Artwork for podcast You Are Not A Frog
How to Cope With Your Kids’ Anxiety, Your Colleagues’, and Your Own
Episode 18619th September 2023 • You Are Not A Frog • Dr Rachel Morris
00:00:00 01:04:02

Share Episode

Shownotes

Confronting anxiety is easier said than done. It’s hard enough with adults, but with children it’s even more tough. Anxiety keeps us safe, but often we over-predict that something bad will happen and under-predict our ability to cope. The key is to learn how to manage anxiety before it becomes a problem.

This week’s guest is educational psychologist Nicky Odgers. She specialises in working with kids who are feeling anxious about attending school. A lot of what she helps kids with applies to adults – things like mapping thoughts and emotions to physical sensations, replacing negative thoughts with more realistic ones, and practicing techniques to help us relax.

Anxiety can interfere with our lives and become a problem if it goes unaddressed. Naturally we want to avoid things that cause us anxiety, but this stops us from learning that we can cope and that the terrible thing we fear may never happen.

Listen to this episode to

  1. Learn about anxiety in children and teenagers, and how it can manifest as school avoidance
  2. Gain insight into how anxiety affects adults, including healthcare professionals, and how to manage it effectively
  3. Understand the thought patterns, physical sensations, and behaviours associated with anxiety, and how to address them to prevent avoidance and build coping skills

Episode highlights

  • [00:03:46] Epidemic of anxiety
  • [00:09:21] Anxiety as pathology
  • [00:14:00] Thoughts, feelings, physical sensations, and behaviours
  • [00:20:54] Safety behaviours
  • [00:23:26] When is it right to step in and offer help
  • [00:29:18] Anxiety in healthcare
  • [00:31:47] How to persuade someone their fears are unfounded
  • [00:34:35] Mind-reading
  • [00:41:03] Teaching people to solve problems
  • [00:45:14] Worry time and worry monsters
  • [00:47:14] Distracting yourself from worry
  • [00:48:24] Helpful safety behaviour
  • [00:49:52] Helping anxious people
  • [00:52:48] Neurodiversity and autism
  • [00:55:58] Nicky's tips for managing anxiety

About the guest

Nicky Odgers is an educational psychologist with a particular interest in school anxiety. She helps parents and schools to support children and young people to feel less anxious about attending school, to better manage their emotions, to develop their confidence, to initiate and sustain positive relationships and be more successful in their learning.

LinkedIn | Website

Resources

Enjoyed this episode?

Write a review and share this with your friends.

Connect with Rachel

Have any questions? Contact Rachel through these platforms:

Find out more about our training

Mentioned in this episode:

🛟 Download Our New "Get Your Life Back" Course
Wake up excited to go to work, with enough time and headspace to get the important stuff done AND enjoy your life.

🆘 Overwhelm SOS – FREE PDF
Stop the overwhelm and get back on track with this free PDF guide.

Transcripts

Rachel:

When was the last time you confronted your anxiety about something?

Rachel:

It's easier said than done.

Rachel:

Isn't it.

Rachel:

When we feel anxious, we tend to avoid the thing.

Rachel:

That's making us feel that way.

Rachel:

Obviously, nobody wants to feel anxiety, but when we avoid tackling our problems, we keep enforcing that land behavior.

Rachel:

And tackling the issue then becomes harder and harder.

Rachel:

But there are small steps that we can take that build up to finally addressing the things that are worrying us.

Rachel:

Now many of us are not only coping with our own anxiety, but also have anxious colleagues or have kids who are showing avoidant and anxious behavior.

Rachel:

And my guest, Nicky Odgers has a wealth of tips and resources you can put into practice.

Rachel:

So listen to this episode to find out how to help you and those around you tackle anxiety, and discover some amazing things you never knew you could do.

Rachel:

If you're in a high stress, high stakes, still blank medicine, and you're feeling stressed or overwhelmed, burning out or getting out are not your only options.

Rachel:

I'm Dr.

Rachel:

Rachel Morris, and welcome to You Are Not a Frog.

Nicky:

My name is Nicky Odgers, and I'm an educational psychologist.

Nicky:

I work in private practice in Cambridge and I have a particular interest in supporting young people and children with anxiety.

Nicky:

And within the school context, obviously there's a lot of that that comes out in terms of school avoidance, um, because of anxiety.

Nicky:

But, uh, school avoidance doesn't start off with kids, um, not coming to school.

Nicky:

Often there's all sorts of anxiety that happens before that, before ultimately you can end up with kids not going to school at all.

Rachel:

Thank you so much for being on the podcast, Nicky.

Rachel:

And I've got Nicky on for a few reasons.

Rachel:

Well, firstly, Nicky, you were one of our first guests, I think, a long time ago, weren't you?

Rachel:

What were you talking

Nicky:

My goodness, Rachel, that is going back in the depths of time.

Nicky:

I think I was talking about growth mindsets.

Rachel:

was it.

Rachel:

It was brilliant.

Nicky:

was it.

Nicky:

Yeah, yeah, thank, thank you.

Rachel:

So there's a, yeah, like I was saying, a couple of reasons.

Rachel:

Firstly, I think all this stuff about kids and school avoidance I find really fascinating.

Rachel:

And I know a lot of our listeners have children who are school age and have children that if they're not school avoiding may be quite anxious, um, in other ways.

Rachel:

You know, I have kids myself and at certain times all of them have been anxious about, about various things.

Rachel:

So I think this is something that we all have going on in our lives really.

Rachel:

Secondly, I've got you on Nicky, because, uh, listeners dunno this, but Nicky is my go-to wise old owl.

Rachel:

And so I'll, I'll use less of the

Nicky:

That's old.

Nicky:

Thanks, Rach.

Rachel:

Nicky and I spend hours and hours coating about various new, um, models and concepts in psychology.

Rachel:

And you know, if you sit there saying, well, I thought about this the other day, Nicky will say, yeah, well you know what?

Rachel:

And she's already, she's already read five books about it and delved deeply into it.

Rachel:

So Nicky's just the best fountain of knowledge about all things psychological.

Rachel:

So, um, yeah, so she'd be already talked about Growth mindset, which you introduced me to, which we use all the time.

Rachel:

And side note, today was A level results day.

Rachel:

So,

Nicky:

oh, and what a day for anxiety for families across the, across the country.

Rachel:

Oh my goodness.

Rachel:

And I didn't sleep well last night, you know.

Rachel:

I, I did wake up really early thinking what if, what if, what if?

Rachel:

And luckily my daughter, she'd been a total, total superstar.

Rachel:

But, um, we have a lot of our own anxiety about our children, and presumably we pass that on to them massively as well, but we'll talk about that in a minute.

Rachel:

One of the reasons Nicky, I thought it would be good to talk about anxiety in kids and teenagers is because whenever I've talked about it with you, a lot of the tips and things that you've given, I've thought to myself, oh my goodness, those directly apply to me and they apply to adults as well.

Rachel:

Now, I know that you are a child educational psychologist, so your REIT is very much working with kids and teenagers.

Rachel:

But really I think as adults we, we don't know this stuff ourselves.

Rachel:

And a lot of us are not just coping with kids with anxiety, but we're coping with our own anxiety and we're coping with colleagues, maybe partners who are also very anxious about stuff.

Rachel:

So I'm hope hoping that this podcast will help us on lots of different levels, you know, coping with, with people back at home, but also perhaps coping with some of our colleagues.

Nicky:

Well, I certainly think a lot of the theory around anxiety can be applied to grownups as well as kids.

Nicky:

Um, and I think just as when you work with kids, what you, one of the things you are hoping to do with them is to help them understand, um, anxiety, the purpose of anxiety, what maintains anxiety.

Nicky:

I mean, certainly that's something that, as adults as well can be very helpful in terms of thinking about how you, you as a grownup can manage your own anxiety.

Nicky:

Um, and of course we're going through sort of an epidemic of anxiety at the moment.

Nicky:

I mean, and you know, partly I think that's some of the overhang of covid that's still here.

Nicky:

And I think it's really important for people to sort of learn more about it, learn more about the theory of it, because I think once you understand it, then um, you have a much better grip on how you can actually learn to deal with it.

Nicky:

Um, and that's ultimately what we want, isn't it?

Nicky:

We want people to go out and be able to feel they can cope and their lives aren't ruled by anxiety.

Rachel:

Okay.

Rachel:

So, oh, so many questions.

Rachel:

Um, firstly, I know you've mentioned Covid and I know that you've seen a massive rise in school avoidance since Covid.

Rachel:

Is it, is it purely Covid or is there something else going on in this sort of anxiety epidemic, do you think?

Nicky:

I think it's really difficult to tell.

Nicky:

I mean, I think Covid did have a pretty big impact on things, I think.

Nicky:

It reduced opportunities for young people to go out and do things that are sort of age appropriate for them.

Nicky:

And so when they emerged two, you know, two years later, often they hadn't had the opportunities to go out and do things and learn that actually they can cope with them and they can do them.

Nicky:

And so suddenly, you know, they went in maybe to covid as a, you know, an 11 year old.

Nicky:

They came out as a 13 year old and they're being asked to do things that typical 13 year olds can do.

Nicky:

And if you are of an anxious disposition anyway, um, and you haven't had the experience of doing these things in little steps that gradually get you to what a typical 13 you might be able to do, then actually suddenly that big step seems really tricky and really difficult and it can feel very overwhelming for young people.

Nicky:

So I think, I mean certainly within schools you now seem to see a lot more anxiety, um, and school avoidance.

Nicky:

I mean, there's, the levels of attendance are, uh, really big cause for concern at the moment and the Department of Education's constantly producing information about, you know, uh, about that.

Nicky:

And not all of that obviously has to do with co uh, with, uh, anxiety.

Nicky:

But I think quite, quite a lot of it might be.

Nicky:

And then of course there are all the sort of things that, you know, teenagers always have to cope with.

Nicky:

So, you know, high stakes exams, as we said, sale of exam day today.

Nicky:

Um, you know, social media.

Nicky:

It's not to say that all social media's bad, sometimes social media can be fantastic, um, can be, uh, sort of a lifeline for connection.

Nicky:

But you know, when things go wrong with social media, then that could be quite tricky as well.

Nicky:

So I think it's a whole range of different things really, that are, that are causing anxiety amongst our young people at the moment.

Rachel:

I think similar things probably causing anxiety amongst our older people as well.

Rachel:

You know, social media doesn't help overwhelm after covid.

Rachel:

And I do remember, you know, when lockdown finished, it was quite anxiety inducing going and doing stuff that was completely routine, like going to a shop or a concert.

Rachel:

You're suddenly like, oh my gosh.

Nicky:

Absolutely.

Nicky:

And you've been given the message for the last, you know, two years.

Nicky:

It's really dangerous out there.

Nicky:

So if you are of an anxious disposition, you know, you believe it, right?

Nicky:

Oh, well, I, I genuinely was dangerous at one point as well, but, um, you know, how do you pull back from that?

Nicky:

That's, that's the thing, isn't it?

Nicky:

And I got you guys as medics, you know, you had an absolute shocker.

Nicky:

I mean, it was extraordinary what you guys did during the, during the pandemic to keep everyone together and, I mean, incredibly difficult circumstances.

Nicky:

So, you know, it's totally unsurprising if, as a medic you felt overwhelmed and you felt anxious, you know, about everything that happened.

Nicky:

And, and then that over spills.

Nicky:

And you see that with children.

Nicky:

So you see, well, particularly with, again, with kids who are avoidance about coming to school, but, um, you know, you might have a child with sort of an anxious disposition, uh, and then something happens.

Nicky:

So, you know, it might be a bereavement, it might be a, you know, family separation.

Nicky:

It might be, you know, just something, some, something a little bit tricky or traumatic, and that's a trigger.

Nicky:

And at that point the anxiety can sort of slightly, you know, take on a bigger role in kids' lives.

Nicky:

And I, I mean, I, you know, as I said, I'm not a psychologist of grownups, but it would seem plausible that, um, you know, exactly the same things would happen amongst adults as well.

Rachel:

I thought it was interesting that you said that we are just not very anxiety literate.

Rachel:

And I know we had a conversation before this podcast about, you know, who's gonna be listening?

Rachel:

Is it gonna be healthcare professionals?

Rachel:

We can have psychiatrists listening, we can have gps, et cetera.

Rachel:

In my opinion, I don't think doctors are very literate about anxiety.

Rachel:

Some people might, might be if they really looked into it, but I certainly didn't know much about it.

Rachel:

And traditional GP training has very little psychology in it, and so we do find it really difficult to understand ourselves.

Rachel:

And one thing that I find quite difficult to tell the difference between is, you know, fair enough anxiety, like something you actually should be anxious about and something that is overblown anxiety.

Rachel:

And, uh, I, I do think there's a little bit of a zeitgeist, and I have noticed it sometimes with teenagers saying, well, I have anxiety around this issue.

Rachel:

And I'm thinking, well, you just worried about this.

Rachel:

That's normal.

Rachel:

You know, so people saying, I, I have anxiety about my exams.

Rachel:

No, you're just worried about your exams and that is fair enough anxiety, that is really, really normal, right?

Rachel:

But we seem to have pathologized it a little bit.

Nicky:

So I think that's a really interesting point, Rachel.

Nicky:

And I think, um, I think what's really important to know is that, uh, everyone has anxiety.

Nicky:

Absolutely everyone in the world, and it's really, really helpful.

Nicky:

Like we need anxiety.

Nicky:

Anxiety keeps us safe.

Nicky:

So, if you're just looking at it from a biological perspective, you feel anxiety, uh, or fear when you feel under threat and when you feel under threat, your body is primed to release, um, called zone and adrenaline and it just pumps you up and gets you ready to deal with that threat that's coming along.

Nicky:

And from a biological perspective, what we are looking at is that threat from, you know, I don't know, a hundred thousand years ago, which was probably a, I dunno, I wouldn't say a mammoth, but I'm pretty sure that's the wrong time zone for grownups and crack.

Nicky:

Humans are

Rachel:

been some sort of tiger,

Nicky:

yeah, like a tiger thing, right?

Nicky:

So yeah, exactly.

Nicky:

Something with teeth.

Nicky:

So teeth, right?

Nicky:

So what you had to do was you had to like bash it over the head or run away as fast as you can.

Nicky:

Or like go completely still and um, just freeze.

Nicky:

So that's the fight flight, or sometimes freeze response.

Nicky:

Um, and that's what kept you safe.

Nicky:

But of course in modern days, unless you're very, very lucky or unlikely to come across something with big, scary teeth, but you have all these other things that are going on.

Nicky:

So you would have a levels or you would have, uh, like a really stressful meeting, or you, you have, you have things where you think you're under threat, and your body responds in exactly the same way as it did as humans did, you know, a hundred thousand years ago when we were faced with that big, scary tiger.

Nicky:

So all those, um, hormones are running around your body and you have those physical sensations in your body.

Nicky:

So you have flashy tummy.

Nicky:

Your heartbeats go apart, beats really fast.

Nicky:

Your face might be flushed, you feel sick.

Nicky:

Um, you know it's rubbish, right?

Nicky:

It feels absolutely rubbish when you are frightened in that way.

Nicky:

And it's a really unpleasant feeling.

Nicky:

But sometimes anxiety now is helpful.

Nicky:

So for example, if we go back to the exam, things we were talking about earlier, you know, actually a little bit of adrenaline is quite good.

Nicky:

It gets you thinking straight, it gets you geared up, helps you revise, puts you in a bit of panic, helps you revise.

Nicky:

So a little bit of anxiety.

Nicky:

It's actually quite good because it will gear you up to do the things that you need to do.

Nicky:

The problem is, the problem comes when you have lots of false alarms.

Nicky:

So when you start to feel you are under threat, when actually you are not really.

Nicky:

And sometimes that can have a little bit and happen a little bit and that's kind of fine, but if it starts to happen a lot, then actually that can become quite a big problem because what then happens is it really interferes with your life.

Nicky:

And then that can become really tricky.

Rachel:

So.

Rachel:

The anxiety in itself often isn't the issue.

Rachel:

It's actually our dealing with it.

Rachel:

That then becomes the issue, and as you see in kids, they get very anxious or heightened anxiety, and then they have ways of dealing with it that then are really unhelpful.

Rachel:

Is that what you're saying?

Nicky:

So I think it's really helpful to think about anxiety in terms of thoughts, feelings, physical sensations and behaviors.

Nicky:

Because when we sort of look at it in the whole, like that, first of all, we can unpick all the different bits of anxiety, um, and they're all linked together, but we can also begin to see what maintains the anxiety.

Nicky:

And as you say, what the issue is actually, it's not the anxiety in itself, but if it carries on for long periods of time and it starts to really get in the way of other things, then that's when it becomes a problem.

Nicky:

So what we want to do is to think about how we can deal with anxiety when it's a false alarm.

Nicky:

If it's real, right, it's good to be scared of stuff.

Nicky:

Run, run from the tiger, but um, yeah, so we need to be able to work out what to do and the false alarms.

Nicky:

Okay.

Nicky:

So we have just been on a holiday, uh, in, um, Europe.

Nicky:

And, um, I am really frightened of driving in Europe because I've never done it right.

Nicky:

So I've been driving in the UK for over 30 years.

Nicky:

I'm a very competent driver.

Nicky:

I've never had an accident.

Nicky:

I'm very safe.

Nicky:

Like I know I'm safe.

Nicky:

But in Europe, I think, Oh my God, if I get in the car, I will.

Nicky:

I.

Nicky:

Kill us all 'cause I'll do something stupid.

Nicky:

So my thoughts are, I won't be able to do this.

Nicky:

I can't cope.

Nicky:

I will kill us all.

Nicky:

We will all die a horrible death on an Austrian Alps.

Nicky:

And I, and I know that's kind of stupid when I stop and listen to it, but that is sort of what, what I think.

Nicky:

So when I think about driving, I just sort of get slightly panicky, right?

Nicky:

And I feel a little bit sick in my tummy.

Nicky:

So that's sort of the physical sensations.

Nicky:

And I feel worried.

Nicky:

So that's the feeling.

Nicky:

And the behavior that then happens is that I make every excuse underneath the sun so I don't drive.

Nicky:

And my husband, who drives all the time in Europe and is very accommodating, just says, should I put you on the drive?

Nicky:

Should I, should I put you on the insurance to drive?

Nicky:

And every time I'm like, oh, yes, yes, yes, let's do it.

Nicky:

That's fine.

Nicky:

I'll definitely drive this time, and I don't do it.

Nicky:

So my behavior there is I avoid it because it's scary.

Nicky:

I don't want to do it.

Nicky:

Why would I do something that's scary?

Nicky:

And that's a completely normal response.

Nicky:

Okay, so let's just go through that again.

Nicky:

So the thoughts are I'll be useless, I won't be able to do it and I'll kill us all.

Nicky:

Okay.

Nicky:

So that's my thought.

Nicky:

That's my anxious prediction.

Nicky:

My physical sensation when I think about it is should start hyperventilate and I feel a little bit sick.

Nicky:

Um, and the behavior is avoidance.

Nicky:

And that would be a very typical kind of pattern.

Nicky:

So you have an anxious prediction, which is really negative.

Nicky:

So what I've actually done there is that I have, um, again, this is very typical of people with anxiety, is they, um, they over predict that something bad is gonna happen.

Nicky:

Uh, and they over predict how bad the thing is gonna be.

Nicky:

We're all gonna die, right?

Nicky:

Um, and they under predict their ability to cope.

Nicky:

I won't be able to do it.

Nicky:

So that's just a little overview how it worked.

Nicky:

But let me just give a little thing follow on from that, which I think gives us a little bit of context into the moving on bit, which is around how do you deal with it.

Nicky:

So, um, for various reasons.

Nicky:

This time, my husband, who is a fanatical cyclist, wanted to go off on his bike that he'd hired.

Nicky:

So this time, instead of saying, it's all right, Nicky, I'll drive, he said, oh no, I need to go and, um, collect my bike and you need to give me a lift there, and then you need to drive back to the house all by yourself.

Nicky:

And so I kind of had to do it this time.

Nicky:

I kind of had to step up and do it.

Nicky:

So I was very brave and I did it.

Nicky:

And of course, it was utterly fine.

Nicky:

So this thing I've been avoiding for 20 years was completely fine because I've been driving for 30 years.

Nicky:

I've never had accidents.

Nicky:

I'm a very competent driver.

Nicky:

So, uh, I got back into the house, I was like, great, driving's fine.

Nicky:

But an hour later, what my brain said was, got away with it.

Nicky:

This time I got away with it.

Nicky:

But next time, who knows what could happen?

Nicky:

So next couple of days, again, my husband's off cycling, so I have to go and drive the car, cheer myself up every time.

Nicky:

I think, oh my goodness, um, this is, you know, tricky.

Nicky:

But actually every time I could do it and it was fine.

Nicky:

And that's one of the things that you, it's really important to know about anxiety, is that the drive is that you avoid the thing that you're scared of.

Nicky:

Everyone does this, like, it's completely normal and natural.

Nicky:

Like everyone in the whole world, if you possibly can, you do, because frankly it's horrid who wants to do it and, you know, potentially die and, you know, all those things I was telling you about, right?

Nicky:

But between when you avoid things, what you do is you lose the opportunity to learn that actually it's not so bad.

Nicky:

You know, probably the really terrible thing isn't gonna happen.

Nicky:

And also very importantly, that you can cope.

Nicky:

So even if it goes wrong, you can cope.

Nicky:

And again, there was a really interesting, well, there was an example of this.

Nicky:

So, um, uh, we were parked somewhere I the second time in the, in the car driving and it was an uphill reverse start which I, we live in c Cambridge, Rachel and I live in Cambridge.

Nicky:

Cambridge is like the flattest place in the entire world.

Nicky:

Like literally we don't have hills.

Nicky:

There's no hills for miles around.

Nicky:

So like no experience for probably the last 20 years of reversing Upper Hill.

Nicky:

Anyway.

Nicky:

And then there was this new like hand break catch thing, which didn't work.

Nicky:

And I could not get this bloody thing to work.

Nicky:

And there was a cyclist standing a meter in front of me.

Nicky:

Every time I tried to reverse, I inched further towards the cyclist.

Nicky:

Instead of going up the hill, going downhill.

Nicky:

Like it was a nightmare.

Nicky:

In the end, I just said to my husband, I can't do it.

Nicky:

I can't do it.

Nicky:

You have to do it for me.

Nicky:

And we got out and he did it for me.

Nicky:

But actually, even though in a sense, some of my negative predictions about I can't, you know, I won't be able to do it, sort of came true there, what I actually did then was I was like, but that's like, why didn't that work?

Nicky:

What was wrong with the hand brakes?

Nicky:

So I went away, looked at some YouTubes, oh, that's how electric hand brakes work.

Nicky:

Oh, okay.

Nicky:

And I went outside and I practiced on the hill when there was no one around and I got it.

Nicky:

So even when things go wrong, they can be opportunities to learn.

Nicky:

So it's not like you have to try things and it always goes right.

Rachel:

So you're saying that as you drove more and more and more, your brain was saying less and less, or you got away with it.

Rachel:

You got away with it, you just sort of got habituated and, and

Nicky:

So I got habituated, but what was interesting was about how long it took.

Nicky:

So for, so one of the things that happened was first couple of drives, my husband was in the car with me.

Nicky:

And, and then what happened, I was like, well, I can do it with he, well, he's in the car with me, right?

Nicky:

But if he gets out the car, then it's not gonna work, right.

Nicky:

And I realized what that was.

Nicky:

That's called a safety behavior, right.

Nicky:

And again, when you have anxiety, then lots of people have what we call safety behaviors.

Nicky:

So for example, if you have, um, social anxiety, some people's safety behaviors might be, for example, to put lots of makeup on.

Nicky:

So they're sort of hiding their safe, their self, you know, they can't go out without their makeup.

Nicky:

'cause the makeup in some ways keeping 'em safe.

Nicky:

Or it might be that you are preparing what you, uh, your topics of conversation beforehand.

Nicky:

So like you can go out and you can do it, but only if you thought around beforehand what you're gonna say.

Nicky:

Or, um, with kids going to school, for example, it could be as far I can go into school, but only if Ms.

Nicky:

Brown's there with me and she meets me at the front gate.

Nicky:

So we, those are safety behaviors, right?

Nicky:

So they, they are sort of reassurance that things are gonna be okay.

Nicky:

But actually the reality is, you know, really what does make, how does makeup keep you safe?

Nicky:

You know, how does my husband being in the car really keep me safe?

Nicky:

Apart, apart from in reversing, upwards up the hill?

Rachel:

stop.

Nicky:

Stop.

Nicky:

Yeah, you're right, you're right.

Nicky:

But, but often they, they sort of take on a life of their own as well.

Nicky:

So, um, you know, that, again, that's something to think about if you have, if you are anxious or if you've got a child who's anxious, you know, are they relying on, on safety behaviors, um, to sort of keep them through?

Nicky:

Because actually what you really want to help people or young people to do is to feel confident that they can cope on their own and they're not having to rely on these kinds of safety behaviors to keep them through.

Rachel:

So that's interesting.

Rachel:

So there's two ways of dealing with the anxiety, which are not helpful.

Rachel:

So the first one being absolutely avoiding that thing like,

Nicky:

yeah, absolutely.

Nicky:

And avoidance, avoidance tends to make stuff worse.

Nicky:

It's not just, it just sort of leaves it in a, you know, neutral state.

Nicky:

It yeah.

Nicky:

It makes it worse

Rachel:

And that's really hard, isn't it?

Rachel:

Because if you have a child with anxiety, then as a parent you want to make it better.

Rachel:

And so you say, oh no, of course darling, you don't need to do that.

Rachel:

No, don't worry.

Rachel:

You don't need to go to that.

Rachel:

You don't need to do that.

Rachel:

I'll do that for you.

Rachel:

I'll sort it out.

Rachel:

And you jump into rescuer mode, and that's not a very helpful way of doing it.

Nicky:

The other thing that it's really important to know is that, Our children are our most precious things in the world, right?

Nicky:

Like, we love them more than anything.

Nicky:

And you know, if you're looking from a biological perspective, you wanna keep them, you know, solve the species, you wanna keep 'em safe, right?

Nicky:

So, of course we do that, like everyone does that.

Nicky:

Of course, because that's normal and natural, and we do it because we love them.

Nicky:

And like, so no one should feel bad or guilty about doing that because you're doing something that's normal and protective.

Nicky:

And what's interesting is there's research that suggests that if you've got a child who doesn't have an anxious disposition, going out and sort of helping them and, you know, Stepping involved doesn't increase their anxiety at all.

Nicky:

But if you have kids who do have an anxious disposition, then sometimes what can happen is that if there's a parent, you step in a little bit too early.

Nicky:

I'd say parent, but frankly, you know, it doesn't have to be a parent.

Nicky:

It could be anyone around them.

Nicky:

It could be a grandparent, it could be an aunt, it could be a friend, it could be a teacher, like people who want to help.

Nicky:

So sometimes if you've got people around the child who are sort of stepping in really early and reducing opportunities for kids to have a go at stuff, what can happen is, well, first of all, the child doesn't have the opportunity to have a go at stuff, and so they never learn that actually it's probably not so bad.

Nicky:

Or they can cope, but also kids are like, Really tuned in on those around them.

Nicky:

So if they are looking up at granny or the teacher or mom or big sister or whatever, and like the mom, like they're looking anxious or you know, whatever, then the kid is, if you are got an anxious disposition, then you are going to be thinking, oh my god, you know, like, okay, like there really is something to be worried about now, right?

Nicky:

And if you know everyone's jumping in to help me, then you know, I'm absolutely right to be worried.

Nicky:

Um, and so, It can have sometimes a sort of counter, uh, it, it can be not, not helpful.

Nicky:

But what I want to stress is that really nobody should feel bad about this.

Nicky:

Like it's honestly, it's just, it's like human nature, right?

Nicky:

So, and we are like programmed to do this.

Nicky:

But it's helpful possibly to be thinking about are there people in the child's realm who might be completely adversely and with absolutely the best intentions, enabling the child to avoid the things that they're finding really scary?

Nicky:

And the other thing I want to say about this is that, When we are talking about ,if you've got a child or a young person who's got, who's really anxious about things, like they're ready at the anxious point, right?

Nicky:

So, if you are gonna try and help them to face their fears and to learn that they are able to cope, what you are absolutely not gonna do is say, well, avoidance is terrible, we're just gonna make you face your fears full on, you know, in the same way that you wouldn't, like if somebody had a phobia of spiders, you wouldn't say, right, we're gonna lock your room for, you know, two hours with 25 tarantulas, right?

Nicky:

And that would just kill your phobia.

Nicky:

'cause you'll, you know, you'll just learn you're okay.

Nicky:

That's not what I'm talking about when I'm talking about encouraging kids to face their fear, because that's too much.

Nicky:

So what happens if you put, you know, children, young people in that situation and, and I imagine grownups as well, but again, as I say, it's not my area.

Nicky:

Um, is that.

Nicky:

If people are too overwhelmed, they don't learn.

Nicky:

And what you are hoping to be able to do is to, for the young person to learn that they can cope.

Nicky:

So you are not throwing kids in the deep end with stuff.

Nicky:

You are not saying face your most dangerous fears, you know, straight off, what you might be doing is saying, okay, so this is something you, you know, if it's school anxiety, for instance, you know, I know at the moment you are really anxious about, you know, going to school, let's just break it down.

Nicky:

Let's break it down into 10 little steps.

Nicky:

What would the easy first step be?

Nicky:

Putting your school uniform on?

Nicky:

Try out.

Nicky:

What do you think would happen if you put your school uniform on?

Nicky:

There's c shall we?

Nicky:

Ooh, interesting.

Nicky:

What will happen, let's do a little experiment to find out.

Nicky:

And um, so you are breaking it down to steps.

Nicky:

So the first one might be, put your school uniform on.

Nicky:

The second one might be, put your school uniform on and drive in the car with mom or dad very slowly pass the school gates at six o'clock in the evening when there's nobody around.

Nicky:

And then step number three might be to walk up to the school gates at, you know, Three o'clock when school's coming out.

Nicky:

So you were providing opportunities for children or young people to face their fears, but in a series of really teeny weeny steps at a rate that feels manageable for them.

Nicky:

And the idea is that by doing this, they are learning new information about the experience and that it's not as awful as they think it's gonna happen, and also they, they learn that they are able to cope.

Nicky:

And that's one of the key approaches to supporting with anxiety.

Nicky:

But obviously it's really scary because, you know, because everyone wants to avoid things that they're scared of, like everyone.

Nicky:

So the key there is to pitch it at the right level so it's not overwhelming.

Nicky:

And so that, um, you are able to have success.

Rachel:

Just thinking about how this might apply to adults, I know that often situations happen, don't they?

Rachel:

And I'm just thinking maybe if you've made a mistake in your, in your practice, and then people are very avoidant of doing that thing again because, well, I made a mistake last time and it can completely cripple people for years and years and years.

Rachel:

But again, it's that sort of, I guess, supported, graded exposure really is what you're, what you're talking about.

Nicky:

Yes.

Nicky:

And presumably, I mean, you know, I'm not a medic rich, but there must be, I mean, I hope there are procedures in place to support doctors when, you know, things have gone wrong and it's not just punitive.

Nicky:

It's, you know, okay, let's do it in a supportive way.

Nicky:

Because everyone makes mistakes.

Nicky:

Like, you know, doctors aren't superheroes or like everyone in the world makes mistakes sometimes it just happens.

Rachel:

Yeah, yeah.

Rachel:

And there are certainly things that can support, but I think a lot of people are, are left pretty, pretty unsupported.

Rachel:

I think what happens with anxiety with lots of people in healthcare is even if it's not based on a mistake or something that's happened, the more stressed we get.

Rachel:

You know, we end up sort of catastrophizing and predicting about things that are gonna happen, which I'm sure is the same for children, for teenagers, and for adults.

Rachel:

And then we have this really uncomfortable feeling that we think we just got to make go away.

Nicky:

that's really hard.

Rachel:

No, and no one likes feeling anxious.

Rachel:

And if we're on the receiving end of someone else's anxiety, again, even if it's not a child, but it, maybe it's a trainee or a colleague, we think we have to make their feeling go away by rescuing them and doing that thing that they are anxious about, because that is being a good colleague.

Rachel:

But from what you said, actually, that's often gonna make things worse rather than, than make things better.

Nicky:

I think with kids what you would be, I mean, again, Rachel, this is up to you to say whether you think this is appropriate for adults or not, but if you were, if you had a colleague who was work, well, if I was talking to a parent and saying, you know, how you could support your child with anxiety?

Nicky:

So remember what we said, that like the thinking often goes a little bit wonky with, you know, 'cause it's a false alarm.

Nicky:

So, um, people will sort of over, you know, catastrophize often, you know, it's all, you know, it's gonna be a disaster.

Nicky:

It's sort of black and white thinking.

Nicky:

So it's either all great or, or awful.

Nicky:

Um, so the thinking is, so what we, so you can have what we call thinking errors.

Nicky:

So, um, what happens is that people tend to have automatic thought.

Nicky:

If you have a big feeling about something, often you can link it back to what we call automatic thoughts.

Nicky:

So automatic thought is something that just pops into your head, and often goes unchallenged, and often can sort of stem back to, like, even things in your childhood, for instance.

Nicky:

And they're just wrong, And we tend to, there's tend to be sort of certain, as you said, categories of thinking of, of these automatic thoughts.

Nicky:

Um, so like catastrophizing for one sort of black and white thinking, a fortune telling, you know, if, if, if I do that procedure, it's gonna go wrong.

Nicky:

If I go into school, everyone will hate me.

Nicky:

And what can be really interesting, well, we talk about with, you know, sometimes with kids is you try and get 'em to catch, catch the thoughts.

Nicky:

So what is the thought that they're actually thinking?

Nicky:

And again, if you're a parent with a kid, you could, you could say, well, what do you think's gonna happen?

Nicky:

So can you try to identify the anxious production?

Nicky:

What do you think's gonna happen?

Nicky:

Um, and sometimes just sort of verbalizing stuff is enough to make others think, oh, actually, do I, do I really think that?

Nicky:

Or is that a little bit bonkers?

Nicky:

So, um, with kids, what you might want to be doing is, you know, if a charter's really worried about something, you ask questions.

Nicky:

So, you know, what do you, what do you think is gonna happen?

Nicky:

You know, has that happened before?

Nicky:

Has that happened to anyone?

Nicky:

You know, you know, what, what would be so bad about that happening?

Nicky:

So instead of sort of going for reassurance, Uh, and kids sometimes can become a little bit hooked on reassurance, it can be that safety behavior that we talked about before.

Nicky:

So, you know, it'll be okay this time 'cause mom, mom and dad told me, you know, it was all right.

Nicky:

And I think at that point what you want to do is to say, to move into the questions.

Nicky:

Because the questions, you know, why do you think that?

Nicky:

So what do you think, what do you think is gonna happen?

Nicky:

So that happened to anyone before?

Nicky:

So what that does is gently allows the person you are talking to, to just reflect on whether their thought is true or not.

Nicky:

It just opens up the possibility.

Nicky:

If you are actively trying to persuade someone that what they're saying is nonsense, they might appear to agree with you, but whether they actually believe you or not, I think is well questionable.

Nicky:

You know, if you are sort of trying to force people into believing something, I don't, something I don't think that really works.

Nicky:

But by the questioning approach, what you're doing is you just say helping them to think things through and just to think, oh, actually how, how have I got that right?

Nicky:

And as I said, because they are these automatic thoughts, often people don't question them.

Nicky:

They just sit there and, uh, can have a very powerful effect on people.

Rachel:

I think we often think that we know what someone else is thinking as well, so it's like, right.

Rachel:

Well, I know exactly what Nicky's thinking right in this situation.

Rachel:

She's anxious.

Rachel:

I know what she's thinking.

Rachel:

Well, you have no idea unless, and she say, Nicky what's behind that?

Rachel:

What's, you know, what things are going through your head now?

Rachel:

Yes.

Rachel:

And then you might come back with, oh yeah, I'm gonna kill everyone on the, in France if I drive on the road, right?

Nicky:

yes, exactly.

Nicky:

But that sort of mind reading thing is another, you know, very typical, one of the sort of thinking errors.

Nicky:

So, um, for example, like if you've got social anxiety, you know, typical thought might be, they think I'm so boring, they, I'm just boring them to tears.

Nicky:

They just think I'm awful.

Nicky:

Like, why would they want to hang out with me?

Nicky:

Do you know?

Nicky:

It's, that's a mind, like, how do you know?

Nicky:

Maybe they think you're the most interesting person you've ever met.

Nicky:

Like you have no idea, right?

Nicky:

But for some people, those thoughts are just there in their minds all the time.

Nicky:

And, um, and of course if you think that, right, of course, if you think that you're gonna be anxious, anyone would think that, be anxious if they thought that the people that we're talking to thinks they're incredibly boring and why would they want to talk to them?

Rachel:

Just on a side note, I was listening to this podcast about mind .Reading and they'd looked at the science of it and they'd actually done a study on who was the best at mind reading.

Rachel:

And it was totally hilarious.

Rachel:

So who do you think, uh, they were looking at, um, adults and different relationships in adults and who were best at reading their thoughts.

Rachel:

Who do you think were the best people at mind reading?

Nicky:

I've got no.

Nicky:

50 year old women.

Nicky:

Menopausal women.

Rachel:

Menopausal women and their friends maybe?

Rachel:

Okay.

Rachel:

the people who were the best at knowing what the other person was thinking were couples on their first date.

Nicky:

No.

Rachel:

Yes, yes.

Rachel:

You know why?

Nicky:

Why?

Rachel:

Because they asked each other.

Nicky:

Oh.

Rachel:

Because they didn't.

Rachel:

Okay.

Rachel:

So, right.

Rachel:

You'll get this one now.

Rachel:

Who are the worst at mind?

Rachel:

Reading.

Nicky:

People who've been married for 50 years?

Rachel:

Yes.

Rachel:

Married couples because they thought they knew what the other person was thinking and they were the worst.

Rachel:

Yes.

Rachel:

Isn't it?

Rachel:

So the basic thing is nobody can mind read.

Rachel:

Absolutely nobody.

Rachel:

And the more you think you know somebody, the more you think you know what they're thinking and the, the, the more wrong you are.

Rachel:

And, and so the couples on the first date, 'cause they didn't know each other at all, they'd go, oh, whatcha thinking?

Rachel:

What do you, you know?

Rachel:

And they would ask each other so then they would know.

Rachel:

But I think that's interesting.

Rachel:

So if you're supporting a colleague or a trainee or a child with anxiety, do not assume you know what they're, you know what they're thinking.

Rachel:

But I'm, I'm interested to hear that you are saying that just the question of asking them is gonna be helpful for them as well.

Rachel:

Because once you have to articulate some of the bonkers thoughts, like, I'll kill everyone on the road if I get in that car, you go, well actually yeah, I know that's a bit extreme, isn't it?

Rachel:

You know, once you hear, you say it yourself, say it.

Rachel:

That's quite powerful.

Nicky:

But also it gives you a, a way up.

Nicky:

So let me give you like, this is, my daughter's gonna kill me, but I'm gonna tell you this anyway.

Nicky:

So this is an example of how it works in children, right?

Nicky:

So when my daughter was in year three at school, she had a group of lovely friends, and then one week she became very sad, like really distressed and, you know, I couldn't work out what was, what was going on.

Nicky:

So on, on another Friday or whatever, I said to her, you know what's, tell me what's happened.

Nicky:

And after March sort of probing, she said, well, What's happened is they've all started playing Harry Potter at lunchtime, and they know that I hate Harry Potter, um, and they're doing it because they don't wanna play with me anymore.

Nicky:

And she was absolutely devastated, bless her.

Nicky:

So, because I just read a book on using cognitive behavioral therapy approaches with young, with young children, I said to her, darling, should we do an experiment?

Nicky:

Like how can we test that out?

Nicky:

You know, what could we do to see whether that's actually true or not?

Nicky:

And, um, she said, well, maybe I, maybe I could ask.

Nicky:

So, so I was like, Hmm, maybe you could, good idea.

Nicky:

Right?

Nicky:

So, um, next school day, she went in and on the way back I said, so, so what happened?

Nicky:

Did you ask them?

Nicky:

And she said, yes, I did ask them and they said, of course we wanna play with you.

Nicky:

We just like playing Harry Potter, but, but we thought you didn't like us because you didn't want to play Harry Potter.

Nicky:

So like, she had just completely and utterly got the wrong end of the stick, right?

Nicky:

It was nuts.

Nicky:

Like to any like buses, great luck, we're like, that's nuts, right?

Nicky:

But in her head, that was really, really true.

Nicky:

And the lovely thing about it is her and all her friends are now 19, 20 and they are still friends.

Nicky:

They still go out together.

Nicky:

But honestly, if she hadn't asked that question, I think it would've sort of fallen apart.

Nicky:

So that's a child example.

Nicky:

But what I'm saying is that because there are these automatic thoughts, people don't challenge them.

Nicky:

They just pop into your head.

Nicky:

And actually having an opportunity to challenge them can can be really interesting, but you tend not to do it unless you can catch that thought in your head, and then, you know, it's great if you've got somebody who can ask you those questions.

Nicky:

Or maybe what you could do is you could even have a little prompt sheet.

Nicky:

Let's just ask myself, is it true?

Nicky:

What's the evidence that thinks true?

Nicky:

What's the evidence?

Nicky:

It's not true.

Nicky:

What's most likely?

Nicky:

Is it?

Nicky:

Is it likely?

Nicky:

Is there another alternative?

Nicky:

You could just have a little crib sheet just to ask yourself.

Nicky:

I mean, that's what we'd suggest with sort of older teens.

Rachel:

And it's so funny you're saying that's nuts, isn't it?

Rachel:

Totally nuts.

Rachel:

And here's me thinking, Nope, this happens with adults all the time.

Rachel:

You know, so many times wrong.

Rachel:

End of the six, someone assumes that the other person's not talking to them because they've somehow said something that offends them, but actually the other person's not talking to 'em either 'cause they literally didn't see them, or they, their mind is on a patient that they've just seen and they're worried about that.

Rachel:

And um, it just got me thinking about how many.

Rachel:

Times, maybe we assume that the other people is being lazy or obstructive or, you know.

Rachel:

I, I do sometimes here, I've probably got lots of irate emails about this, but sometimes you hear more senior doctors talking about the trainees as being quite snowflake, you know, not wanting to step up to this or that.

Rachel:

And it does make me wonder about, I think certainly there are, there are different ways in which people work these days.

Rachel:

There is that, but I do wonder whether sometimes anxiety in, in trainees or the younger generation, you know, because it's quite scary when you start having to do all these different things, um, and then they say, oh, I don't, I don't feel comfortable with that, whatever.

Rachel:

So the use of sort of language of I'm not comfortable or whatever, and all that is, is just, it's just anxiety and avoidance.

Rachel:

And then the seniors go, well, they're not comfortable.

Rachel:

I can't possibly question them what they mean.

Rachel:

But if they just sat down and they went, actually, yeah, well, tell me what it is that you are not comfortable with.

Rachel:

Let's unpick that, the generations might actually start communicating a bit better.

Nicky:

So that's kind of interesting, like, I mean, so, you know, obviously I'm not a medic.

Nicky:

I'm thinking about med, like you as trainee medics doing stuff for the first, you know, cutting people open.

Nicky:

Like I imagine that's completely terrifying.

Nicky:

Right?

Nicky:

I think that's pretty normal to be frighten of doing stuff like that as a non-med.

Rachel:

Well, it's interesting, Nicky, 'cause some of those, like cutting people open and stuff, you've, you've always got, you, you do have people around to do that.

Rachel:

It, it's some of the other stuff that is just as anxiety inducing.

Rachel:

Like going and having that, that difficult conversation where you might not have that supervision there or actually doing something on your own that's not a really high stakes procedure.

Rachel:

But there's other things that you can really build up in your mind as being.

Rachel:

You know, and I think this is actually.

Rachel:

More to do with interpersonal relationships, perhaps with colleagues than it is with procedures and things that you do with your patients and things which are quite highly supervised, and you have to be signed off and things and things like that.

Rachel:

Does that make sense?

Nicky:

It does, I mean, what's kind of interesting about that though is maybe it brings us back to what we were talking about right at the beginning.

Nicky:

We were saying that, um, you know, sometimes you have anxiety and it's for, you know, it's because of false alarms.

Nicky:

So like, you know, you've sort of slightly got, got the wrong end of the stick about how actually worrying is, but sometimes people are anxious about stuff that is genuinely worrying, right?

Nicky:

Like for real.

Nicky:

So for example, in a school setting, you know, kids being bullied, of course they're gonna be anxious.

Nicky:

Like, but in the same way, I think if you're a medic and you have to do like a really complicated medical procedure that you've never done before or whatever, you know of, of course you're gonna be worried about that, but, and you sort of need a slightly different approach for that.

Nicky:

So with young, with kids, what one of the things you would be talking about if the kid, if a child is anxious about something that is, they've got a good reason to be anxious, you might be saying, okay, well let's do problem solving.

Nicky:

Let's, um, actually talk it through.

Nicky:

What's the best way to approach this?

Nicky:

And actually teaching children and young people, a problem solving framework is super helpful, because often kids just dunno how to do that.

Nicky:

So the framework you would be looking at is, okay, so let's really define what the problem is.

Nicky:

Let's think about a whole range of different solutions.

Nicky:

Doesn't really matter what they are because we are just, you know, pulling as many as we can outta the air.

Nicky:

Then what we wanna do is we wanna evaluate them.

Nicky:

Like, is is it a good solution?

Nicky:

It's a terrible solution.

Nicky:

Is it, you know, good enough?

Nicky:

And then is it doable?

Nicky:

Then you choose the best one.

Nicky:

And then you might need to practice how you're gonna put that into place.

Nicky:

And with kids, you know, sometimes it depends what it is, you know, that might involve role play or talking things through, or a new skill, whatever.

Nicky:

And then you say Off, off you go, go and have a go and then come back and you review how that works.

Rachel:

Sounds like coaching to me.

Rachel:

You sit down, you talk about what the problem is, you work out what the issue is, you work out how you might solve it, you go, you go and have a go at it.

Rachel:

It would really work in adults.

Rachel:

I think what we struggle with is actually defining the problem.

Rachel:

Because I was gonna say to you, In adults, and I'm sure you probably see this in kids as well, it is one thing if you've got a specific thing that they're anxious about, but what if it's sort of just the general anxiety about, about everything, so it's actually very difficult to identify a specific problem or, or, or, or are there often very specific underlying, underlying things?

Nicky:

Well, it's different.

Nicky:

So some kids will have specific phobias or specific thing like, you know, scared of dogs, common ones, scared of going to bed by the by themselves.

Nicky:

So with kids with those sort of things, what you might be doing is talking about worry time.

Nicky:

I dunno how this would apply to grownups.

Rachel:

my goodness.

Rachel:

It a hundred percent.

Rachel:

I do worry time.

Rachel:

Often if there's something really on my mind, I'll say, right.

Rachel:

I, I can't.

Rachel:

Right.

Rachel:

I'm gonna worry about this later, six o'clock and I get six o'clock.

Rachel:

Generally it's gone.

Nicky:

Yeah,

Rachel:

I've applied all this to myself,

Nicky:

Okay, cool.

Nicky:

Well done.

Nicky:

So yeah, so with kids, what you or you teens, what you might encourage 'em to do is like you know, just to write a note, put it in a worry monster.

Nicky:

Have you seen worry monsters, Rachel?

Nicky:

Oh, they're lovely.

Nicky:

So worry monsters for kids.

Nicky:

Yeah.

Nicky:

Get your own.

Nicky:

Everyone, everyone listening to the podcast, she get their own worry monster, right?

Nicky:

So they're like to toys, um, monsters and they often have little pouches or like zipped mouths and you write down what the worry is and you pop it in the pouch of the mouth.

Nicky:

And their worry time you come to worry time and then you take out the worry, and then you, you think about the worry then.

Nicky:

And then that's a good opportunity then because what you're, you can apply problem solving if it's an actual something you can do something about or you can, you know, ask the questions if you've got, you know, somebody there to help you about it.

Nicky:

So worry time is, is not about, okay, we are just not gonna talk about worry.

Nicky:

But the purpose of worry time is to say, let's just put it aside for, to practice putting it aside for the moment so we can come back to it, so that it's not all consuming all the time.

Nicky:

You know, and different things will work for different people.

Nicky:

So if you are in a real, you know, panic about something, you know, those grounding exercise, so, okay.

Nicky:

Five things you can see, four things you can touch, five things, you know, three things you can hear.

Nicky:

Um, that's great.

Nicky:

Or if you, again, you're in a total panic about something, okay, let's go through the alphabet, we're gonna think of, um, women's names.

Nicky:

So Amy, Barbara, Carly, let's do that.

Nicky:

So this, that sort of distraction technique can be very helpful just in terms of sort of calming you down.

Nicky:

'Cause what can happen is if you start to sort of focus on the thoughts and the physical sensations, all that does, like if you are just thinking all the time, as I'm thinking with my car example, I'm gonna kill them, I'm gonna kill them.

Nicky:

Like, you know, that's not gonna keep you calm, right?

Nicky:

Just thinking that is gonna maintain the anxiety.

Nicky:

If you're focusing on that, I feel sick, I feel sick, I like, where's my tummy going?

Nicky:

That's gonna make you feel anxious.

Nicky:

It's gonna make you want to avoid it.

Nicky:

So if you can try and distract yourself away from things that can work.

Rachel:

And all those are really helpful and know when we do our webinars about anxiety and stress, often we talk about worry time, we talk about distracting yourself with physical activity, star junk, things like that can be really helpful as well.

Rachel:

Um, I want to ask you about safety behavior because it strikes me that safety behavior in the way that you described it can be unhelpful just as much as avoidance is unhelpful.

Rachel:

Is there ever any safety behavior that can be helpful?

Rachel:

So say, um, I'm just thinking with, with adults as someone being very anxious or having, almost having a phobia about having a, a difficult conversation.

Rachel:

Giving someone feedback and, you know, the, the avoidance be, well, don't worry.

Rachel:

I'll do it for you.

Rachel:

I'll do it for you.

Rachel:

But is there ever a case of you go and do it.

Rachel:

I will be in that room over there and you can stop and phone me at any point.

Rachel:

So to almost give them a way out?

Nicky:

I think that sounds like a great idea, but I t hink, you know, that sounds like a, like a one off conversation.

Nicky:

Like if you were what you would, I suppose the thing is what you want ultimately is for the person to think, you know, I've got this, like, I can do this

Rachel:

to have you in the other room.

Rachel:

the whole time.

Rachel:

Yes.

Rachel:

Okay.

Nicky:

But remember what we talked about, small steps?

Nicky:

So, you know, if I, you know, I, I just can't have this conversation, it's too much for me, it's too overwhelming.

Nicky:

But if they can do it with somebody else in the room or just on hand, you know, great.

Nicky:

That's one of the small steps towards it.

Nicky:

But if they have to have the same conversation, you know, with somebody else, then maybe next time the person on it doesn't have to be in the room.

Nicky:

Maybe they could be at the end of the phone if they need to be.

Nicky:

So that's just a series of building it up in small steps really.

Rachel:

What do you recommend for adults who have say, anxious kids, anxious dependence, maybe even anxious colleagues?

Rachel:

Because I know when we were talking earlier, you said you have to model not being anxious yourself, or model, model dealing with anxiety.

Rachel:

Well, so how can we model that well to our families and to our patients, and to our colleagues?

Nicky:

Well I think, I mean, you can just literally, you can talk about it.

Nicky:

You can say, do you know what, when I was your age, I had exactly this problem.

Nicky:

And, you know, I felt really panicky about it.

Nicky:

But then I thought, and then you tell, tell them.

Nicky:

But you could be saying I could do this.

Nicky:

Or for example, you could say, God, you know, I'm really, I've got this problem at work.

Nicky:

I'm really worried about it.

Nicky:

I don't quite know what to do.

Nicky:

maybe I'll do that problem solving, you know, that thing we talked about last week?

Nicky:

Okay, let's sit it down, I'm gonna work out, so you could do that.

Nicky:

Or it could be that if, you know, again, you could say, gee, you know what?

Nicky:

I was at that part of the other day and this voice in my head the whole time came up saying, you're so boring, you're so boring, you're so boring.

Nicky:

Why would anyone want to talk to me?

Nicky:

But, you know, I stopped and I thought about it and I said to myself, actually I don't know if that's true, I don't think I was that boring actually.

Nicky:

So you are sort of just modeling the sort of strategies that we've talked about.

Nicky:

Or again, it could be, you know, feeling, I'm feeling a little bit panicky now.

Nicky:

I'm just gonna go and take three deep breaths.

Nicky:

I'm gonna do the grounding thing.

Nicky:

You know, five things I could hear.

Nicky:

So all the techniques that you might want your young, your kids or young people to do, you could be just, you know, you, you can verbalize it so you can do that.

Nicky:

But I mean, it's really tricky, right?

Nicky:

Like, you know, if you've got a kid who's really anxious in front of you, how do you deal with that?

Nicky:

And I think, you know, acknowledging the feelings, you know, I can see this, you're really worried about this, normalizing it, you know, lots of people feel worried when they're trying things for the first time, let them know you're really confident, you know, I'm really confident you can handle this, 'cause you've done this before, you did something exactly like this last year when you remember you were worried about that and then you did it?

Nicky:

And then let them know that you're there to help.

Nicky:

You know, I'm here, I'm, you know, I'm, you got your back, you just let me know what I can do to help and I'm with you on this.

Nicky:

And I think that message makes them feel heard, normalizes the experience, but also helps them hopefully to believe that they can cope.

Nicky:

But as I say, it's, you know, often with anxiety, it's sort of small steps, isn't it?

Nicky:

And not throwing people in at the deep end too much.

Nicky:

Not asking 'em to do too much too soon.

Rachel:

And I think that's something we do get wrong in medicine.

Rachel:

It's like, yeah, deal with it.

Rachel:

Just do it, just do it, and then you'll be fine.

Rachel:

And then it's like, then you feel you have to, and then it's a horrible experience and then it then you going, okay, well I did it and look what, look how that turned out.

Rachel:

And so I'm not, not doing that again.

Rachel:

And just finding, Nicky, I know that in your role as an ED psych, you often deal with neurodiversity and there are some conditions that make anxiety a lot worse.

Rachel:

Is, is there any changes in what you might do for, say, kids who have autism or A D H D in terms of helping them manage their an anxiety?

Rachel:

Is it a different sort of anxiety or is it exactly the same just with different ways of coping?

Nicky:

Well, so, um, autism kid, people with autism, uh, have often have higher rates of anxiety.

Nicky:

Um, I mean, it's considerably higher rates of anxiety than, um, uh, than others.

Nicky:

So, I mean, there's some research that suggests that, you know, over 70% of, um, people with autism have sort of measurable levels of anxiety.

Nicky:

Um, so that's kind of like a pretty big deal.

Nicky:

Right?

Nicky:

Um, and for those people, there are issues around sensory sensitivities that can make them feel very overwhelmed.

Nicky:

So you would want to be doing something kind of different for them around that.

Nicky:

You know, if they're in noisy environments, then it, we might be thinking about, okay, uh, ear offenders or, you know, can they just go and do their stuff somewhere quieter?

Nicky:

Or, um, with kids there's a lot of, uh, you know, labels and uniforms that just, it's like, really find quite difficult.

Nicky:

And that can be very overwhelming.

Nicky:

And of also with, um, people with autism, there's a lot of, uh, because of the difficulties with social communication, social understanding, that can also make life very difficult for them.

Nicky:

And they can, um, particularly social anxiety can become an issue.

Nicky:

And also I think sometimes because they can be, you know, sometimes a little bit quirky personalities.

Nicky:

Certainly in school settings, sometimes they can become, um, victims of bullying.

Nicky:

So actually then like, you know, genuinely, you know, really rubbish things happening to them.

Nicky:

So I'm, I'm not sure it's that the an, the feeling is different, but the triggers for the anxiety can be different, uh, can be different.

Nicky:

And then they need to be supported in different ways.

Nicky:

So, as I said, with the sensory stuff, it's around how can we manage the environment to make that more supportive with social understanding.

Nicky:

It can be around, well, how can we help 'em to understand, you know, what might be going on in the situation.

Nicky:

So they've picked up on the nuances correctly and then not, not thinking somebody doing that means that everybody hates me or you know, whatever.

Nicky:

That's sort of perpetuating the anxiety.

Nicky:

And I think with ADHD, again, I think there's, you know, I think the difficulties that you have might have there around organizing and planning, I mean that genuinely just makes some activities more stressful than, than it is for other people, and that will probably make you feel worried.

Nicky:

So then again, it's not so much the anxiety's different, but it's what you would do to support with that is different because it might be that those people need to be thinking about, okay, right, let's have, we got a system, what system can we put in place to support you with the planning of the organization?

Nicky:

And you know, all of those things that will help.

Rachel:

that makes a lot of sense.

Rachel:

Thank you.

Rachel:

So Nicky, if you were gonna give us your top three tips to managing someone else's.

Rachel:

Or helping someone else manage their, their anxiety in, in the context of children, teenagers, which I know you work, which I'm sure we can apply to adults as well, what, what would they be?

Nicky:

So I think it's probably really important that people understand.

Nicky:

The purpose of anxiety, um, and sort of understand that idea about thoughts, feelings, physicalization behaviors are all linked together, 'cause that gives you a sort of theoretical background for you to really get it, and you know, pretty young kids can get that.

Nicky:

And there are all sorts of books, um, for kids that are great at helping that.

Nicky:

And there's great YouTube videos as well.

Nicky:

Um, little clips that appropriate for all different ages that you can, um, find that will help, um, young people to understand that.

Nicky:

I think the other thing is that it's just super important to face your fears, and I know that's really tricky and I know people might need a little bit of support with that because, you know, as we've said, It's completely natural to want to avoid things, but it's about facing your fears in a way that's manageable for you.

Nicky:

So doing it in teeny weeny weeny steps if you need to, thinking about that overarching goal and what can you do, what do you need to learn, so that to feel that you are able to cope with the things?

Nicky:

And then I think probably it's great to have some support with this as well.

Nicky:

That would be the other thing.

Nicky:

You need a buddy, right?

Nicky:

You need like backup.

Nicky:

Somebody who's on your side, who's gonna be your cheerleader, right?

Nicky:

Throughout all of this.

Nicky:

Um, so if you're a parent, what you're gonna be saying to your kids is, you know, I noticed when you did that brave thing, right?

Nicky:

Well done.

Nicky:

You know, you, I saw you didn't want to talk to john, but you went over and you said hello to him, even though you were worried.

Nicky:

Well done you, great stuff.

Nicky:

But I imagine it's the same with grownups, right?

Nicky:

If you know, if your partner can do that, fantastic.

Nicky:

If you haven't got partner, maybe your friends can do that, and have somebody there.

Nicky:

And again, the role of that cheerleader is not necessary to be giving reassurance, um, because as we said before, reassurance can sometimes reduce opportunities for people to learn.

Nicky:

They can cope, but, um, you know, gentle questioning, cheerleading, when things are going well, normal, you know, everyone feels worried about stuff, you know, it's, it's, it's normal, right?

Rachel:

Great advice.

Rachel:

Great advice.

Rachel:

And it just shows the importance of air cover, which I've been talking a lot recently.

Rachel:

Get your mates around, you, get your colleagues around you just to, just to cheer you on and to, yeah, make, make you go for stuff.

Rachel:

Really, really important, I think.

Rachel:

And books are really good.

Rachel:

I, I love the, there's something about anx Beat the Anxiety Gremlin or something like

Nicky:

Oh my goodness, there's great books.

Nicky:

So, uh, Beating the Anxiety Gremlin, there's for older teenagers, there's, um, something called My Anxiety Handbook.

Nicky:

The Younger Kids, there's Poppy O'Neill books which you see in The Works, very cheaply at the moment.

Nicky:

They're great.

Nicky:

what to Do When You Worry Too Much?

Nicky:

That's a fantastic book for sort of upper, primary, lower secondary school.

Nicky:

Whole range of really fantastic books out there for, um, yeah, for kids and young people to help 'em understand anxiety and also strategies about what to do.

Nicky:

And also, I must mention this one too.

Nicky:

if you've got a child with anxiety, there's an absolutely fantastic book called Helping Your Child With Worries and Fears by Kathy Cresswell and Lucy Willetts, which I would very strongly recommend.

Rachel:

And I must say, I was just, I was just looking this up while you were talking.

Rachel:

One of the best books about anxiety I've read for adults is swearing alert, Get Your Shit Together by Sarah Knight.

Rachel:

And she, she wrote the, uh, Magical Art of, you know, Not Giving a F as it were.

Rachel:

Um, and, and I read that and I just thought it was brilliant.

Rachel:

So if you are an adult that's struggling with anxiety, then, then do check out that book.

Rachel:

And I would say as well, do get some help.

Rachel:

Do get some professional help.

Rachel:

'Cause talking to a therapist about this is, can be really, really helpful can't it?

Nicky:

Anxiety has got a really good success rate if you get the right support.

Nicky:

So I mean, yes, you can't guarantee everyone will be cured of it, but on the whole, it's pretty good success rate

Rachel:

I mean Nicky, I think managing one's anxiety is, is a basic life skill that should be taught everywhere.

Rachel:

You should be taught at school and at medical school and, and all other jobs really, 'cause it's, it's such a big, big thing and we're just not very literate about our emotions and what happens with the amygdala and all that sort of stuff.

Rachel:

So thank you for the work you're doing.

Rachel:

It's really, really helpful.

Rachel:

So I know that you offer sort of one-to-one and group support for, uh, grownups for adults who have children who particularly suffer with anxiety and school avoidance.

Rachel:

So if people wanted to get in touch with you about that, how, how could they find out more?

Nicky:

So they could go to my website, which is odgerspsychology.com, um, and you can find information there.

Nicky:

So, yes, so I am gonna be running a support, um, group for parents, uh, of kids who are worried about attending school.

Nicky:

So, and also I've got, um, A P D F that has got some information about resources, so books, um, that are helpful for kids, uh, and also a couple of links to YouTube, um, videos that you can share with your kids if they're anxious.

Nicky:

Um, and also a little format around how to support your child to do problem solving.

Rachel:

Great.

Rachel:

So we'll put the link to that in the show notes.

Rachel:

If you want that, and you can just sign up and get that from Nicky.

Rachel:

So Nicky, thank you so much for being on the podcast.

Rachel:

That's been really helpful.

Rachel:

I think that's gonna be helpful for grownups with kids, with anxiety grownups, with colleagues with anxiety and grownups with anxiety themselves.

Rachel:

So thank you and we'll get you back again soon.

Nicky:

Lovely.

Nicky:

It's lovely to be here, Rach.

Nicky:

Thanks so much.

Rachel:

Thanks for listening.

Rachel:

Don't forget, we provide a self coaching CPD workbook for every episode.

Rachel:

You can sign up for it via the link in the show notes.

Rachel:

And if this episode was helpful, then please share it with a friend.

Rachel:

Get in touch with any comments or suggestions at hello@youarenotafrog.com.

Rachel:

I love to hear from you.

Rachel:

And finally, if you're enjoying the podcast, please rate it and leave a review wherever you're listening.

Rachel:

It really helps.

Links

Chapters

Video

More from YouTube