My 14-year-old daughter is fearless and reckless. She charges down the soccer field like there is no tomorrow and plays basketball with her two older brothers, who are a head taller than she is. I admire that; I was shy at her age. But she is deathly afraid of dogs. That is probably because a neighbor’s dog nipped her when she was a in kindergarten. We would really like to get a dog (her brothers want one) but how can we help our daughter get over this fear? Or should we leave well enough alone and not even try? – Mom in Boston
Dear Mom in Boston,
I love hearing about your brave and tough daughter! She sounds like a wonderful kid. And I’m sorry to hear about her fear of dogs. One of the very strange things about anxiety is how irrational it can be. You have this small fearless daughter who faces physical challenge with ease, but then seems in a total panic when she experiences a dog. This is exactly how anxiety works.
In my practice, I see kids who will do the tallest, loopiest roller coaster at an amusement park, but completely panic when they are asked to meet with their teacher to discuss a low grade on a test or a question about an essay. Anxiety doesn’t always make sense. In fact, that’s part of how we determine whether a client has clinical anxiety versus regular (and necessary) anxiety.
In Cognitive Behavioral Therapy (CBT) we think of anxiety as an overestimation of risk and an underestimation of resources. Your daughter sees dogs as more dangerous than they are and does not feel like she has the ability to cope with the danger.
Luckily, she can learn to change how she thinks about dogs with a combination of exposure work (slowly learning to face the fear in a structured and safe way) and coping strategies.
There is no reason you can’t have a dog in the future (I think dogs are great for kids!), but there is some work to be done ahead of time. My guess is that you can slowly do this work with her, but if you aren’t making progress, I would look for a therapist who specializes in CBT and specifically exposure therapy. And, I am making the assumption that your daughter wants to get over this fear, and that she wants a dog. If that is not the case, I would not recommend the following approach.
Identify the Fear
The first step is to identify the biggest fear about dogs. Sometimes it’s hard for kids to name the fears, they often don’t even let themselves think about their worst fears, but naming the fear is crucial.
In CBT we have three questions that we use to try and get to this fear.
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- What is the very worst that can happen? (encourage her to name the absolute worst case scenario- no matter how embarrassing or scary it is)
- How likely is that thing to happen?
- If it happened, how would I cope?
Build a hierarchy of exposure
Once she has named the fear, and how she would cope, we begin to build a hierarchy of exposure with a dog having the ability to bite her neck at the top. To build the hierarchy, you may find it helpful to have her use the feeling thermometer included. As you work to build the exposures, you use the thermometer as your way to rate them. “On a scale of 1-10, with 10 being the worst, 10 being the dog biting your neck, how scary would it be to…..”
Once we have the hierarchy in place, we begin to plan the actual exposure work. It is crucial that your daughter gets to always be in control. If she wants to back out, she can. You can still push her to keep going, but she always has the final say.
Tools to manage her emotions
The final step, before beginning the exposures, is for your daughter to build some coping tools to manage her emotions. Everyone has different coping strategies that work best for them, but here are some ideas for her to try.
Deep breathing: Deep breathing is entirely under-rated. It is one of the most effective ways of managing our stress response, but because it is so common, kids tend to dismiss it. I like to remind kids that Navy Seals use Box Breathing (breathe in for 5 seconds through nose, hold for your breath for 5 seconds, slowly exhale through mouth for 5 seconds)
Coping thoughts: These are my go to strategy for facing fears. Thoughts she might use include: “Feelings are temporary. This feeling will end.” Or “My anxiety is making this seem bigger and worse than it really is, what are the facts of the situation? Am I truly in danger?”
Visualization: There’s a reason sports psychologists use visualization with world class athletes- it helps. Prior to the exposure, have your daughter visualize the experience going well- from start to end. Have her describe what it would look and feel like to have the experience go well.
Exposure isn’t new or magic, but it is the most effective way of working through fears. It is necessary to practice multiple times a day at first, frequency matters in exposure work (needle phobias are hard to treat because we don’t get shots every day). The more your daughter practices, the easier it becomes.
Sincerely,
Elaine Nebolsine, LCSW
National Association of Social Workers (NASW) member Elisa Nebolsine is a licensed clinical social worker and author specializing in cognitive behavioral therapy (CBT). She’s the author of Your Amazing Teen Brain and The Grit Workbook for Kids. Washingtonian Magazine named Nebolsine a top therapist in four different areas. Nebolsine frequently consults and presents for schools, mental health organizations, nonprofits, and other private practices looking to improve their implementation of CBT with youth.
