Understanding Your Child's Anxiety — “The Anxiety Monster”

Instead of talking about traditional treatment, I offer a metaphor I’ve found helpful for describing anxiety to children, adolescents, and their parents. Simply, I explain that anxiety is like a small monster that sits on their shoulder and whispers in their ear.

The Anxiety Monster tries to convince people that if they attempt to do something:

It’s important to remember that anxiety exists on a spectrum. Anxiety is natural and can even be helpful at times — it can warn us of danger, help us focus while studying, or give us a boost of energy before a sporting event. But there’s a point at which anxiety is no longer helpful, when it exists in a more insidious form — for example, as an actual disorder, when symptoms are extreme and/or excessive, last too long, and create significant impairment and suffering.

While the Anxiety Monster is whispering, it also pokes, causing a discomfort that’s hard to describe but familiar to us all — for some, a pit in the stomach; for others, faster and shallower breathing, an increased heart rate, or feeling sick to the stomach.

The Anxiety Monster says that instead of doing a particular thing, a person should avoid it. For example: “If you take the shot, you’ll miss — so don’t take it…” Or: “If you ask her out, she’ll say no — so don’t bother…”

It also magnifies the perceived consequences of failure: “…AND if you miss that shot, no one on your team will like you.” “…AND if she says no, it’s because no one would want to date you.”

The Anxiety Monster persuades people to avoid activities by promising bad things will happen if they act, by magnifying perceived consequences, and by promising temporary relief from that uncomfortable feeling if they avoid the situation.

I conceptualize the Anxiety Monster as a creature whose sole purpose is to continue its own existence, like a parasite. When someone avoids doing something that makes them anxious in order to seek temporary relief, this feeds the Anxiety Monster a cookie — making it a little larger, its pokes a little stronger, and its whispers a little louder and more convincing next time.

When someone begins avoiding feared situations more often than facing them, they can get caught in an avoidance spiral. Each avoidance brings momentary relief, but that relief feeds the Anxiety Monster, making it bigger and stronger over time. Let’s look at how this happens for Jacob, a young basketball player whose growing Anxiety Monster leads him to avoid more and more of something he once loved.

Jacob loves basketball. He enjoys being part of his team, spending time with his friends, and playing in games. During one close game, Jacob takes the final shot — and misses. His team loses.

On the way home, Jacob’s Anxiety Monster gets loud: “Everyone is mad at you. They probably think you lost the game for them. What if it happens again?”

At the next game, Jacob has an open shot in an important moment. His heart starts racing, and his Anxiety Monster tells him, “Don’t shoot. You’ll miss again and everyone will blame you.” Jacob passes the ball instead.

Jacob feels relieved — Whew, I didn’t have to risk missing. But without realizing it, that relief teaches his brain that avoiding the shot was what kept him safe. His Anxiety Monster has been fed.

Soon, Jacob starts finding more ways to avoid situations that make him anxious. He hangs back during practice, avoids taking important shots, and worries about games hours before they begin.

Before a playoff game, his Anxiety Monster tells him, “If you play, you might mess up and let everyone down.” Jacob complains of a stomachache and asks his parents if he can stay home.

Again, Jacob feels better once he knows he doesn’t have to play — but the relief doesn’t last. His world is beginning to get a little smaller as his Anxiety Monster gets a little bigger.

When the next basketball season arrives, Jacob tells his parents he doesn’t want to try out. “I don’t really like basketball anymore,” he says.

But Jacob does like basketball. Anxiety has slowly convinced him that giving up something he loves feels safer than risking the discomfort of failure.

This is how avoidance can quietly strengthen anxiety. What begins as an understandable and natural attempt to feel better in the moment can gradually keep a child from the activities, relationships, and experiences that matter to them.

This metaphor is helpful not only for understanding how avoidance fuels anxiety, but also for externalizing anxiety. Externalizing helps children see anxiety as something they experience, rather than something that defines who they are — reducing shame and self-blame while making anxiety feel more manageable. Giving the metaphorical Anxiety Monster a name can help children further separate anxiety from themselves and make it easier to challenge with exposures and other CBT tools.

Once children and families understand how anxiety works — and learn to separate the voice of anxiety from their own thoughts — they can start to feel more confident challenging the Anxiety Monster. Proven treatments, including CBT strategies such as exposure, help children gradually face the things anxiety encourages them to avoid. Just as avoidance can feed the Anxiety Monster, facing fears little by little can begin to starve it. Over time, the Anxiety Monster becomes less powerful, allowing children to feel more confident and in control.

As children learn to separate themselves from their anxiety, they can also understand that feeling uncomfortable doesn’t necessarily mean something is bad, wrong, or unsafe — that discomfort can be a sign they’re doing the hard work of pushing back against anxiety. Little by little, children can begin reclaiming the activities, relationships, goals, and experiences that anxiety may have taken away.

If your child’s Anxiety Monster is getting bigger rather than smaller, you don’t have to figure it out alone. If you need to talk to someone right away, the Nebraska Family Helpline and Boys Town National Hotline are both available 24/7 and can connect your family to local providers.