A: Thank you for writing; this sounds very difficult. An interesting part about writing this column is how little I know about what is truly happening. Here is a list of just a few factors I don’t know that could be having a huge impact on her life: her family situation, siblings, bullying at school, learning differences, psychological issues, medical or allergy issues, and that’s just a few.
Nine-year-old children are whole and complex humans; they are experiencing many of the worries, fear and issues we adults do without the benefit of a fully mature brain to navigate all of them. I don’t know whether her anxiety and the school refusal is related directly to an issue at school or her anxiety is causing her to focus on school (in a more random sense).
But here is the biggest red flag of everything you wrote: “though her friendships have waned because of her attachment to me and anxiety behaviors.” Whoa, whoa, whoa. A child who was “once generally happy,” does not lose friends because of her attachment to her parent. Something isn’t adding up. Why is this happening? I don’t know, but let’s do a little 101 on attachment.
Attachment theory is concerned with how humans connect to one another, and in the case of children, how these stable and secure connections facilitate either secure or insecure attachments. Secure attachments lead to children that grow into stable, emotionally healthy and responsible adults (mostly), and children with insecure attachments are prone to depression, anxiety, bullying, poor social skills and more.
For newborns, attachment is so important that we see this reflected in how they are cared for in hospitals, with skin-to-skin contact directly after birth, as well as cuddling sick and premature babies and not leaving them in their incubators. This secure attachment depends on proximity; a child must be physically close to their caregiver to eventually keep that attachment over space and time as they get older. This is how we develop. The deeper the attachment, the more likely it is for a child to mature and go forward into the world feeling safe and loved.
Why does a child become insecurely attached, needy and anxious, and what does this have to do with your daughter going to school? There are multiple explanations: trauma or significant loss at an early age; ambivalent, avoidant or insecure attachment style from the parent from an early age; or even a mismatch in parenting style and a child’s temperament can lead to some attachment problems.
I don’t know, but if your daughter was already born sensitive (see the book “The Orchid and the Dandelion” by W. Thomas Boyce to understand more) and then you and she shared an insecure attachment in her early years, you can easily have a needy and anxious child. I want you to know that this is not your fault per se, and you haven’t done anything wrong. It is easy for parents to fall into the trap of responding to a child’s needs and unknowingly contributing to insecurity. The child can become almost like a bully for your affection, but it is never enough. The child never feels satiated or secure, and so the child keeps going round and round, chasing you, you giving and giving, the child asking for more. This cycle is insidious, and parents often don’t see it, even as it is happening to them. The child is called “spoiled,” and people will recommend punitive measures when, we know, the child is only responding to deep impulses that all humans are born with.
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The act of leaving for school is an obvious separation for your daughter; she literally doesn’t want to leave you. The rage and tears are the manifestation of the frustration and alarm she feels; these emotions are not personal, and though you may feel manipulated, I can promise you your daughter doesn’t want to behave like this. She feels as out of control as she looks.
Could your daughter have good ol’ fashioned generalized anxiety, as described in the latest Diagnostic and Statistical Manual of Mental Disorders? Yes. But you mentioned attachment, and I have a spidey sense that there is something there.
What should you do? Don’t stop therapy just because your daughter hasn’t opened up after four sessions. It makes sense that she will not readily open up to a person she doesn’t know. You may want to consider finding someone who specializes in attachment, anxiety and school refusal, and the therapist should work with you as much as they work with your daughter.
I also recommend working with a parent coach who specializes in attachment challenges (go to the Neufeld Institute for names of coaches and therapists) so you can have a deeper understanding of what your daughter needs. As for school, don’t focus on or give your attention to the rages. Instead, try to connect deeply with her. Not easy, right? This is why you need professional support — so the specific strategies work for you and for your daughter.
Good luck.
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Hi,
There are several red flags here that indicate PANS/PANDAS should be looked into. Anxiety behaviors–including separation anxiety from primary caregiver, sudden school refusal, tantrums and screaming fits from her ‘once-happy, almost overly-compliant’ daughter with no other known trauma in her life? At 9 YO? Please, I would urge you to tell this parent to have her child worked up for PANS/PANDAS asap. She can learn more about the diagnostic criteria and find a physician here: https://www.pandasppn.org/.