Q I suffer from anxiety and have managed it quite well, but not always. I am really worried about my oldest daughter who is 7.5 yrs. She has always been a worrier but it's getting worse. Her younger sister wet herself at school the other day and now my oldest is scared she might wet herself too. She is constantly going to the loo and is really upset and in tears. This has lasted for a week. I talked to her and told her how to help herself with the thoughts, but it's not working. What should I do next? I'm very sad for her and I don't want her bladder to get confused with her going to the bathroom so much.
I think it’s great that you have recognized your older daughter’s distress and have tried to help her learn how to take control of her thoughts. Reframing distressing thoughts is actually a strategy that is used in cognitive behavioral therapy (CBT), which has been found to be very helpful in treating anxiety disorders.
Employing another principle of CBT may be helpful to you and your daughter. We know that our thoughts, feelings, and behaviors all influence each other, and by changing just one part of this equation we can help change the other two. Oftentimes with younger children, focusing first on the behavioral part of CBT can be more effective than only challenging thoughts, especially as kids’ cognitive capacities continue to mature.
Your daughter’s fears about wetting herself are being inadvertently reinforced by repeatedly using the bathroom when it is clear she does not actually need to go. As you have already done, it is best to inform her that waiting longer to urinate is not going to result in her wetting herself. Once this conversation has taken place, discontinue family conversations about her frequent urination. Commenting on her frequent urination or accompanying her to the bathroom will only continue to reinforce her fears. If she is consistently asking to use the bathroom and there is an opportunity to intercede, remind her that she recently used the bathroom and immediately redirect her attention by engaging her in an enjoyable or relaxing activity. If she is able to wait and remain engaged with the task, praise her for being able to do so and note that she did not have an accident.
As you clearly understand, anxiety is hereditary, but also manageable. And we also know that anxiety disorders are extremely treatable. If your daughter’s anxiety symptoms persist, it might be time to visit a therapist who can help guide you more directly in these exercises, especially if you feel your own anxiety might be making it difficult to manage hers.