Q: My 4-year old has suddenly developed pretty bad separation anxiety. She screamed and cried last night that she doesn't want "to be alone!!!"...Even just to sleep across the hall from us. This is my first child so I don't know how normal this is. She was born 11 weeks early and seems to get "overwhelmed" easily but this one is a new reaction. It breaks my heart. Any suggestions?

A: This is a tough issue to deal with.  It is always a challenge to know when to set limits and when to offer comfort and support.  The good news is that you can do both!  To start, children her age still have a difficult time identifying and expressing their feelings the way grown-ups do, so if you are able to both identify and validate what she is feeling, you'll begin to teach her these valuable skills and help her feel understood.  This sounds something like, "Honey, I know you're feeling nervous about being alone, and that's ok.  Everyone feels nervous sometimes.  Let's take some slow, deep breaths together and see if it helps."  This is just a first step, but it can help you deal with the frustration and concern that you may feel when this happens.  I also suggest implementing a structured reward system for giving positive reinforcement when she stays in her own room and/or does other activities independently.  For example, you can have a bag of marbles.  Each time she is successful, she gets to put a marble in a jar.  When she gets 10 marbles (or whatever you choose, but make sure it will not take too long to reach the bigger goal) she gets to do some special activity, a small toy or book or some other modestly bigger reward.  Don't be afraid to praise generously - there's no such thing as too much!  If combining validation, self-soothing and positive reinforcement does not succeed, you may want to have her assessed by a mental health professional just to ensure that there is not a bigger issue going on.  This will also provide another opportunity to learn and practice self-soothing/parenting strategies.

Answered by Jeff Palitz, MFT



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