Separation Anxiety

What is Separation Anxiety?

Separation Anxiety is a developmental disorder or stage where a child will get extremely
agitated and anxious when separated from his or her mother, father or other care-giver.

What Causes Separation Anxiety?

Separation anxiety results from a complex set of interactions between the child
and parent or care-giver. Every infant is different and every parent or care-giver
is different. Therefore, every interaction between the child and the parent is different.
As you and your child develop an emotional attachment toward one another, your child’s
temperament will partially determine how he or she will respond when there is a
separation between the two of you. It is not unusual to feel guilty about this common
occurrence.

In order for children to become anxious about separation, they must first establish
a significant attachment with their parent. The infant accumulates an increasingly
sophisticated repertoire of memories of the parent. In a short time, your child
will begin to compare these memories with the faces of other people that he or she
encounters. Your child may develop a certain level of stranger anxiety in addition
to separation anxiety.

Who gets Separation Anxiety?

Most often, children between 7 and 18 months of age will experience varying degrees
of separation anxiety. However, separation anxiety may return to children at an
older age during emotional or stressful times or during unfamiliar situations.

What are the Symptoms of Separation Anxiety?

A child suffering from separation anxiety may show extreme and excessive emotion
or distress when separated from his or her parent or care-giver. Since your child
has already had an opportunity to bond with you, he or she may have difficulty developing
a level of trust with a stranger in a short period of time.

As a child gets older, she or he may be exposed to new situations that require prolonged
separation from the parent, i.e. child care or school. The child may even resist
going to school or elsewhere due to the anxiety. There may also be a fear that you
will be harmed. Children may occasionally develop sleep problems, including nightmares
or sleep refusal.

How is Separation Anxiety Diagnosed?

Separation anxiety is a normal developmental condition. There are no tests for diagnosis.
However, if anxiety persists beyond age 2 years, an evaluation with your child’s
health care provider may be necessary.

How is Separation Anxiety Treated?

This condition can be quite disconcerting to parents and it is important to remember
that separation anxiety is fairly universal among babies and toddlers. It would
be natural for a baby to get upset when he or she has been separated from the individual(s)
with whom he or she has already bonded. The presence of separation anxiety should
be a clue that you have succeeded in helping your child develop normally in the
attachment process.

Your baby has been developing strong bonds with you over many months. It is important
to realize that the treatment of separation anxiety is a gradual process, often
requiring many months for your child to get comfortable with other caretakers. This
is partly due to your child’s developmental stage in life. In fact, developmental
behaviorists recognize that children may not develop object constancy (retain a
stable image of his/her mother when she is absent) until 3 years of age.

As adults, we look for familiar patterns to comfort us whenever we encounter a unique
or new situation. Our task with our young child should include the establishment
of familiarity. Ask a new sitter to visit with you and the baby before leaving your
child alone with him or her. Visit a nursery, church or health club center ahead
of time before you make the initial separation. Leave a picture of yourself as well
as a familiar toy, blanket (transitional objects) or a piece of your clothing from
home. However, once you leave the location, you should leave without returning repeatedly.
Creative mothers have used technology to bring themselves to their baby, making
home videos of themselves doing routine tasks so that they can leave the video with
a caretaker.

As a child gets older, it is important to prepare him or her for separations. Let
her know ahead of time that there will be a time of separation and ask her to partner
with you in finding familiar objects or circumstances that will help her to feel
more comfortable with the temporary separation.

References

Simons, RC; Pardes, H; Understanding Human Behavior in Health and Illness, 1977,
1985, Williams & Wilkens

Reviewed by: Noah Makovsky MD

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