Strategies for dealing with obsessive anxiety

Post Reply New Topic

My son has an obsessive fear of aircraft. He is gripped by fears of an apocalyptic war and imagines that any and all aircraft may be about to rain destruction on the area. This is a fairly big problem because we live in the greater New York City airea, and hear aircraft on approach or departure from Newark Liberty, Teterboro, Morris Municipal, Laguardia and JFK airports... It's a busy piece of sky.

He had this very badly in the spring and summer, but was convinced by a a rational argument about the relative power of USAF and Navy combat aircraft to deter any foreign attack. He was relieved to learn that the US had airbases and carriers all over the globe, ensuring that any military trouble happened far away. We went so far as to visit to an an air show at McGuire-Dix-Lakehurst, which he quite enjoyed. He said it was one of the best days ever.

There has been no sign of the anxiety for months, until the last couple of weeks--he told me the other night that the fear has been slowly coming back--especially at bed time. He can usually make it go away, but sometimes a loud jet passes overhead just as he is struggling with it and he is gripped by fear.

Any suggestions about what to do to help him?

Would stories like Chelsey Sullberger's heroic landing in the Hudson help him at all? Maybe if he knew that most of the planes he was hearing were piloted by people like Mr. Sullenberger he would feel more comfortable? Just a thought

Could you tell him that most planes are carrying people to see their families and loved ones? My kids would never be able to see their grandparents were it not for airplanes.

I wonder if you could find examples of typical flight patterns in your area: I know you won't be able to capture all of it, but if you could show him schedules for the main airlines at JFK, Laguardia, Newark at least to show him the extent of benign flights in your area. Maybe a mountain of data will help with the anxiety?

Thank you for the great suggestions, Bombaloo. InThisTogether and ASDMommyASDKid!

I already tried the grandkids and grandparents, and he knows this, because he has flown to visit people--but the news upsets him. He is aware of the nuclear programs in Iran and North Korea... Las night his sister gleefully ran to him as he got into bed to say that she had heard a news bulletin saying China was surprised by North Korea's missile and warhead tests--and it took me two hours of holding his hand to get him to sleep.

The Sullenberger story is a great idea! I will try that.

The charts for this area are very complicated, but I found this:
http://www.wolframalpha.com/input/?i=flights+overhead

That will let him know exactly which engines he is hearing. "American 2207" is much less frightening than a roar that could be anything with engines.

Have you taken him to the Intrepid? I'd go without him first to check it out - because there is a lot of it that IS about war and there are parts you might want to skip. However, there is a "petting zoo" of aircraft on the hangar deck that might demystify them and make them easier for him to tolerate.

In the Chicago area, there is an actual airplane body set up over the miniature train exhibit, so that kids can get a sense of what it is like to be inside a real passenger airplane. IDK if there's anything similar in New York, but I think positive exposures can go a long way to helping with anxieties like these (we took DS before his first flight, it helped a lot.)

We struggle with DS's irrational fears all the time - one of the things that happens is that eventually, he will pick something to be scared of that we can't make go away. For instance, once we had logically eliminated the possibility of monsters in his room, he suddenly became scared of ants and flies (which do, sometimes, show up in his room, although rarely.) I think DS needs to find a "reason" to be anxious: he often doesn't see anxiety coming, and will then find something to attach it to, just so it makes sense in his head.

A technique we sometimes use with him: if there is a change in his schedule, I remind him that it might make him "feel weird" and that the feeling is normal and will go away, because it is just the way he reacts to something being different. Sometimes we find that it was because of a social interaction he didn't understand...but he doesn't connect the anxiety to upsetting things that happened to him. I help him connect those dots, and sometimes that makes the irrational fears subside, too.

This makes tons of sense. I suspect I do very much the same thing!

Thanks for the insight.

My son has been on a long flight to the caribbean and spent the night on the Intrepid. It's a tougher challenge than it seems.

The wolfram alpha thing helped today. We saw that the flight that was making noise overhead was landing in LaGuardia and had left from Fort Lauderdale earlier in the day. He ignored planes for the rest of the day!

What helped us a lot, is using the ABC-model of anxiety and stress in cognitive therapy.
It's fairly easy to explain, I got my six-year old to understand it.
The model basically shows how, in a certain situation (a) fear and anxiety (c) are induced by what we think (b), not by the actual situation itself. Once you understand that it isn't the situation that is causing distress, but your thoughts and beliefs, it's a matter of rationalising. You need to 'replace' the irrational thoughts by rational ones. This sounds hard, but if you break it all down, it's quite feasable.
You, or better, he himself, just needs to identify exactly when he gets anxious, what it is he thinks at that moment, and how it makes him feel.

So that would look more or less like this:
A- (sound of) airplane
B- the apocalyptic war has begun and we are all going to die
C- I'm scared

Then you question B. In this case, I think you need to focus on probability vs possibility. This can be done by asking, 'what is the evidence for the thought being true?' and 'what is the evidence against this thought being true?'. It is useful to do this in a quite a structured manner and to write it down. Just keep asking questions. there's a lot of online resources to help you ask the right questions. Once you're there, he should try to 'replace' his thoughts about the apocalypse with a rational one that doesn't cause anxiety.

It got my son over his water fobia. He's still scared, but at least he's able to get in the water now. The good thing is, you can use it for anything. The technique offers you a deeper understanding of anxiety, which in itself, reduces it.

Thank you, sidney!

This is an excellent framework for working at this--I am going to start using this immediately.

In fact, I think I have been using these elements, but without the organization this system provides.

Last night I had to sit by his bed between 11pm and Midnight, calming him down so that he could sleep. He worked himself up after bed time and only when he was in full panic screamed for help.

I convinced him that the fear of the engine sounds was irrational using the software that let us see flight information. Then he asked, "why does my mind keep giving me these kinds of thoughts?" I said I did not know, maybe he was stressed about something else and it was coming out that way, or maybe he was just a person who tends to worry, like his dad and that he would not worry so much about worrying thoughts once he got used to them coming and going.

I suggested that he not think about why the scary thoughts were coming, but instead think about something interesting and not scary instead. He has been very interested in atoms lately and made a little film about the periodic table of elements, so I talked about that with him. As we discussed the way that atoms sit at the juncture of physics and chemistry, he relaxed and began to smile.

I can see that the whole A,B,C recognition process was there, as was the replacement of irrational thoughts with rational ones. We got to this by hit and miss last night, so I am looking forward to getting straight to it methodically next time.

Thanks again for this excellent write-up of the technique!

You're very welcome. I'm a big fan of the technique myself . And it sounds like your son is very receptive for it, judging by his question. He seems to be aware of the process even before it was explained to him.

In general, I think people on the spectrum are particularly receptive to cognitive therapy, because it is an evidence-based, rational, analytical view on thought processes.

And in response to his question, what his mind is doing is called 'cognitive distortion'. There's about 9 different types of it, and I suspect this one to be 'magnification or catastrophizing'. I'm not sure, though.

This is an interesting point. Throughout my life, I have had intermittent periods where I suddenly notice my pulse rising and a feeling that I need to flee. They are never connected to anything, so a very long time ago, even before I knew anything about ADHD or ASD, I told myself, basically, that there was a short in my wiring, and that it WASN'T anxiety, just a misfiring system. I avoided attributing it to anything and just carried on with whatever I was doing. Later in life, I had a friend with issues with anxiety and in talking to him, I became convinced that the same thing was happening to him, only instead of just recognizing it as a physiological state, he insisted on attaching it to some psychological meaning, which would then push him to full blown anxiety.

Once I was studying the relationship between eating disorders and ASD and I came across an interesting article about ADHD, not ASD, and the clinicians were explaning that a disproportionate number of their clients with binge eating had previously undiagnosed ADHD. They hypothesized that the usual feelings of restlessness experienced by many with ADHD were being misperceived as anxiety and leading to binge eating to try to cope.

None of this really helps the OP's son, but it does bolster the idea that he may be creating a plausible reason for his internal state.

You might also want to read up on Ironic Process Theory. It will help your son understand why trying not to think scary things will actually make him think scary things. http://en.wikipedia.org/wiki/Ironic_process_theory

Did I mention upthread that we've been helped a lot by the book "What To Do When Your Brain Gets Stuck" which is for kids with OCD? It does talk about OCD specifically, so we had to discuss it with DS in terms of having some of the symptoms of OCD but not enough to be diagnosed with it. It provides an excellent frame for this issue - it talks about "garbage thoughts" and how most people's brains just throw those away, but that mechanism doesn't work in some people.

Another version of this technique is the "it's not me, it's OCD" and "talk back to OCD" (which, in a very literal child with AS who isn't diagnosed with OCD may be a problem, so you may have to figure out language that works for you) http://www.netplaces.com/parenting-kids ... -enemy.htm

OCD and anxiety are common co-morbids with autism, and ordinary autistic rigidity can express itself in a way that edges over into OCD - the techniques we learned were very helpful for my son, even if we aren't sure if he qualifies for a diagnosis of OCD. We did very carefully explain that whil parts of the book didn't apply to him, we were going to use the techniques for the parts that did (my son has obsessive thoughts that are disturbing to him, and also rituals - but the two are completely separate things.)

Sidney, do you happen to know any good links for CBT that would be appropriate for using with elementary school children. I don't know if my son had quite the reasoning capacity for it or not, yet, but I would like to get a head start on it.

My son has anxiety about imagined disasters and safety issues. He may make a great safety engineer one day. He also has social anxiety during and after a meltdown.

Anyway. We had good success with a program called Turnaround from www.myanxiouschild.com. It's a little pricey, but worth it for us. It is a mix of CBT and Narrative therapy.

@ASDMommyASDKid: I'm sorry, the link I used was in my native language (dutch), it wouldn't help you much, but I'm sure there must be stuff on the web.
For the swimming, I made cards myself with pictures some of his favorite robots. Good robot for rational thoughts, bad robot for irrational ones. I know, talking about stereotypes😊.

I really like the robot idea. I can also see using the transformers. Thanks for the ideas.