Childhood Anxiety and The Fear-O-Meter

A mother sent me a picture of a drawing she made with her son. Labeled the Fear-O-Meter, it was shaped like a thermometer, with a scale from one to ten. One was marked “piece of cake,” six was “getting tough,” and ten was “out of control!” I use some version of a scale like this whenever I work with an anxious child (or adult). Sometimes the scale is from 0-100, and sometimes it has no numbers at all. Instead of numbers, there might be faces representing “just a twinge” and “about to explode,” or a color code from green to red. For children who don’t understand the idea of a step-by-step scale you can use hand gestures to signify low and high distress or big and small distress.

shutterstock_167465669In the language of behavior therapy, this type of scale is called a SUDS, which stands for subjective units of distress scale, but I like to have children name the scale themselves if they want to. SUDS are subjective because they capture a person’s inner experience. When an airplane hits some turbulence, I might be at eight, but the person next to me might barely be at two. When I am at eight I might hyperventilate and break into a cold sweat. Someone else might experience those symptoms at five. It’s highly individual, and that is what makes it a powerful tool. I have seen many parents try to argue with their children about their Fear-O-Meter number. Don’t! It’s the child’s subjective experience that counts.

Notice that the “D” in SUDS stands for “distress” instead of a more specific word such as fear or anxiety. This is deliberate. It gives children the chance to define their experience for themselves. Some children prefer to link their scale to a specific emotion, like the Fear-O-Meter, and that is fine. Others use a high number on the scale to refer to any strong unpleasant feeling, such as worry, anger, upset or panic. The low end of the scale is also deliberately vague. Low distress can mean complete calm, total relaxation, or happiness. The simple act of creating a Fear-O-Meter or SUDS scale together can help you and your child find a good way to talk about anxiety, worry, and fear. Let your child take the lead in naming the scale and labeling the points.

What’s Your Number? is the simplest way to use the SUDS to lower anxiety. Once you have the scale ready, just ask children to rate their current level of distress. It’s that easy. Even if the number is high, the act of searching inside for the answer to that question helps reset the Security System. When a person is anxious, the alert and alarm functions are highly active, while the rest of the brain isn’t doing much. Assignment of a number on the Fear-O-Meter activates different pathways of the brain, and that helps turn down the alarm.

Identifying the number on the scale is just the beginning. As children activate more of their thinking brain they can lower their anxiety even more. That happens when children describe a feeling in detail, name it, or draw a picture of it. Unfortunately, it’s hard to think when you’re anxious. Fortunately, the opposite is also true. It is hard to stay anxious when you engage in certain types of thinking, such as numbers and creativity (unless, of course, you have math or art anxiety!) In most people, numbers and creativity flow through different pathways of the brain than anxiety does. Therefore, when we activate numerical or creative thinking we lessen the hold of anxiety. Activation of the non-anxious brain can calm the alarm and boost the all-clear signal.

Parents often ask anxious children, “How do you feel?” or “What’s the matter?” But they may not be ready to put their feelings into words. Try asking first, “What’s your number right now?” Children often feel criticized when parents tell them to calm down. But they may react more positively if you say, “Let’s see if we can get that number down to where you want it to be.”

A conversation about the SUDS number can also prevent unpleasant arguments. Many parents try to tell their children, “You seem anxious or stressed.” The goal is to raise the child’s awareness, but it usually backfires: “You don’t know what you’re talking about!” Instead, try it this way: “Hey, I just noticed my number is getting up around five or six. What’s yours?” If the child’s number is high you can begin a good conversation about bringing in down, with no arguments. If their number is low you can express genuine curiosity, “That’s so funny, I would have guessed it was higher. Do you want to know what I saw that made me guess that?”

The Fear-O-Meter or SUDS is a useful way to measure the effectiveness of any anti-anxiety technique. A drop from eight to six on a ten-point scale is a tangible achievement, which gives children confidence that they can lower it even further. The goal is movement down the scale—don’t worry if it moves slowly. I remember one girl who announced proudly that she had lowered her distress from 97 to 96.34! Remember that your child “owns” the scale. If your daughter says she is at ten, don’t say, “You can’t be at ten, ten is a complete meltdown, you must be at seven.” If your son says he is at ten million, just take that number as the upper end of the scale: “Wow, ten million! That is enormous. I wonder if you can lower it to nine million nine hundred ninety nine thousand nine hundred and ninety nine?”

Take some time to create your own family version of the Fear-o-meter with your child.


By Dr. Lawrence  Cohen


From the Book, THE OPPOSITE OF WORRY by Lawrence J. Cohen. Copyright © 2013 by Lawrence J. Cohen, Ph.D.. Reprinted by arrangement with Ballantine Books, an imprint Random House.  All rights reserved.

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