 Hello. Apparently we're live. How very exciting. Bear with me while I grapple with the technology, hopefully it all works well. Thank you for those of you who are here live this afternoon for the Q&A about anxiety. I've now got a double screen thing going on and I can hear myself twice, which is most disconcerting. So let's have a go, sort that out. This is what it's all about today is grappling with the technology, trying to make it work and then hopefully answering your questions about anxiety. So thank you to those of you who have pre-submitted some questions. If you have got questions, I will prioritise those of you who are live. So do pop them into the chat. So I'm going to start first with a couple of questions that came in from one of my patrons and a huge thank you to those of you who are already signed up over on Patreon. Really, really appreciate your support, helping me to create more content for parents and carers, which is hugely, hugely important, but not always much commissioned. So the first question is, what tips do you have for parents to help anxious children who have a tendency to avoid situations if fear will cause anxiety and therefore miss out on lots of experiences they'd probably enjoy? How do you encourage participation, even if the child feels anxious? So basically, the situation we're looking at here is a child where as their parent, their carer, their supporting adult, you think this kid would get so much out of doing this, they'd love it, but they're too anxious to participate. So what do we do? So in this situation, there are a few things that we can do. We can think about, A, working with the child to understand their motivations and really understand do they actually want to do this and why and help them to think about what's driving them. So this is that thing which I spoke about recently on YouTube, or maybe I haven't put it live yet, but thinking about child's motivations versus an adult. So sometimes we want our children to do something because we can see kind of medium or long term reasons for that, the benefits for it. Whereas our child might have quite different motivations. So with this, if there's something that you think your child will get something out of, it's about thinking with them about what's in it for them, why would they enjoy it and making sure they really, really do want to do the thing. Once we've established that and we've established this is something they do want to do, but they're too anxious, then in terms of actually enabling them to access that thing, I would be looking at breaking it down into tiny, tiny, tiny, tiny steps. So we always try and break things down into the smallest steps that we possibly can. What we're looking for here is for our next step always to be one that is so small that our child is going to turn around to us and go, whatever, I can obviously do that because we're often here working with children who don't feel that they can do things. So we're trying to create, I can type scenarios. So make tiny, tiny, tiny steps. And then we're going to recognise and celebrate those steps and keep a track of them, maybe keep a note of them. I often talk about writing sharpies and putting them on pebbles in jars or maybe a chart of post-it notes just or a journal. Your child actually noticing what it was that they were able to do. We can also think about things like how to support and scaffold the actual situation to make it feel more accessible. So we might think with a child about what is it about this thing, this situation, the thing you want to do that's making you feel anxious, which bits about it are really playing on your mind? And then we can work through those and think, well, what can we do to help that? So maybe they're very nervous about walking into a situation on their own. So we might think about whether a buddy can join them, for example. Maybe they're nervous because it's in a new place and it's not somewhere they've been before. So we might think, OK, well, maybe we can visit that place ahead of the scheduled event so that you can kind of get used to it. There's all sorts of different barriers that there might be. And until we work out what the barriers are, it's a bit hard to know exactly how to overcome them. But yeah, so work out whether your child is actually motivated to do it, get them really on board with wanting to do this. So they're going to be prepared to do the hard work because it is hard work. Break it down into teeny, teeny, teeny, tiny steps with them. And then think about what are the actual bits here? What are the flash points that are worrying them? And how might we be able to support and scaffold that experience so they feel able to do it? And then we just need to set our expectations realistically so that our child doesn't feel like they're going to go all or nothing. They haven't got to get this thing done perfectly the first time. It might be that they managed to sort of do a little bit of it. And then maybe next time we do a little bit more and next time we go bigger again. So maybe, I don't know, your child would really, really like to do like a weekend sleepover with all their mates at a party. That might just feel too big. But maybe on the first occasion, they're going to go and just spend an hour at the friend's house with one front and they're going to work up to the thing that they really, really want to do. And that way it feels more doable. OK. Question in the chat here. How can PE be better at school for young people with autism? Oh, Louise, this is a really great question and quite a live one in our house at the moment. So my daughter Lyra, as many of you know, is autistic. We've actually withdrawn her from games because it became such a flashpoint. And I had some really, really good advice from a colleague about how team sports can be really particularly challenging for our autistic children. And so we decided to stop pushing that and stop causing this real tense moment in the week. And actually what we've done, which I appreciate not every family could do, but what we've been able to do is to withdraw Lyra from her school games lesson and the team games and actually to put her in for individual squash coaching. So she's still getting skills development. She's still getting input in sport. She's really enjoying it. She's getting some exercise and and and that's really positive. That doesn't really help with your question though. How could we generally make PE and games more accessible for our autistic children? That's a big one. I'm not sure that I know the answers here. Things that I think would help. So things that we know help generally are creating calm environments, which often is not the case in PE and games. So we need to think about how to make this feel a little bit less overwhelming for our children. Often it can be quite noisy, quite chaotic. Quite kind of change in terms of the social expectations and they might not really be aware of kind of how the rules sort of work for games and PE so it can feel quite unsettling. So we might try to make it sort of if we're able to make it a little bit calmer, maybe think about those transition moments, like when kids are getting changed and the bits leading into games can be really, really challenging too. So we can think about making it calm and consistency is another thing that generally helps our autistic learners in school and thinking about how that would apply in games. This would be about our child knowing what to expect of a PE lesson, knowing who's going to be teaching it, what they're likely to be doing, what the general structure of that lesson is likely to be, what the expectations are of them, what they can expect of the staff and the other people, understanding all of the different rules that govern this. And yeah, just knowing how how it's likely to work and having that kind of consistent and predictable kind of approach. And again, in games and PE, that can sometimes be brilliant. There can be, you know, there are rules to many games, many team sports and so on, and they can be really well applied and some staff really get it. But other times in other schools, other settings, PE games can be more of a sort of letting off steam and it can feel perhaps a little bit unnerving for a child who really needs that routine, rigidity and structure. So we might try to introduce a little bit more of that either for everyone or for them in particular. And then the other thing is about communication. So we can think about how to really clearly communicate with our child about what is expected of them during the situation, how they can communicate their needs as well. Again, one of the flashpoints we'll sometimes get in PE and sport is that it's a different setup than our children are used to for majority of the school week and they might have good systems in place for showing that they're overwhelmed or what to do if they need to emotionally regulate and so on and so forth. And it might be that they're not quite sure what to do about that in PE games or sports. We need to think about how that communication between people and teacher can really work when we get it right. Sports PE games is such a fantastic skill for well-being for every child, including our autistic children who often do struggle with anxiety. They shouldn't they shouldn't have to. It's not inevitable that these things go hand in hand. That's one of my soapbox items right now. But these things often do go hand in hand because being neurodiverse in a neuro-typical world is hard and sport can really, really help us to emotionally regulate. So trying to make it accessible is a really, really good aim. But, yeah, full disclosure, in our household, we gave up and actually have withdrawn Lyra from from Team Games. And she's now doing squash, which is going really brilliantly. And she's loving it. She is doing a PE lesson, which is different from her games lesson. I don't understand the PE lesson. And what they've done for her and this might work for other people is rather than her being on the carousel and getting a different teacher every few weeks and doing a new sport. Actually, she's staying with the same teacher in the same place every week for the whole year. She chose the one thing on the carousel that she most wanted to do. So the children will change, but she will remain consistently with the same teacher in the same place every single week. And that's something that is thus far working very well. So again, that's something that could be thought about. OK, another one coming in. My swimming club has a number of young autistic swimmers. The advice we give coaches and staff is first to talk to the parents and child for ideas to help them and with things they find difficult. I think that's really sensible. And I think one of the things we just need to do as much of as we possibly can, and it works so well when we get it right, is having the different adults and the child all working as a team together to think, how can we make this work? These conversations need to happen at times of calm rather than the times of high stress when our brain is not doing its best thinking and problem solving. But at times of calm, we can do really good problem solving together. We can do really good sharing of ideas and advice. And often our children are able to self advocate or their parents, carers or other staff who know them well, can advocate for them and make good suggestions too. And that kind of cross fertilisation between home and school or extracurricular is again, super helpful. We learn so much when we talk to each other because different people have different ideas and different experiences of our child. Next question, how should parents of children that struggle with eating disorders and self harm cope with their own anxiety? My doctor describes this as situational anxiety, which will only fully resolve when my daughter's health improves. The mental health of parents and carers of children who have mental health issues or other sort of significant issues is something that's of kind of major interest and concern to me. It's something, you know, we really struggle as the parent, as the carer. We take on a huge emotional load and we do see, unfortunately, very high levels of depression and anxiety and other mental health issues amongst those parents and carers. So this is quite typical that you would be experiencing anxiety as your child is facing these challenges. I mean, of course, as your doctor says, it's situational. You're in a really tricky situation here. And the person who is most affected by this, the person that you're observing is someone who you deeply, deeply love. So it's really hard and your doctor's right that it is situational. And as the situation with your daughter improves, as I'm sure that it will with the right support over time, it's likely that your own mental health will improve. What I think is not right, though, is that there's nothing that we can do in the meantime. I think there is lots that we can do in the meantime. And I think this is about being able to take time away from the problem, actually giving ourselves as parents, as carers, as other adults who really care about someone who's struggling with their mental health, giving ourselves absolute permission to just switch that off for a while sometimes and step right away from the problem. Because when we are fully involved all the time, we burn out. It breaks us. We can't then continue to be the adult that that person needs in their life. So we've got to step away. We've got to actually think about our own self care first. It can be really effective if you can possibly find the time to do that, to do that in little doses every day. So even just 10 minutes that are just for you when you do a thing you love, maybe it's reading, maybe you love to take a bath or go for a run or there's a friend that you'd particularly like to catch up with on the phone or maybe you're a Dungeons and Dragons person or there's a TV show that you love and just giving yourself permission to just mindfully do whatever that activity is and take time away from the problem. We also need to do all the other things that we would be supporting our child to try and do to promote their own physical and emotional well-being as well. So we would be thinking about things like our sleep. Sleep is the most important thing and the thing that will have the biggest impact on anxiety and children and adults in my experience. So you might think about what your sleep is like and if there's anything that you can do to have a bit of an impact on how much sleep you're getting or the quality of the sleep that you're getting. And I have in mind to do one of my guides actually around sleep advice and ideas for adults if that's something that people would welcome. I think it's it's a really important topic that we don't talk about enough and it makes so so much difference as well as sleep. We need to think about our diet, difficult in a house with eating disorders, of course, but actually all the time that you're thinking about eating healthily and looking after your own dietary and nutritional needs, you're actually role-modelling really positive things to your daughter as well. And it's it's really important that we don't allow our own health to suffer whilst looking after our child. And then, of course, physical activity is the other kind of of the triad of the physical well-being and actually trying to make sure that we get a little bit of fresh air, a little bit of exercise, just moving around a little bit. Even a small amount can make a huge difference. The other thing I think that can really help it is to connect and to have people and places that we're able to offload to. So things that can help us feel a little bit better in managing that anxiety day today can be feeling less alone with that problem. So joining up with groups of other parents who might be facing similar things. They can't solve the problem for us. They might have ideas and suggestions that might help. But the most important thing they can offer is walking alongside you so you're no longer completely on your own with this problem. That's absolutely crucial. There are, of course, endless things that we can do to help feel better just for a moment right now. We can be looking at things like our breathing strategies or engaging in sort of mindfulness or meditation or listening to music or any of the many things that we would recommend to our children to deal with those kind of feelings of overwhelm can work for us as adults as well. But I think it's the key thing here is just to question that idea that your anxiety can't improve until your daughter's situation improves. Yes, you're anxious for a reason. Your daughter is struggling with self-harm and an eating disorder. That is incredibly stressful. You're going to have to work really hard on your mental health whilst this is ongoing for her. However, you are able to take steps to make right now feel different and stepping away from the problem, exercising good self-care and giving yourself permission to laugh to find peace for a little while sometimes is really, really crucial. The next question I have, I'd like to know how to get the balance between not being afraid to listen to our fears and anxieties and blasting away automatic negative thoughts by, for example, using positive affirmations. So how do we get that balance? How do we understand that, you know, a little bit of anxiety can be a good thing sometimes? This is the thing that enables us to work harder, run faster, sometimes get over the finish line with that tricky deadline and so on and so forth. How do we manage that versus this idea of, yes, kind of always trying to get rid of the negative thoughts and perhaps that feeling that we should be happy and jolly and at peace all the time, which is something we sort of see perpetuated a little bit in the media at the moment. That balance, I think it's about stepping back and being honest with ourselves and recognising how much anxiety is good and healthy and how much of it kind of helps us because if we didn't have any of that kind of anxiety, those kind of little cortisol spikes, those rushes of adrenaline, we wouldn't ever be able to do things like sit through a long exam and perform our best. We wouldn't be able to do well in a race or stay up late for that deadline. You know, a little bit of anxiety is the thing that sometimes enables us to function well in high stress situations, but too much, not so good. So it's recognising when we cross that line, I think. The point at which we cross the line is when our anxiety is long lived, so we look for longevity. It's something that's a lot of the time for weeks or more. So it's something that is quite present in our lives for a lot of the time, not necessarily all the time, but a lot of the time over a period of weeks or more. And it's something that is having an impact on our ability to function day to day. So our anxiety might be stopping us from engaging in tasks that we used to enjoy or it might be preventing us from going to work or school or it might be really hampering our performance in our work or our schoolwork. So when we see those two things that it's going on over a long period of time and it's having a really significant impact on our ability to function and do our normal things, then that's the point at which we begin to really worry. But going back to that idea about blasting away all our negative thoughts, we actually sometimes need to sit with discomfort. Sometimes we feel that anxiety or other more difficult feelings for a reason. Every feeling is valid, sadness, anger, distress, these feelings are all valid. And actually if we don't allow ourselves to experience them, to feel them, to process them and we just try to push them away or kind of make ourselves feel instantly different and we don't properly process those emotions. And actually sometimes that can come back to bite us and that can mean that those feelings overflow at a moment when we're not quite ready for that to happen or in ways that feel deeply uncomfortable for us. It can come out in our physical health. It can come out in sort of more significant sort of mental health type issues as well. So we need to acknowledge and sit with sometimes some of that distress. There's some great literature out there on distress tolerance. That's a really good thing to Google if you're interested in that kind of sitting with difficult feelings and that's particularly important if you're in a situation that you can't fix, you can't change. So for example, if you've experienced I don't know, significant bereavement or big trauma we can't change the thing that has happened. So sometimes we want to just go and fix stuff and make it better. And then like that idea we talked about before about situational anxiety that will pass but some things don't pass. Some things are permanent and not fixable. And so then we just need to think about well, how do we sit with that distress? How do we manage that? How do we make this something that's possible for us to kind of live with? So distress tolerance is really, really worth having a look up. There's a lot of good work out there. That's part of a set of skills involved in dialectical behavior therapy which is a very, very good approach, a skills-based approach for people who experience things like self-harm sometimes used with things like eating disorders has also been used with substance abuse and so on where we are managing difficult thoughts, difficult feelings and we need the skills in order to be able to work through that. Okay, another question. Do you pop your questions on the chat? Becky, as a teacher I'm calmly supporting students with anxiety whilst at the same time in the pocket of my dress I have a set of cards against anxiety and I feel a lot of imposter syndrome. Okay, the first thing to know about imposter syndrome is we need to talk more about imposter syndrome. You are so far from alone in this. When I go and speak in schools or at conferences with educators and I start talking about imposter syndrome people always come and say, thank you, I had no idea, I thought it was just me. We're all living it all the time and actually sometimes to be the adult that a child needs in these situations you've got to fake it because what a child needs sometimes is to have an adult who is cool, calm, collected in control. They need to know that you've got this situation that they're safe that you've got this and maybe you don't feel like you've got this and you're frantically paddling and you're going to go and have a good cry afterwards or somehow deal with that distress but if in that time that student felt held and heard and supported and then able to re-engage with what they needed to that day you've done a really really really good job and those feelings of imposter syndrome whilst they are so common you're doing it, you're making a difference. The difficulty I think is that in the caring professions and I include education very much within that we are populated with people who care deeply about doing the right thing for everyone else but often hugely underestimate the impact that they're having and how very good they are at what they do I don't doubt for a moment, Becky that you're doing a much much better job than you think, the fact that you notice and that you care and that these young people do feel heard by you is incredible and the fact that you experience your own anxiety and yet you're able to do that cool calm collected thing is remarkable. What I would say is if you're doing that you're holding those situations, you're putting the mask on we need to just be aware of the emotional toll that it can take and how if you do it too much and without respite or thinking about how to emotionally regulate yourself in between that can lead to burnout just as masking can lead our neurodiverse learners to burn out when they kind of put on the mask and do normal, do okay try to be like everyone else all day at school then they go home and everything kind of falls apart sometimes and it's the same for us if we're kind of marking that anxiety and being fine because that's what our people need right now we just need to think about okay how do we then allow those feelings that distress to vent for us similarly if you are taking on board big emotional stuff that a young person might be talking to you about you need if you can to stay emotionally present for them to stay in the room to hear their concerns if you can and if you can do that safely for them and for you however that does you know that can be really hard if you really care about young person and they're telling you about really really really hard stuff that hurts and that can make us really distressed and we try to continue to be calm we try not to show big difficult emotions and distress because actually what they need is for us to be calm and supportive and just to be there for them but that takes its toll putting that mask on so we just need to think about how can I look after myself after this how can I let off who can I offload to you might have someone you're able to talk to maybe you've got access to supervision there might be a colleague you might have a partner you might talk to someone like Mark pets are great because actually sometimes we don't need anyone to respond talking to our pet can be great because they have no expectations on us they don't give us advice because often we don't need it and they do listen really really well so just finding ways to offload is really really important are there any more questions coming in on the chat I was aiming to finish about half past if people do have more questions do you pop them in I've got one more that came in ahead which I'll go to which was somebody saying my son gets very anxious at night and it stops him going to sleep have you got any advice now as I mentioned before sleep is hugely important and if we can get sleep right even small improvements to sleep can have a big impact quickly on our ability to kind of cope and thrive conversely if we're struggling with sleep that can hugely impact our ability to cope in the other direction so if we have a really bad night's sleep it can be very very much harder to emotionally regulate turn to our good problem solving skills and to get through things well so sleep really matters but if your son is struggling to get to sleep then what I suggest is we need to have a think about the whole routine around sleep and to try and take the pressure off so maybe don't tell him what I just said sleep for any matters because it's like must go to sleep oh no I'm anxious because I need to go to sleep and now I can't get to sleep and I'm anxious about not sleeping so don't tell him that just be aware of this yourself but think about the whole routine around sleep the best advice I can give is and it comes to sleep think about what you would do for a baby or a very young child yourself, apply it for your teenage child and this is things like how do we create a nice restful environment in the hours and it is hours if we're struggling with sleep, running up to sleep how do we make sure that we're not having caffeine or sugar or doing really heavy exercise making sure we're engaging with activities which kind of calm us rather than activate us we're looking for that restful kind of experience routine is really important so again with a baby or a young child we'd be going to bed at the same time getting up at the same time we'd have a whole sort of bunch of rituals that would lead into the bedtime it might be that we bath at the same time and we put on lovely pajamas and so on and so forth that kind of sense of routine gets our body ready for sleep and over time it gets used to it so this is why some of us people like me who are very rigid about their routine around sleep you know you try and keep us up late we're just going to kind of pass out like someone's pulled out the plug my husband and I went for a meal the other night a bit later than normal and it got to my normal bedtime and we literally went from full flow conversation to me basically just switching off like I went in to kind of shut down because I'm done I'm ready to be asleep now not great when you're out for dinner with your partner but generally good if it means that you can go to sleep quickly and enter that kind of deep and REM sleep quite fast so routine is fantastic the other thing that we can do is make sure that we've got a really nice sleep environment that is just for sleeping if possible so that your son does not associate his room with other activities that might activate and engage so this is not a place where we're going to spend hours on gaming or social media we shouldn't do our homework or other things that really stress us out there or if we do zone the room even if it's a tiny room have a homework zone never be doing it in bed and also think about things like how to make the room really comfortable make sure it's dark enough cool enough that we're wearing comfortable stuff in bed that we've got bedding that we are comfortable with and for many of the young people that we support this means you know having the kind of sensory stuff right so it doesn't kind of scratch or itch or be keeping them awake in those ways if we're having repeated issues with not getting to sleep or waking the next thing just to be aware of here is not to build a what's the word connection isn't the right word but that will work for now between our bed and wakefulness so we can end up kind of teaching our brain this is a place where I can't sleep because we've spent lots of time in bed not sleeping and stressing about it so instead think about some activities that your son could get up and do that are calming and then go back and return to bed a little while later and try to sleep things we encourage in our house things like colouring or reading or knitting just gentle activities something that is not going to get you kind of hooked in which can allow sleepiness to overtake and which are sort of gentle but not trying to not to stress too much if we really can't sleep Andrew what are your thoughts on medication for anxiety particularly for children it seems to be used as a last resort that only gets prescribed after lots of CBT and lots of time passes this is a yeah this is a really challenging one actually I I am someone who came later in life to the idea of medication like personally and then it was absolutely transformative for me and really really did help like when it comes to my own children which I think is always a really good guide I am not averse to it as an occasional thing if it really helps for example I have a daughter who is really really struggling to sleep and I know that sleep will really help then I'm not averse to her having something that will calm her anxiety and allowing her to sleep everyone has different opinions on this and I think what is not helpful is when we become really reliant on medication the other skills that we need or address the underlying situation but I have to say that often medication is something that can help us to get a foothold it's part of the answer rather than the whole answer and I think that's really really important but if it gives us that little bit of help that we might need in order to begin to break a cycle or address a problem I think it can be transformative I think for me personally when I came round to medication was when I was very ill in hospital with anorexia and I couldn't eat and I couldn't break the cycle of not eating and I was so so so anxious around any form of food at all that it just proved impossible and I got prescribed lorazepam it was a benzo I'm rubbish at drugs a benzo is the kind of common vernacular and what it did was it made the anxiety numb enough that I was able to begin to engage with treatment and engage with food and begin to break that massive cycle of anxiety and food it was not it could not be a long term solution but it helped me to get a foothold on recovery and in particular with eating disorders you have the issue that when your weight is very low your brain is starved and you're not able to function well enough to really engage with treatment and therapy you've got to find any way to begin to take some nutrition on board so your brain can do its thing and help you to help yourself to get better so yeah it's a big and gnarly question I have to say it's not really when I've explored deeply when it comes to children and medication and I think we often kind of step away but I think I have I've really come round to it certainly from an adult point of view thinking about using any kind of medication just always making sure we've got a team around us who are able to really advise and make sure it's all done safely and in the right amounts and so on and so forth but I think that it's you know if it's something that can make a difference and you're able to do it safely there should be no shame in using medication but it should be part of the answer not the whole answer okay okay that was that was a half hour that went quickly people kept asking questions so I'm assuming this that you were able to see and hear me okay more of course has made an appearance now I've started actually going places in real life again people keep on saying oh you've not bought more with you because she's always in like everything that I ever do I've given up trying to stop her being here but thank you ever so much for those of you come today and I'm hoping to do these kind of monthly or so and I'd really welcome your suggestions on topics I don't know if you want to go broad so today I just said anxiety but we could equally go like quite narrow if we wanted to I'm completely open you tell me what you want and we will do it I'm really just keen to help you in whatever way works best for you so do drop me a line or leave a comment let me know what you would like and I will make a recording of this available and I will chapterize it so you can find the individual questions as well yeah thank you all have a lovely evening please do something nice for yourselves now take a moment to reflect take a moment to find some calm do something that sparks a little bit of joy for you and remember that none of you are alone in this we're all in it together ah Ian's just joined Ian we're just about to close up buddy is where is buddy buddy is the scrambling outside the door actually the thing is that I had him on one of these the other day and he spent the whole time at that door trying to get out and I think it just made me look really uncool so yeah nobody today but he'll join us next time at your request Ian he just knew that you weren't going to be here so he didn't come but you have got more of course okay with that I'm going to call it a day thank you everyone for coming and I hope that we will build up our little community over time we're in it together and yeah it's going to be okay got this right over and out see you next time