When Molly was 10 months old, her parents took her to a Halloween party with other young families. While the other babies explored their surroundings, Molly sat and watched. She’s always been cautious, says Molly’s mom, Rachel. Early on, though, the little girl’s shyness didn’t raise red flags.
By the time Molly turned 4, however, life was getting harder — for everyone. Even though she loved to dance, Molly refused to engage in class without her parents nearby. She clung to her mom in public and became whiny and upset. The family began avoiding outings. Dance classes ceased, as did gymnastics. Playdates were rare and had to be held in Molly’s home. “Our world was getting smaller,” says Rachel, who asked to use only first names to protect her daughter’s privacy.
Molly’s therapist was employing classic cognitive behavioral therapy, a hands-on approach to changing patterns of thinking or behavior and the current gold standard for treating anxiety in adults. Another promising therapy for treating anxiety in young children is a modification of a program geared at strengthening the parent-child relationship. In that approach, known as Parent-Child Interaction Therapy, or PCIT, a therapist sits behind a one-way mirror and directs parents in their interactions with a child through earphones. The thinking is that, rather than deal with their child’s anxieties by avoiding scary situations — a common survival strategy — parents can learn with the child how to manage those fears.
Cognitive behavioral therapy — which also will include parents when used for young children — is thought to work by aligning the feeling and thinking parts of the brain, the amygdala and the prefrontal cortex. In scary or new situations, the amygdala sends a fear signal to the prefrontalcortex. When things are working well, the prefrontal cortex deciphers the situation and sends a message back to the amygdala along the lines of, “Hey, chill out.” But when anxiety strikes, communication between the amygdala and the prefrontal cortex breaks down, and the “chill” message never reaches the amygdala. The feedback loop breaks down.
So cognitive behavioral therapy aims to tamp down the amygdala’s panic response — by making a scary situation, like going to a friend’s house, routine — and amp up the prefrontal cortex’s calming effect. Knocking the amygdala down a notch should in theory help it sync better with the prefrontal cortex. Essentially, says Kate Fitzgerald, a child psychiatrist at the University of Michigan in Ann Arbor, the brain learns “to feel the fear and [go ahead] anyway.”
Read the full article at Science News.