Wed, February 15, 2017

Is Anxiety in Young Boys the New Normal?

WENDY MOGEL, Clinical Psychologist and Writer

I’ve been in practice for 35 years. In the old days, most parents of lower school boys came to see me at the recommendation of the school. The student was behind in reading and writing, or restless, devilish, or puzzlingly out-of-sorts. Today, most parents of young boys are self-referred. The most common presenting problem? Their sons’ worrisome worries.

These anguished parents use such similar phrases that I feel like I’m listening to actors reading sides for a casting agent. Here’s Kate, mother of six-and-a-half-year-old Spencer and four-year-old Bella:

Spencer insists that one of us stay in his room with him while he gets dressed for school.

Even if he wants something badly—a Lego part or his Wii controller—he refuses to go upstairs by himself.

He asks so many questions about his homework that I usually just sit with him the whole time.

He’s miserable if he knows we’re going out for the evening. If we leave before he’s asleep, he begs the babysitter to let him call.

He has bad dreams and wants to get in our bed. If we say no, he gets in bed with Bella.

And he’ll only consent to sleepovers if they are at our house.

I know what you’re thinking: spineless, overprotective, sissy parents create entitled, bratty, babyish boys. What else is new? Or, if you’re inclined toward more refined means of evaluating childhood mental health problems: Perhaps Spencer was born with an unusually sensitive temperament, or has faced a painful life experience: an illness, the death of someone near, money or marriage troubles in the family, a wrenching move to a new neighborhood or school. Maybe something fishy is going on in the family and this troubled and troublesome boy is “the identified patient.” Or has he observed or experienced something TERRIBLE and no one knows?

But as I’ve discovered through hours of probing and pondering, neither hyper-parenting nor early trauma is the key to understanding this new trend. Many children tolerate parental overprotectiveness and over-involvement without becoming chronically anxious, and the majority of these young boys have what psychologists call an “unremarkable” family history. But they do have two seemingly unrelated characteristics in common.

As heartbreaking, pathetic, or annoying as their parents find them to be at home, these boys’ teachers think they are terrific. When I inquire about what transpired at the last parent-teacher conference I hear more “sides.”

Oh, the teachers LOVE him! They say he’s a great addition to the class. That he jumps right in. Is a leader and kind to the other kids. They so enjoy his sense of humor.

Frequently the parents follow these comments with: Spencer? We thought his teacher might accidentally be describing another kid in the class.

The other common characteristic: As responsible, capable, enthusiastic, and thoughtful as these boys are at school, they cannot be relied on at home. They can’t even remember to flush the toilet.

Digging Deeper: The View from the Nurse’s Office

Around the time that I was struggling to make sense of this new triad—yeoman student/nervous son/non-flusher—I was preparing to give a talk at the Sacred Heart Schools in Chicago. Gathering background information about the community gave me the opportunity to talk with Joan Callahan, the schools’ longtime nurse. Joan is a genius. Her ability to see the world from the students’ perspective and to provide them with comfort without coddling led me to consider that school nurses might be the ticket to understanding these changes. Unlike the classroom teacher’s panoramic view of a single age cohort of students or the intimate and sustained but tiny sample size on which parents base their theories about what children need, nurses have a unique lens, one that is both broad and long.

So, during my visit to Sacred Heart, Joan organized a roundtable discussion with a varied group of independent school health professionals. The more I heard from these frank, wry, wise women, the more I wanted to hear.

Immediately upon returning to my office in Los Angeles, I teamed with the National Association of Independent Schools to launch a research project. Nancy Raley, then vice president of communications, graciously sent a query to member schools inviting “the school nurse or staff person students seek out to care for their splinters, tummy aches, or heartaches . . .” to participate in phone interviews that would be recorded, transcribed, and analyzed for trends.

Here’s what I learned. While there have always been “frequent fliers” in the school nurse’s office, a greater proportion of today’s students seek care from the nurse, they present their symptoms with far greater urgency and at younger ages, and more and more of them are boys.

Some boys are near frantic over everyday ailments. Others complain of such exotic symptoms the nurse suspects vigilant eavesdropping has taken place at home. I think it’s a concussion. Can I try to follow your finger with my eyes. Oh no! I can’t! They describe boys with “hyperacusis” (abnormal sensitivity to loud sounds) who beg to be alerted before a fire drill. Others fear thunder or the darkening afternoons of winter. The nurses describe these students as “hyper-reactors”—“They come running to my office acting like a hangnail is an amputated limb.”

Following the Clues to the Source of the Problem

Putting together the observations of the parents, teachers, and nurses, the boys’ anxiety equation became clearer. Most boys valiantly hold it together through the school day (those needing a refill wisely slip into the nurse’s office for a bit) and then soldier through their extracurriculars or practices. But once they hit the soft landing of home, drop their backpack by the front door, and remove their literal or figurative tie and jacket, or jersey and cleats, these admirable young men regress into needy, irritable puddles of babyishness.

I spend a great deal of time working in therapy sessions with parents to first understand the sources of their son’s polarized behavior and, second, to offer suggestions about what they can do at home to raise resilient boys. But part of the work needed to reverse this trend—I now see, thanks to school nurses—falls to schools. How can schools shift their expectations and shape environments that will help boys sustain their exuberance, confidence, and accountability?

First by understanding that helpless boys are not born but made.

The Need to Engage

Michael Tomasello, an American developmental psychologist and co-director of the Max Planck Institute for Evolutionary Anthropology in Leipzig, uses observations of spontaneous, independent acts of helpfulness and cooperation in toddlers as evidence that altruism is hard-wired, an instinct, the necessary basis of all community building. In his experiments, toddlers—accompanied by their moms, who sit in a chair nearby—play in a quiet room. Enter an unfamiliar adult carrying an armful of magazines. The adult simply looks at a cabinet on the floor, and with no further cue every child—without turning to mom for permission, approval, or assistance—walks across the room to open the cabinet door, allowing an adult to unburden himself of his load.

Wishing to study the strength of this intrinsic altruistic motivation, Tomasello litters the path between child and cabinet with alluring obstacles (bright attractive toys and balls). Same response. Every child, some as young as 12 months old, sizes up a need, instantly stops playing, and helps out.

Neuroscience research provides more evidence. Imaging studies show that contributing to community and feeling purposeful causes the reward centers of the brain to glow and releases all the good drugs: dopamine, oxytocin, and endorphins. The independent, resourceful toddlers in Tomasello’s lab are getting high. But none of this is really news. Little ones have always announced with satisfaction: I helped! I do it myself!

So why is it downhill from the nursery? What causes helpful toddlers to morph into helpless second-graders? Why are our big boys in a panic over a loose tooth? What has changed so dramatically in their lives that they are willing to risk provoking parental contempt and exchange opportunities for dignity and pride with displays of dependence and distress?

The Weird Ways of WEIRD Societies

David Lancy in his eye-popping new book, The Anthropology of Childhood: Cherubs, Chattel, Changelings describes how the current norms and expectations of parents in Western, Educated, Industrialized, Rich, Democratic (WEIRD) societies contrast with those of America of the past, and with all other cultures around the world. He describes how the “chore curriculum” for boys in non-WEIRD societies provides them with social standing and identity, but is designed in a practical fashion with respect and recognition of boys’ need to move.

Boys long to run errands, patrol distant fields, hunt in the bush, Lancy writes. And if denied this opportunity, trouble awaits.

If schools wish to reverse this rising tide of anxiety in boys, it helps to be aware of its sources—to understand the problematic cultural trends at play—and work to mitigate them.

Consider boys’ anxiety as energy, imagination, and adventure turned against the self.

I often make a distinction between “good tired” and “weary” to parents of boys. In school, was there an opportunity for derring-do, enough time spent outdoors, a sense of mastery gained through his own desire and will, and not through the efforts of a teacher, tutor, or coach?

It’s not reasonable or fair to expect small boys to sit for long stretches of time doing desk work, following adult directions, being physically still and mentally focused on academics. The boys use up so much energy keeping their energy contained. Good schools understand the value of time reserved for imaginative, creative, and rough-and-tumble play and opportunities for self-directed physical, mental and social problem solving.

Sorry about the economic downturn, but if your school has lower admission standards for boys than for girls, you’re playing a game of emotional roulette with young minds.

Many schools have unwritten policies of accepting siblings, legacies, sons of generous donors, or even sons of tireless yet uncomplaining, undemanding volunteers. But if you are admitting a child just to fill a space or to please a parent or donor—without carefully considering the boy’s ability to thrive in your school—consider this offer of admission a health risk for the child.

Follow the lead of sensible curriculum disruptors using both old-fashioned and pioneering models.

Many independent schools are experimenting with experiential learning models, developing problem-based learning activities, building innovation spaces and maker or tinkering labs, getting students outside of the classroom and into the field. All of these efforts benefit boys, especially those who learn best by doing.

Study the pedagogical philosophy of activists like Gever Tulley and Doug Stowe. Tulley is a “tinkering” advocate and a school and camp administrator who puts power tools in the hands of second-graders. (His popular TED talk is called “5 Dangerous Things You Should Let Your Kids Do.”) Stowe runs the “Wisdom of the Hands” program at the Clear Spring School in Arkansas. It’s based on the principles of Sloyd, a program of industrial arts training for children that began in Sweden in the 1870s. Sloyd emphasizes the value of nontraditional activities in daily curriculum including sleight of hand, woodworking, paper folding, and sewing.

Reread Maria Montessori. Study the beautifully articulated age-by-age goals laid out by the Waldorf schools. Take care that our children do not lose what Virginia Woolf referred to as “the great Cathedral space” of childhood.

Follow the lead of enlightened boys’ schools.

Here’s Julie Seymour, a school nurse at Fairfield Country Day School in Connecticut: “We’re geared toward the way boys learn. We have plenty of recess at every grade level and sports everyday. The boys are allowed to move. Our new desks and chairs all swivel and they have a foot swing.”

Boys need room for high-spirited self-expression. “They act silly. They sing in the hallways. We have an incredible music program here and everybody has to do everything: sports, music, arts, and academics. So it’s okay to be singing. A lot of things are okay here because the boys don’t even know better and they’re not made fun of for anything.”

In order to reach parents on their favored channel, offer insight into the social and emotional needs of boys in a variety of forms: at back-to-school night, during parent coffees, in a letter from the head of the lower school, as part of a speaker series.

It helps to be creative here. The school counselor of an academically elite independent school, frustrated by the very poor turnout for middle and upper school parent education nights, devised a clever strategy. She titled an upcoming event: “How to Get Your Child into College: Surprising Aspects of Adolescent Social and Emotional Development.” When an overflow crowd showed up, she suspected that most parents never read the sub-title.

Requiring boys to demonstrate consistent and reliable citizenship reduces anxiety.

We shortchange boys if we don’t require a little helpful servitude. At home, little ones want to fold the socks, they want to help, but we’ve moved them to the point where they say, “Help me, please.” The kindergarten teachers say, “Please make sure that the children carry their own backpacks and they walk into the classroom themselves,” and then the parents are carrying the whole child plus the backpack into the classroom.

Schools can counteract this trend by requiring boys to do chores in school. Let them be helpful. Anyone old enough to remember when being selected to clap the blackboard erasers together was considered a high honor? Give boys a task, the necessary tools and trust (that they can handle an important job) and they grow stronger. At Waldorf schools, young students wash and chop vegetables for cooking projects, stand on ladders to hang art, scrub their boots so that mud is not tracked into the classroom, water the plants, write the day and date on the blackboard, and, like sailors learning to tie knots, wind up all the jump ropes neatly before putting them away at the end of yard time.

Build confidence by being enchanted with his enchantment.

Ian McEwan, in his novel The Children Act, describes how an eight-year-old’s release of a “a silvery stream of anecdote, reflection, fantasy” created in the adult listener a “wave of love for the child (that) constricted her throat and pricked her eyes.”

It helps enormously to let boys run with their budding intellectual interests.

Did you know there are 450 kinds of sharks? The biggest is the great white. It’s 60 FEET LONG! But sharks kill only one person a year! Dogs kill 200 people a year! And the types of sharks are mako, hammerhead, great white, blue, bluntnose, cookiecutter, goblin, leopard, nurse, dogfish. Do you know what country has the fastest Wi-Fi in the world? South Korea. It does. South Korea. We are so slow. We’re behind Lithuania and Latvia and Portugal. Way behind.

Information is the conversational channel boys tune into. So educators would be wise to sample from the menu of topics boys find engaging and deem important.

Conversing with little boys requires a surprisingly delicate touch. A good tactic is to act a bit ignorant, seeking their expert knowledge no matter how meager. Being enthusiastic and captivated is a deposit in the bank of goodwill. Say: “Interesting!” “What else do you know about that?” “Are there other tricks spies use?” This esoteric, passionately communicated information is their gift to you; by asking for details and appreciating the answers, you show your gratitude.

Listen to the savvy nurses.

Wendy Mogel: The nature of the problems they’re coming in with, has that changed?

Joan Callahan: Stomachaches and headaches are huge. I’m just amazed at the number of kids that come in with headaches.

W.M.: What’s your sense of the cause?

J.C.: I think both are very stress-related. It’s tension. I have a thing we call WOW. It’s water, oxygen, wait. So when they come in, they know they’re going to drink 10 little cups of water, they’re going to take 10 deep breaths, and then they have to wait 30 minutes to let me know how they are feeling. I always take a temperature on a kid with a headache, unless I know that they’re really always getting headaches, because oftentimes headaches are the first fever thing. So they get their temperature taken and then it’s time for WOW. Take your 10 drinks. For a lot of kids, that’s all it takes, just 10 drinks of water and 10 deep breaths and it just seems to dissipate.

W.M.: What percentage of the headaches disappear?

J.C.: I would say 80 to 90 percent. I also give out ice all the time. We call it magic ice. They usually just get a cup of ice and we talk about the time of day it is. Is it low blood sugar? Did you eat breakfast? Just to check. Two minutes of focused, “You’re the only important person in my life right now, so I will sit and talk to you for two to three minutes.” We’ll sort through things and that alone just seems to take the edge off.

A brief interlude of adult concern, compassion, and calm can yield a big payoff in anxiety reduction and a willingness to jump back into the day.

The nurses are sophisticated diagnosticians, alert to the symptoms of previously overlooked disorders of sensor-motor integration, allergic reactions to food and latex, the latest concussion protocols. The frequent fliers, hyper-reactors, and students suffering from a variety of general and specific forms of “health anxiety” are not physically ill but they are, for certain, suffering.

When schools regularly check in with their nurses, they can trace more of these symptoms back to institutional causes—then work to mitigate them.

The Anxiety Paradox

Are the boys anxious because their lives (no matter how privileged and successful on the surface) are too stressful? Or are they playing the anxiety card because, just as exaggerated fear-mongering news headlines capture the attention of a distracted, jaded public, a young boy’s expression of fear, in the proper dose, elicits attention, empathy, and care even from busy, distracted, preoccupied adults?

The answer is both.

Think of a boy-friendly curriculum—the opportunity to do exciting and important physical and mental work and shoulder responsibilities beyond grades and scores—as anxiety-proofing and dignity-promoting agents.
Too many boys are suffering in school. Without change I’m afraid they are going to file the largest class action suit in history against us. They’re going to sue us for stealing their childhoods.

Wendy Mogel is a practicing clinical psychologist. She is the author of The Blessing of a Skinned Knee and The Blessing of a B Minus.

This article first appeared in the Winter 2016 issue of Independent School, published by the National Association of Independent Schools. It was also included in the 2016 Edition of Parents League Review. ©2017 Parents League of New York. Get the current edition of the Parents League Review free here with a family membership. Or purchase it directly here.

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