Fear

An aversion to a person, place, activity, event, or object that causes emotional distress and often avoidance behavior.

Fear is defined as emotional reaction related to a person, place, activity, event, or object. Symptoms of fear may include stiffening and crying in the newborn; crying and avoidance of the feared person or object in toddlers; bodily symptoms such as a stomachache or headache in children or adolescents (especially regarding school or separation anxieties); anger, avoidance, and denial of the fear in adolescents and teens; and panic reactions—sweating, trembling, fast heartbeat. While normal fears tend to be experienced in phases and tend to be outgrown by adulthood, abnormal fears are those that are persistent and recurrent, or fears that interfere with daily activities for at least a month. Abnormal fears, including extreme separation anxiety, school phobia (being afraid to go to school), or extreme social fears, may indicate an anxiety disorder.

More than 50% of children experience normal phobias (fear of a specific object) or anxieties (more general worries) before they are 18 years old. For adults it may be helpful to distinguish between rational fears, such as fear of snakes or guns, which are survival mechanisms and serve to protect a person from danger, and irrational fears (phobias) which cannot be traced to any reasonable cause. Many childhood fears fall somewhere between the rational and irrational, occurring in phases as the child or adolescent is exposed to new experiences and as both cognitive reasoning and the capacity for imagination develop. Whether a child's fear is considered normal generally depends on his or her age, background, and most importantly by how much it interferes with his or her normal daily activities. Fear of water may be considered normal in a child who has never learned how to swim, but it might be considered abnormal in the adolescent son of a coastal fisherman.

There are many avenues that parents, guardians, and teachers can follow in responding to childhood or adolescent fears. The first step is to assess whether the fear is age-normal. Following are some normal fears and their approximate ages of occurrence.

Other fears not associated with any specific age are fear of visiting the doctor or dentist; fear of traveling by car, boat, or plane; and fear of going to school, sometimes called school phobia. School phobia often results in a refusal to attend school and is caused either by a deeper separation anxiety or fear of some aspect of the school environment. Many children experience a mild, temporary form of school phobia. If refusal to attend school lasts longer than three days in a row, however, parents might want to seek the help of a school counselor in addressing the underlying problem(s). In earlier grades the many new experiences of school may contribute to the phobia—being with strange authority figures, older children, submitting to a new rule system, publicly performing or speaking. In later grades the social and academic or extracurricular pressures may create additional fears.

The most significant factors in overcoming fear are identifying the fear, developing a sense of control over the feared environment (autonomy), and envisioning alternatives to the feared negative outcomes. Forcing children to perform activities they are afraid to do destroys, rather than builds, autonomy and self-confidence. If a child refuses to do something or explicitly voices fear, it should be taken seriously and explored through questioning and discussion. Ask the child or adolescent what change can be made to accommodate the fear and make him or her feel more in control.

Some theories hold that reading scary picture books functions as a courage-building tool for children and helps them face their fears in a controlled environment—they are free to turn the page or to remind themselves that the monster is not real. Horror stories or movies may serve the same purpose for teens (though children do not have the same level of choice in leaving the theater and should not be exposed to disturbing movies). Controlled exposure—i.e., gradually introducing the child to the source of fear—often provides the necessary structure for addressing most fears. For instance, treating a child's fear of water might begin by incrementally filling the bathtub higher and working up to wading in a small stream or baby pool. Treating or preventing school phobias may require repeated short visits to the school accompanied by the parent, and brief meetings or gatherings with teachers and/or groups of other children before leaving the child alone.

Before, during, and after exposure to the source of fear, the child can begin to imagine controlling the environment and his own reactions in other ways. Creative visualization can be used, for example, to imagine a switch the child can use to control his fear when visiting the doctor or dentist. A comforting ritual, a familiar object, or thoughts of a beloved person can be used as a good luck charm before embarking on a scary trip or performing a task such as speaking in class or sleeping alone. Relaxation techniques can also be taught.

Infants—Fear of being dropped or of falling; most are also afraid of loud noises.

Toddlerhood/Preschool—Fear of strangers, animals, bugs, storms, darkness, people with masks, monsters, "bad" people; fear of being separated from parents or attachment figures (i.e., age-appropriate separation anxiety); fear of being left alone, especially at night.

School-age years—Separation anxiety; fear of death and violence (war, murder, kidnapping); anxiety about school achievement.

Adolescence—Anxiety about school achievement; fear of social rejection and related worries; sexual anxieties.

Brown, Jeffrey. No More Monsters in the Closet: Teaching Your Child to Overcome Everyday Fears and Phobias. New York: Crown Paperbacks, 1995.

Joseph, Stephen M. Mommy! Daddy! I'm Afraid: Help Your Children Overcome Fears That Hold Them Back in School and at Play. New York: Collier Books, 1979.

Kellerman, Jonathan. Helping the Fearful Child: A Parent's Guide to Everyday and Problem Anxieties. New York: Norton, 1981.

Lobby, Ted. Jessica and the Wolf : A Story for Children Who Have Bad Dreams. New York: Magination Press, 1990.

Sanders, Pete. Feeling Safe. New York: Gloucester Press, 1988.

Warren, Paul, and Frank Minirth. Things That Go Bump in the Night : How to Help Children Resolve Their Natural Fears. Nashville, TN: T. Nelson Publishers, 1992. (This book also addresses Christian aspects of fear.)

Note: For titles of children's picture books on specific fears, look under the subject bibliotherapy at your local library or bookstore.