Does My Child Have Separation Anxiety?

Life is full of separations, from birth to nursery to starting school, leaving home and death. The addition of a pandemic may explain why so many parents are contacting me with this concern. To help you cope with the separations, here are some suggestions and ideas:

What is Separation Anxiety?

Separation anxiety is a natural developmental stage. A baby may cry when their mother is out of view, and a young child may cling or become tearful starting school for the first time. Since children depend so completely on their caregivers, it’s natural for them to feel vulnerable when separated.

What’s actually happening underneath is your child’s Guard Dog, the amygdala, sounding an alarm. Its job is to keep your child safe, and separation from a parent, especially early on, genuinely registers as a threat to a young nervous system. That alarm triggers the stress response, a racing heart, tummy aches, tears, clinginess, or a full meltdown at the door, all signs the body has moved into fight, flight, or freeze, not defiance or manipulation. My free guide Understanding Your Child’s Guard Dog Brain explains this properly, and it’s genuinely useful context for understanding everything else in this blog.

The degree and duration varies hugely from child to child, but a degree of anxiety about being away from parents is normal, even as children get older.

When does it become a Disorder?

For some children, separation anxiety doesn’t ease with time, even with a parent’s best efforts. It can persist or recur into junior school years and beyond. These children often complain of tummy aches, headaches, or other physical symptoms, and the distress can genuinely prevent them from joining in age-appropriate activities, sports teams, sleepovers, or in some cases attending school at all. It can mean they need a parent constantly present, which is exhausting for everyone involved.

If separation anxiety is excessive enough to interfere with school and friendships, and persists for months, it may indicate separation anxiety disorder.

Symptoms of an Anxiety Disorder

A persistent fear that something terrible will happen to a loved one while they’re apart, worry that an unexpected event will lead to permanent separation, such as being lost or kidnapped, refusal to go to school, reluctance to go to sleep alone, and repeated physical complaints like headaches, tummy aches, nausea, or vomiting.

Risk factors for developing the Disorder may include:

Life stresses or losses involving separation, illness, bereavement, the loss of a pet, divorce, or moving school. A sensitive temperament, particularly a highly reactive Guard Dog, the amygdala, which I explain more in my free guide Understanding Your Child’s Guard Dog Brain. Family history, anxiety in blood relatives can suggest an inherited or intergenerational pattern around attachment and separation. And overprotective parenting, understandably well-intentioned, but one that can unintentionally reinforce the anxiety. If nighttime fears feel like a bigger part of the picture in your house, my blog Understanding the Link Between Sleep Problems and Nighttime Fears goes into this specifically, and my free guide When Darkness Comes was written exactly for this.

What is the treatment for Separation Anxiety Disorder?

There’s relatively little research specifically on separation anxiety disorder compared to generalised anxiety, and medication is rarely used in the UK for this. Cognitive behavioural therapy, including psychoeducation, relaxation, coping self-talk, and gradual exposure, is the most established approach.

CBT tends to work best with children who have good cognitive capacity to identify their own negative thoughts. For younger children, or those who find talking therapies harder, play or art therapy alongside a parent has been shown to help both the anxiety and the parent-child relationship. In my own practice, I favour an integrative approach involving both parent and child together, this tends to be more effective than child-only CBT, since it addresses parental fears and parent-child attachment alongside the child’s own anxiety.

How to ease normal Separation Anxiety

Practise separation at home. First; small steps help. Leave your child with a caregiver for brief periods and short distances first. You are even helping them move from downstairs to upstairs on their own can help. Games like hide-and-seek and peek-a-boo can help the process as your child gets used to separation. You can gradually leave for longer and travel further.

Schedule separations after naps or feedings. Babies are more susceptible to separation anxiety when they’re tired or hungry.

Develop a quick “goodbye” ritual at night or other transitions, such as just before school.

Rituals are reassuring and can be as simple as a particular wave or a goodbye kiss through the window.

Identify a safe attachment figure for the handover. It is not helpful if you are anxious to have multiple attachment figures. You can use a simple three-step process: hug goodbye and hand them over to a teacher or someone your child has an attachment with.

Use a transitional object—something of yours to keep if they are worried about being away from you.

I know it might be strange to leave mummy or not be at home but I know you are going to be fine once you are there. Let’s think of something you can bring in to help you feel safe. What can I do to help you?

For children whose parents have gone through a divorce or experienced the loss of a loved one, provide them with a worry stone, a personal item to hold onto, a bracelet, or a cherished toy to serve as a “transitional object”.

Name the Worry– even younger children need their feelings named and acknowledged.

If you know a significant separation is coming, listen, plan, and problem-solve with your child. Make a picture book of positive separations in readiness. Talk about previous transitions and think about what worked and what you may do differently this time.

You can use the Ladder of Success to help work together on goals

Try not to give in. Be positive; setting consistent expectations and limits will help your child’s adjustment to separation.

Even though it is often from a loving place, it maintains the cycle if we give to anxiety.

It’s not just younger children

Separation anxiety is often thought of as something only toddlers and young children experience, but that’s not quite right. Teenagers can experience it too, sometimes in ways that are much harder to recognise, since it rarely looks the way it did at three years old. I write more about this specifically in Even Teens Have Separation Anxiety, if that sounds like your family, it’s worth a read alongside this one.

Interested in working with me?

If you would like more tailored support for your child or family, I offer one to one therapy for children and young people, therapeutic parenting support for parents, and training and consultation for professionals working with children and families. Please do get in touch if you would like to find out more.

You can reach me via my contact page.

Free resources

Understanding Your Child’s Guard Dog Brain explains what is happening in your child’s nervous system when big feelings take over.

Holding in the Storm is about staying steady as a parent in the hard moments.

When Darkness Comes includes specific support for sleep difficulties and anxiety at night.

All free to download.

References

Boyd, A. Exeter University, IAPT Training, Separation Anxiety.

Telman, L.G.E. et al. What are the odds of anxiety disorders running in families? A family study of anxiety disorders in mothers, fathers, and siblings of children with anxiety disorders.

American Psychiatric Association. DSM-5.

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With warmth,
Catherine