learn to move towards rather than reflexively away from the things that are making them feel nervous 

Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner.

Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com.

Follow her on Instagram: @AskDrJessica
Subscribe to her YouTube channel! Ask Dr Jessica
Subscribe to this podcast: Ask Dr Jessica
Subscribe to her mailing list: www.askdrjessicamd.com

The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

Transcript

Unknown: 0:00

Hi everybody I'm Dr. Jessica Hochman, paediatrician, and mom of three. On this podcast I like to talk about various paediatric health topics, sharing my knowledge not only as a doctor but also as a parent. Ultimately, my hope is that when it comes to your children's health, you feel more confident, worry less, and enjoy your parenting experience as much as possible. Hi, everybody. Welcome back to another episode of Ask Dr. Jessica. I can't believe it. But today is episode 140. And today I'm elated to have on Dr. Don Huebner as my guest. You may have heard of Dr. Huebner is best selling books for kids like what to do when you worry too much, which I personally have been recommending to patients for years. On today's episode, we are going to talk about how to help kids with common summertime worries like going to camp bees swimming, and even fear of the dark. You are going to love this episode. It's packed with so many pearls of wisdom to help kids that worry. Thank you so much Dr. Don Huebner for sharing your expertise. And before we get started, I would like to ask that you take a moment and leave a five star review and subscribe to ask Dr. Jessica, thank you so much for listening and now on to the interview with Dr. Don Huebner. So Dr. Don Huebner I am such a big fan of yours. I cannot tell you how excited I am to have you here as a guest on my podcast. So thank you so much for taking the time to be here. Thank you for having me. So tell our audience, I'm sure so many people are familiar with the work that you do, and that you've done. Tell everybody about yourself and what you do for work. So I am trained as a clinical psychologist and worked for many, many years as a therapist for anxious children. I shifted recently to parent coaching. And I'm also an author and have 20 Mental Health books out most of them for children. It's amazing, I have to tell you, my sister is a school psychologist, and she's a school psychologist who I trust very much. And I often go to her for advice. And I was over her home during the weekend. And I saw on her bookshelf about 10 books that were authored by you. And so she was also very excited that I would be talking to you today. Yeah, there are books that really work well, for therapists and for school psychologists because they teach things in kind of bite sized ways, in a way that a clinician can really use with a child. And they also work well for parents to you to do with their children. I think they're brilliant. I mean, especially because it's hard for parents to get to a therapist, sometimes it can be expensive, it can be time consuming. And so how great to be able to buy a book to give parents something to work on with their kids actively at home in a very practical way. Right? Yes, that's the genesis of the books, I wanted to have something for my clients to be able to take home with them to practice what they were learning in therapy. And the first book I wrote what to do when you worry too much, was literally a handwritten, hand illustrated book way before the days of self publishing, that I Xeroxed and I gave out to kids to take home, and then ultimately developed it into a book that was published in a in the more conventional way. And can you tell everybody, just because I'm so proud of this, tell everybody what happened with that book? How successful is it today? And how did it happen? It really took off, it was the first of its kind in terms of teaching skills in a very clear and engaging way to kids, and there was nothing like it on the market. And it did really well really quickly. And it continues to do well. Today. It's sold well over a million copies. It's distributed in 25 languages at this point around the world. So yeah, it's a book that's doing well. And a second edition of it is about to come out. We're nearing the 20th anniversary from the release of that book. And I've updated it. And so a second edition is coming out in August. And I'm just curious when you say it was the first of its kind. What do you mean by that? How did this book separate itself from other books that have talked about childhood anxiety? Well, for one, it was written for children rather than for parents or therapists. And it broke down cognitive behavioural strategies in a really specific and easy to understand way. And it was interactive. So my whole first set of books that what to do guide for kid guides for kids have drawing and writing activities that allow kids to customise what it is that they're learning. So it helps them to make the skills more specific for them. It helps them to integrate the skills and better remember and use what it is that they were learning. So it combines I hate to call it a workbook because it's not, you know, word searches and mazes, but it's an interactive book with places for kids to draw and write and customise the term cognitive behavioural therapy gets used a lot and I just want people to understand exactly what that type of therapy means, can you explain what is CBT? Or cognitive behavioural therapy? And how are you able to use that method in your writings in your teachings? Right? So cognitive behavioural therapy is the empirically valid treatment for a number of common issues, including anxiety. And it's based on the notion that we have an internal triangle made up of our thoughts, our feelings, and our actions. And it's a triangle because those are all related to one another with bi directional arrows. So our thoughts influence our feelings, our feelings influence our actions, our actions influence our thoughts and our feelings. Everything interacts with everything else. We often feel distressed, or get ourselves into trouble because of what we're feeling. But of those three things, thoughts, feelings, and actions, feelings, we can't change that easily. We can't just decide I don't want to be angry anymore, or I don't want to feel sad, and poof, the feeling changes, we can't just change our feelings. But we can change our thoughts we can specifically and consciously work on changing modifying what we're thinking. And we can certainly change our behaviours. And there's a robust body of research now that shows that by changing our thoughts, and or our behaviours, we change our feelings. And so cognitive behavioural techniques are activities to directly address thoughts and behaviours as a way to modify feelings. And even though that's a fairly sophisticated concept, children can be taught those techniques in ways that resonate for them or makes sense for them and are doable to them. I'm thinking is it sort of like when my mom used to tell me when I was sad about something, just fake it till you make it? Yeah, except that's not quite what we are teaching kids anymore. But yes, it's that kind of thing where we can learn to tell ourselves something different. And when we do that enough, that becomes our more natural way of thinking or responding to something. I think what's so helpful is the idea of kids being anxious. It's a universal feeling. We all feel anxiety. And I think what's hard for parents oftentimes is how to know when to intervene when to help our kids, because it's normal to be anxious. But how do you know when it's too much? How do you know when we should be seeking help and attention? Right? So when anxiety and avoidance are the default for kids, when they feel nervous, every time they're in a new situation, so they don't want to go places or try things, when anxiety is getting in the way of normal unhealthy behaviour. So makes it hard to go to school makes it hard to do activities or things with friends makes it hard to fall asleep alone, when anxiety is getting in the way, it's important to do something about it. So it's not so much what the anxiety is about. It's more about how big is it? And how much is it getting in the way or kind of impairing a child and when it's getting in the way, if something needs to be done about it. Anxiety is really treatable. You know, there are things that parents and kids can do whether or not a child is in therapy, that make a very real difference. And that's the good news about anxiety. The goal is not to make the feeling go away. The goal is to teach children to change their relationship with that uncomfortable feeling of anxiety, and to learn to move towards rather than reflexively away from the things that are making them feel nervous or afraid to say things that are making them feel nervous or afraid. I think that's really helpful because as a parent, I think a lot of times our instinct may be to try to brush off a feeling or maybe to ignore the feeling and hopes that it will go away and improve if we don't draw attention to it. Exactly. So parents do a fair amount of minimising, so they tell their children there's nothing to worry about or everyone else is doing it or you're gonna like it once you start it, right, that's minimising the feeling. Parents also do a fair amount of accommodating, so allowing their child to avoid or move away from and and the third thing that the mistake, common mistake that parents tend to make is to try to talk their child out of their feelings to try to use logic or reason to talk their child out of it. None of those things work. All of them come from a place of love. Right? So it's hard to see your child feeling afraid. It Sometimes triggers a parent's own anxiety or own distress seeing their child in distress. And so when we see our children feeling anxious, we want that anxious feeling to go away. And so we do whatever is the fastest and most efficient thing we can do to try to get rid of the feeling, and often that successful in the moment. So if a child is feeling anxious about going to a birthday party, and a parent says either, okay, you don't have to go, or I'll stay with you. Presto, the child is no longer anxious, right? So it seems like it worked in quotes, because it in the moment, it got the anxiety to go away. But those kinds of accommodations for anxiety or ways of fostering avoidance of anxiety, make the anxiety better in the moment, while making it worse in the long run. And that's why it's important for parents and children to learn what the alternative is. So can you just summarise are the three common mistakes that parents make with childhood anxiety? Yeah, so they are dismissing the anxiety telling a child you have nothing to worry about and being dismissive. They're overly accommodating, which means fostering the avoidance or anxiety that a child is feeling by kind of capitulating to the anxiety. So research has shown that 97% of parents of anxious children routinely accommodate their children's anxiety, virtually all parents do it. And again, it comes from a place of love, and a, you know, lack of knowledge about what to do instead, right? And then the third mistake is trying to talk your child out of it. Right? Yeah, I've done that, too. I must admit, absolutely. Because it seems so clear to us or know that our child isn't actually in danger. And so we try to talk them out of the fear that they're feeling. But that doesn't work. Because when a child is in that heightened state, the logical part of their brain isn't working. And so they can't hear or can't benefit from the ways that we try to reason with them. I agree with you. I'm picturing instances in my own family life where I've tried to push my kids along when they show signs of fear. And it definitely doesn't work and almost backfires. They dig their heels. And further, it seems they do. And then it also makes us as parents more frustrated, because we're kind of explaining to them why they're safe, or why they shouldn't be afraid, and it doesn't work, and that is irritating, right. And then we start to get mad. And then kids get even more anxious because having a parent mad at you is not a comfortable or fun thing, or having a parent not believe you or see you or acknowledge what you're feeling. And that's why one of the first really important things for parents to do is to simply hear their child to make a clear verbal acknowledgment, I can see that you're afraid. Wow, that seems scary, right? You're not agreeing with your child that they're actually in danger, but you're acknowledging their fear. And that's a powerful thing to do. Because it helps children feel seen and heard. And it makes them feel safer with their parent, and more inclined to listen to or believe whatever their parent is going to say or do next. The power of empathy is very strong. Absolutely. Yes. What I was thinking I could do with you just to provide good examples for parents as Summer is approaching and for many of us summers already here. But I'm hearing common anxieties arise in my office talking to parents with their kids. So I thought maybe I could share some personal examples and see from you how I should handle this with my own kids. Sure. So the first being that summer camp is coming up. Now many kids go to day camp and they're afraid to go to day camp. My kids are going to a sleepaway camp and for the first time my youngest, who's eight years old will be gone from our home. And not only will she be gone, but she's going for 12 days to a sleepaway camp, and she's understandably nervous. Absolutely. And the older siblings are, as to your point, this is not what they should be doing, but they're minimising her fear. They're saying, it's not such a big deal. 12 days is not a big deal is because my two older kids are going for longer than 12 days. Okay, so how do you think we should approach this with my youngest and she, she's visibly nervous about going to camp in a couple of weeks. Right. So I think the first thing is to validate, you know, to let her know, it totally makes sense to be nervous, right? Most kids who are going to camp for the first time feel nervous. Most counsellors feel nervous, right? We feel nervous when we're about to do something new. Right? And that's because there's a part of our brain that says Way back in early, early days of evolution, a part of our brain developed to help us to recognise and feel cautious around new things. Because New might mean dangerous. So so we have an instinctive fear response when we're about to do something that's new. So it absolutely is helpful to normalise that to tell your daughter, her brain is doing exactly what it's supposed to do. And it's letting her know that she's about to do something new, right? Second piece is telling her that new is different from dangerous, right. So what she's responding to is the newness of this, there's nothing dangerous about camp, but it is definitely new. And when she feels nervous, it's the newness part of it that she's nervous about, right. And it helps to kind of build a bridge for kids so that they see that there are things that are still familiar. So you might talk about your sister's are going to be at that camp, or let's go online and look at pictures of the camp, or if you've ever visited remind her of the visit, to talk to her about what she's going to be doing at camp, what a day is going to look like what the activities are to help where you can to help it to feel more familiar to her. Right? You can also talk to her about some strategies, right? So you can tell her that most kids especially kids going to camp for the first time, feel nervous, and sometimes feel homesick. You know, if if she hasn't already talked about what if I miss home? Or what if I feel scared, you can use the word homesick and define what that means. You can talk to her about the times of day that homesickness usually rises, and then help her come up with ideas about what she can do, right. So you don't want it to be that she gets to camp and the first night she's feeling sad, and she's not sure she can fall asleep and she's missing you. You don't want her to be taken by surprise by that. You want to have some conversations in advance, so that if that happens for her, she can remember, okay, we talked about this, and I can cuddle the stuffed animal that I brought with me, I can read to help my brain have something else to be focused on. I can remember that my mom and dad are at home sending love to me, you know, whatever, whatever strategies you come up with thinking maybe I'll write her a letter? Or maybe, maybe I'll send her with some pictures of the family. Yes. And you're right, a stuffed animal that she can hug when she's feeling homesick. I think that's so brilliant to come up with a plan ahead of time. Right? You know, oftentimes, parents feel hesitant to preview anxiety with their children, because they think you know what, why would I suggest to my child that they might have a hard time at night, or they might feel nervous, or they might miss me, I don't want to suggest that to them. But if a child is feeling anxious, they're already feeling anxious and chances are good, they're gonna continue to feel anxious once they get there. And you want to kind of demystify anxiety, right? So children often think that if they're anxious, it's kind of game over, like they're, they're never going to be able to cope. And instead, we want to help children to see that anxiety is an uncomfortable feeling. But you can cope with it. And there are things you can do to help yourself with it. And you get through it, and you get past it, and it's okay. Right. So it's not like feeling anxious at Camp means that camp was a failure. It's not that at all, you want her to know that there are things she can do. And importantly, there are people at camp who can help her. And you can talk to her about counsellors go to camp a week early, so they can learn how to be counsellors, and a big part of that is helping kids who are feeling sad or missing home or need help in some way. What about when she says things like, can I call you and you'll pick me up if I don't like it? Yeah. So typically, camps have policies about that. And so you can probably honestly answer, no, that's not the way it works, right. And you can say to her, I understand that that feels tempting. But camps don't allow that. And they don't allow it for a really good reason. And the good reason is that anxiety nervousness is temporary. And if you called me and I came and got you, you would never have the chance to see that you were able to get past your nervousness and settle into camp and love it. And that's why camps don't allow that. But what they will do is help you when you're feeling nervous. You're right. I mean when she because I know she's going to do great. I suspect she's going to love her experience, and she'll feel so proud Out of herself on the other end, and I'm pretty sure that that will be the outcome of what will happen, right? And we never want to suggest to kids, that being anxious is a failure in any way. It's not right. So success at Camp doesn't mean she goes to camp and never feel sad or nervous success, it can't mean she stays. And she has fun, at least some of the time, that success, right. It's not the absence of fear. And that's the case for all activities. For Kids. It's we're not looking for the absence of fear, we're looking for the ability to move past the fear. So the same could be true. I'm thinking of summer day camps, I talked to a lot of parents who are nervous because their kids have a hard time with their parents leaving them at camp, they're afraid to be left for the day, the same principle applies here as well, correct? Absolutely. Yeah. And to the extent that parents can do it prior to the start of camp, it's helpful to practice separations. So you know, if your child's not already accustomed to being left with a relative for a part of the day, going to a friend's house without a parent, you know, doing a variety of things that are helping two kids to practice separation, helps to build confidence about the ability to manage separation. You know, it's interesting, as part of it is sweet when I think about how much my kids want to stay home, but I also know it's very, very, very healthy for them to spend time away from us as well. Right. Right. Kids need to learn how to separate and do things independently. It's yeah, that's an important part of growing up. Absolutely. Absolutely. And what about kids, this is something I also hear from parents, kids that are afraid of the dark, and they're worried about going to camp or being away from parents, because they're worried about darkness. Do you have any ideas on how to expose kids to that fear before going to camp? Yeah, so you use an important word, which is expose, and the technique is called exposure. So exposure is intentional practice of something that makes a child feel nervous or afraid, intentional and sequential, like getting sequentially more difficult practice. So if your child is afraid of the dark, you want to start practising being in the dark. And do that in a step by step way. So you can play various hiding games in the dark at home, you can have a child be in the room in the dark, you can do like shadow games on the walls and the semi dark, but you're practising having a child be in the dark, to help them get more comfortable with it, you can also talk to your child some about how our eyes work. So you know, our eyes are designed to help us be able to see even in the dark. And you can go into a dark room with a child and help them to experience the fact that initially you can't see anything. And after a while your eyes adjust and you're able to see more. So you know, children kind of understanding something about the way their bodies can help them is useful. You can certainly pack a flashlight and make sure your child knows how to use it. So if a child is expressing a particular fear, that's great, because it helps you to know more clearly what to practice with your child before they actually get into that situation. That's a good point. And I'm, I'm thinking about myself, when I was a kid, I definitely had a fear of the dark to some degree. And it's interesting how with some time those fears really can go away, because now when I go to sleep, I can't have a dark enough. So it's a good reminder, I can share that with my kids that these fears definitely evolve over time, right. And and the reason that it changes is that we get used to the thing that we were afraid of, right, so exposure is about desensitising or getting used to something. And we can do that just a little bit at a time. The analogy that's often used is getting used to the cold water in a swimming pool. So when we go into a swimming pool, and initially it feels cold, and we swim, and we play and after a while the water feels fine, the temperature of the water hasn't changed at all. It's that we've gotten used to it. And that's how desensitisation works, we can get used to things whether it's separation, or dark, or bees or dogs, or you know, pretty much anything we can get used to it. The pool analogy that I just mentioned is a really helpful one, because most kids have had the experience of getting used to the cold water in a pool so they have direct experience of that. And also because children know that there are actually two ways to do that. One is to jump in and get used to the water all at once. And the other is to go step by step and get used to it a little bit at a time. So when kids are needing to face some thing that scary for them and we're wanting to help them get used to it, we have that same choice, we can do essentially a plunge in method, having them get used to it all at once, or doing it sequentially and step by step. Usually the step by step method works better for kids. And what's important with that is making sure that it's intentional. So you don't wait for the situation to arise, you cultivate the situation. So fear of bees is a really good example of that. You don't wait till your child is outside and panicking to help them get used to it. You work out a plan so that your child is practising in gradual increments, going outside, staying outside, being closer to where bees might be, you can make it fun, like we're going to go on a photo Safari and take pictures of bees. Or we're going to do a scavenger hunt. And you can include things that where kids are likely to encounter bees, but you're doing like very intentional practice, frequent, intentional getting more difficult over time practice. And that's how a child desensitises to something that previously had felt impossible to them. So I'm so glad that you brought up this example, because this is actually going to be my next question because I have a child that has a very real B phobia. And I've tried certain things, we've read books about bees and why they're so important and valuable for the environment. We've watched videos on YouTube of beekeepers collecting honey, but I have to tell you, I I can see that I made an error as a parent. But recently we went on a hike. I took my three kids on a hike and I was really excited about it. It was a brand new hike. There was a waterfall at the during part of the hike, I pack snacks I prepared and about a quarter of the way into the hike, we ran into a couple of bees or some bees on on bushes off to the side and my daughter just froze in her tracks. She decided she was not going to walk any further that she was done with the hike. She cited bees. And I tried really hard to you know, I empathise with her but probably looking back not long enough, not good enough. I was anxious to get her through, you know, through the passing. And I said, let's, you know, let's go, I'll hold your hand and she just would not budge any further. And I said, I kind of pushed it a little more. Come on, let's go. It's going to be really quick. I'll stand next to you. I said what I could say, but she wasn't budging. And it ended up just getting worse. And I probably lost my patience. And you know, the end of the story is we didn't go any further. And I think everybody left feeling frustrated. So where did I go wrong? You know, I didn't want to accommodate her. But at the same time, I could see my approach wasn't helping her. Do you have any advice for my daughter with a with a bee phobia? And with a mom who is trying her best, but also doesn't seem to be making much headway? Right? So there's actually not a whole lot you can do when a child's fear has gotten triggered? There's not much you can do in the moment. Okay, the action needs to be before you get to that, right. So for a child with a bee phobia, now that summer is here, it's really important to practice being in places where bees might be and being around bees and tolerating the fear that comes up, right? So you can't wait till you're on this hike that you were anticipating and looking forward to and expect to be able to somehow push your daughter through that. It has to be that there's been lead up activities where she's learning to stay outside, even though she feels afraid, right. So most fear is about the possibility of a bad thing happening. Right? And it's not about the actual bad thing, right? So when a child is afraid of bees actually get stung by a bee. They often handle it surprisingly well. Right? But it's the possibility of the bad thing happening. That's so that feels so catastrophic to a child, and for any of us who have had an anxious moment. And so that's all of us, right? You know that anxiety is a really uncomfortable feeling. And when you feel anxious, you want nothing more than to stop feeling anxious, right? When you feel anxious, you feel like you are in danger. And so you want to do something to make yourself safe. So your daughter thought that she was in danger when she saw the bees. And the thing that she wanted to do to make herself safe was leave. Right? She needs to practice being in a situation where she feels like she's in danger and wanting to leave and not leaving. So she can see that her fear is essentially a false alarm. She feels like she's in danger, but she's not actually in Danger. So one of the things that is helpful for kids to learn is being afraid is not the same as being in danger. Those are two different things. Right? Yes. But you can say that to your child, and she can learn that intellectually, and it's not going to help. What she needs to do is learn it experientially, right, she needs to have the experience of being afraid, and staying put, and not having the bad thing happen. And she needs to have that experience over and over and over again, which is what exposure is. So the the things that you've done so far, like, talk to her about the wonder of these help her intellectually, but when she gets into that moment of seeing a bee, and she has a danger alarm go off in her head, all of that knowledge about bees goes out the window. Because in her experience, whenever that happens, she leaves, and she feels like leaving is the only way to stay safe. That's what her current experience tells her. And so that's what you're trying to change. The truth is, I I relate to her, I myself don't like bees. If I'm swimming in a pool, and I see bees, I want to go underwater, I want to go away from them. But you're right. I mean, I think the distinction is over time. I've learned I tolerate bees, even though I have a fear, I expose myself, I don't change what I'm doing because they're there. And so that's, that's going to be my goal for her is not to take the fear away, but to get her to tolerate it. And I like I think that's a very practical approach. That's right. So it's like that for lots of fears. So, you know, fear of bees, fear of dogs fear of getting sick, right? They're all based on having something happen that none of us enjoy is none of us would choose right? Being around an aggressive dog being around to be in actually getting stung, getting sick or throwing up those it none of us want those things to happen, right. But there are two things that are important. One is that having large scale trouble in those situations is really unusual, right. So we're around bees a lot without getting stung. And the second thing is that even if she does get stung, she can get through that it's not as horrible as she anticipates it's going to be so it's unlikely. And it's also not as bad as she thinks it's going to be. But again, you can't, you can't just hope that she can learn that intellectually. And that will be enough. She needs to experience that she needs to experience being around bees and staying put, even though she's afraid and seeing, okay, the bees aren't attacking me. They're leaving me alone. As long as I leave them alone, they're going to leave me alone. She needs to experience that many, many, many times. So if you were going to do an exposure with her and it's still early enough in the summer that it would be well worth it to do this, right. You want to go from you know, the early steps of exposure for a bee phobia are often the things that you've been doing, looking at pictures of bees, talking about bees, helping her understand something about how bees operate. Right? Those are the very early steps. And we didn't read your book, by the way, the facing mighty fears about animals. Yep, yep. Okay. So hopefully, she'll go with you from reading the book to actually practising the things that are taught in the book, right. And so that means starting to go outside and maybe try to spot bees through binoculars. So she's a whale's aways away. But she's she's watching the bees up close through binoculars, and then getting closer to bees, maybe give her a camera or cell phone and ask her to take pictures, you know, from a distance zooming in, and then ultimately getting closer. I mentioned you can do something like a scavenger hunt where you're having her find different things outside, you can do an experiment where she's putting different kinds of liquids and little cups and seeing if the bees come to any of them. So you're crafting various activities for her that get her to increasingly approach places that bees are or bees might be and stay put. And when you're doing an exposure with a child, the very best thing is to do practice kinds of challenges every day, 10 or 15 minutes a day, we're going to practice being outside or being in places where we might see bees or we do see bees. That's the surest way to actually have a child benefit from exposure. Okay, so, some exposure targeting 1015 minutes a day sounds like a very practical approach. And I think that's great advice. Right. And, you know, for parents who are new to this, I have a whole series of books that target specific fears and list really specific practice challenges, exposure activities, or you can go online and just do a search for B phobia or dog phobia or vomit phobia, or whatever it is your child is afraid of exposure. And you'll get lists of various exposure activities for kids, because this is the treatment of choice for anxious children. Because it works. I have to say your books are amazing. I recommend them all the time, I want to say daily, probably because fears and children are very, very prevalent. And it's so wonderful, the multitude of books that you have that address so many fears that are out there. So thank you very, very much. Thank you for using and recommending them. One of the pages that I really like and you mentioned this before, is talking about the stepwise approach to facing fears I love even have a picture of stairs in the book that we have. And I agree with you, you could take the approach of fully immersing yourself into cold water. And I'm remembering as a kid, that's the approach that was taken with me when I had swim lessons, they just sort of threw me in the water. And I guess I can't swim today. So it did work. But I do remember not enjoying the experience and being fearful of it. So you're right, there are two approaches that can work. But the stepwise approach to me resonates more. Yes, and for most kids, it's it's the one that is most comfortable and most helpful and helps kids feel a sense of mastery over time. It's important with that stepwise approach, though, to remember that just like if you want to get used to the cold water in a pool, you don't just take one step in and stand there forever after you take one step in and you get used to the water, you know, on your feet. And then you take another step, and you get used to it again. And then you take another step, right. And so when you're doing a stepwise approach for helping children get get used to something that they're afraid of, you have to continue to take steps. It's not just a one step and done. And the analogy is really helpful because again, kids can relate to it. And also you can talk within the analogy. So you can say to kids, let's figure out the next step. Or let's try to do a medium step rather than a too big step or a too small step. Let's not get out of the pool, you can say to a child when they're wanting to kind of bail out entirely. So it's a it's a metaphor or an analogy that you can continue to use, both to help you as a parent understand what you're doing, and to help your child to support and collaborate with you in the plan. I think it's great because you're not ignoring the fear. Because when you ignore the fear, as we talked about fears can actually worsen or build up. But you're focused on making progress in a stepwise approach, right? We actually recently use this with my daughter who has an immense fear of bike riding. And we've been working on slow but sure steps towards getting it a ride a bike, and I can see every little step that we make in the positive direction. She's really proud of herself. And we're really close, we're really close, probably within the next week, she'll be writing on her own. It's really empowering for kids to master something that felt too hard or too scary to them. And also, when you do a step by step kind of exposure with kids, it helps them to see that, okay, taking steps and getting used to something works. And so I can apply that same method with another fear, I can figure out how to take steps with something else entirely. And eventually, there's sort of a generalisation that happens where you know that you can approach the things that you're afraid of in a step by step way, and you'll feel better. One thing I'd love to ask you about, you talk about externalising the fear and making the fear into a creature of sorts that we can separate from the actual child. Can you explain what that might look like to people that are listening? Yes. So worry is a feeling fear is a feeling. But it helps to externalise it, which means to help children Ajin their worry, not just as something they're feeling, but as something that is a part from them a little creature or a little being that they can talk to. They can choose whether or not to listen to and obey. So children can be taught to talk back to their worry, to ignore their worry little creature to do the opposite of what their little worried creature creature is telling them. So it helps to do that kind of externalisation because it allows children to use a different part of their brain kind of their thinking part of their brain and more playful part of their brain to engage with the feeling in a different way. We We also want to we as adults want to always be on the same side as our children. So when you don't externalise worry, and you have a child who's resisting doing something, and a parent who's trying to get their child to do something. It's parent against child. When you've externalise the anxiety, a parent can say, Let's not let your worry creature be the boss of this, or, you know, worry, worm always tries to scare you about that. But we know that we're a warm doesn't really know the truth or, you know, however you're going to talk about it. It allows the parent to be on the same team as their child rather than against their child. And that's tremendously helpful. You know, what I like about that approach is it's silly, and it's fun. And it's light hearted. And I feel like if you can add humour into any fearful situation, it lightens the atmosphere, it makes things a little easier. So I think that's a good technique. Yes. And it works for all ages. It's not something you just do with little kids. You can do this with older elementary kids with adolescents, even adults can do it to externalise their worry, picture what it looks like, name it, and then talk to it in a variety of ways. I'm gonna give mine a fun name. Yes. Yeah. I'm thinking right now. Willie, the worm. Great. All right. We're gonna work on this. I think that's a really helpful practical tip for parents that have kids with worries. Yes. And can I ask you a personal question? I know you did a TED Talk to me. That sounds really anxiety provoking, I read that public speaking is probably the number one fear that people have, I'm sure that felt anxiety provoking to give a talk to so many people. Yes. So I wrote my first book, what to do when you worry too much. And as we talked about, it really took off, it was very popular. And I was invited lots of places to speak. And I found myself declining those invitations to speak. Because I was afraid I had a fear of public speaking that I hadn't addressed before. And eventually, after an embarrassing, long, long period of time, I realised this is ridiculous, I wrote a best selling book about anxiety. And I'm afraid to talk about it, I need to do something about this. And so I did a set of exposure challenges myself, I actually took a course called in the spotlight that helped me build the hierarchy and moved me through talking to increasingly large audiences in less scripted ways. And by the time I got to the TED Talk, that was kind of the culmination of being able to speak to a group without holding a script in my hand and reading from it, but just talking to a large audience of people, and at this point, I'm fine with public speaking. I don't I don't feel nervous about it at all. Because amazing that practice. Yeah, that's amazing. And you yourself had a gradual exposure till you did your TED talk. Yeah, it's humbling, you know, as an adult, as a therapist as an expert, quote, unquote, in anxiety, to sometimes I have to do this myself, right. But it's tremendously useful to practice the things that I'm teaching, and to be reminded of the fact that this isn't easy, that that fear is is hard and scary and uncomfortable. And it's tempting to just avoid the things that you feel afraid of. And I think it's useful for us as adults to remember that, because it helps us to be more patient and more empathic. When we're trying to help our children. I'm taking away a couple of big points. One is it's so important to be empathetic, to be understanding, to really let kids know that you get where they're coming from, and why they feel the way they feel, right. But also, we don't have to agree with those fears and feelings, we can encourage our kids, and we should encourage our kids to move forward and face those fears. Because we know on the other end, they're likely to be proud of themselves feel good about facing their fears. Mostly we know they're going to be okay. Right. So there's someone at Yale University, Dr. Le Liebowitz, who has created a programme called the space programme that some of your listeners might be familiar with. It's a programme that teaches the parents of anxious children to not accommodate their anxiety. And he talks about the importance of supporting your anxious child. And in his view, support has two components. One is to acknowledge and empathise with your child's fear and the other is to encourage them to move forward. And you always want to be doing both of those things. Giving the message of I know this feels scary and hard. And I know you can do it, and you want to be doing both of those things. I'm going to keep that script right at the forefront of my mind because that's those those words sound very powerful and very useful. Yes. So tell everybody, where can they find you if they want to learn more from you if they want to talk to you? Where is Dr. Don Huebner available? Yeah. So the best place is my website, which is Don Huebner phd.com. I have some presence on Facebook. So if you just put my name into Facebook that'll come up and I periodically post tips for parents. But my website also has tips for parents and also has descriptions of all of my books. Well, thank you so much for all the wonderful work you do. I can tell you from my own experience as a paediatrician, you have helped so many people that I know personally, and I can't thank you enough. And thank you so much for being here on my podcast. You're welcome. And thank you for covering this important topic. Thank you for listening, and I hope you enjoyed this week's episode of Ask Dr. Jessica. Also, if you could take a moment and leave a five star review wherever it is you listen to podcasts, I would greatly appreciate it. It really makes a difference to help this podcast grow. You can also follow me on Instagram at ask Dr. Jessica See you next Monday.