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“The most helpful book on childhood anxiety I have ever read.”—Michael Thompson, Ph.D.
 
Whether it’s the monster in the closet or the fear that arises from new social situations, school, or sports, anxiety can be especially challenging and maddening for children. And since anxiety has a mind of its own, logic and reassurance often fail, leaving parents increasingly frustrated about how to help. Now Lawrence J. Cohen, Ph.D., the author of Playful Parenting, provides a special set of tools to handle childhood anxiety. Offering simple, effective strategies that build connection through fun, play, and empathy, Dr. Cohen helps parents
 
• start from a place of warmth, compassion, and understanding
• teach children the basics of the body’s “security system”: alert, alarm, assessment, and all clear.
• promote tolerance of uncertainty and discomfort by finding the balance between outright avoidance and “white-knuckling” through a fear
• find lighthearted ways to release tension in the moment, labeling stressful emotions on a child-friendly scale
• tackle their own anxieties so they can stay calm when a child is distressed
• bring children out of their anxious thoughts and into their bodies by using relaxation, breathing, writing, drawing, and playful roughhousing
 
With this insightful resource of easy-to-implement solutions and strategies, you and your child can experience the opposite of worry, anxiety, and fear and embrace connection, trust, and joy.
 
Praise for The Opposite of Worry
 
The Opposite of Worry is an informative resource for parents and other family members. The book is easy to read, comprehensive and notable for its many practical suggestions.”— New England Psychologist

“Good advice for parents making daily calls to the pediatrician . . . Anxiety is a full-body sport, and Cohen’s main advice is not to treat it with words but with actions. . . . Physicality is about living in the present, and for anxious people, the present is a powerful place of healing. Intended for parents of children ages 3 to 15, this book offers anecdotes and fun anti-anxiety games.” Publishers Weekly
 
“Here’s the help parents of anxious children have been looking for! Dr. Cohen’s genius is in the warm and generous spirit of the strategies he outlines for parents. He grounds his playful approach in a sound explanation of how anxiety affects children, and how they heal. Parents will come away with plenty of ideas to help them develop their children’s confidence. While reading, I found myself thinking, ‘I’d like to try that for myself!’” —Patty Wipfler, founder and program director, Hand in Hand Parenting
 
“If you want to understand your child’s anxiety—and your own parental worries—you must read Larry Cohen’s brilliant book, The Opposite of Worry. Dr. Cohen is one of the most imaginative and thoughtful psychologists you will ever encounter. He explains how and why children become anxious and then shows how we can use empathy and play to help them escape from the terrifying dark corners of childhood.” —Michael Thompson, Ph.D.
 
The Opposite of Worry offers a treasure trove of ideas to help children feel confident and secure. Lawrence Cohen has written a book that will help every parent of an anxious child.” —Aletha Solter, Ph.D., founder, Aware Parenting, and author of Attachment Play

Review

The Opposite of Worry is an informative resource for parents and other family members. The book is easy to read, comprehensive and notable for its many practical suggestions.”— New England Psychologist

“Good advice for parents making daily calls to the pediatrician . . . Anxiety is a full-body sport, and Cohen’s main advice is not to treat it with words but with actions. . . . Physicality is about living in the present, and for anxious people, the present is a powerful place of healing. Intended for parents of children ages 3 to 15, this book offers anecdotes and fun anti-anxiety games.” Publishers Weekly
 
“Here’s the help parents of anxious children have been looking for! Dr. Cohen’s genius is in the warm and generous spirit of the strategies he outlines for parents. He grounds his playful approach in a sound explanation of how anxiety affects children, and how they heal. Parents will come away with plenty of ideas to help them develop their children’s confidence. While reading, I found myself thinking, ‘I’d like to try that for myself!’” —Patty Wipfler, founder and program director, Hand in Hand Parenting
 
“If you want to understand your child’s anxiety—and your own parental worries—you must read Larry Cohen’s brilliant book, The Opposite of Worry. Dr. Cohen is one of the most imaginative and thoughtful psychologists you will ever encounter. He explains how and why children become anxious and then shows how we can use empathy and play to help them escape from the terrifying dark corners of childhood. This is the most helpful book on childhood anxiety I have ever read.” —Michael Thompson, Ph.D.
 
The Opposite of Worry offers a treasure trove of ideas to help children feel confident and secure. Lawrence Cohen has written a book that will help every parent of an anxious child. He describes the causes and symptoms of childhood anxiety and explains how children can overcome even the most tenacious fears in the context of a loving and playful parent/child relationship.” —Aletha Solter, Ph.D., founder, Aware Parenting, and author of Attachment Play
 
“This book will help you calm the storm of worrying that floods so many children and teens. Take these hard-earned lessons and make them your own. Peace and clarity in your family are just pages away!” —Daniel J. Siegel, M.D., co-author of The Whole-Brain Child

About the Author

Lawrence J. Cohen, Ph.D., is a clinical psychologist specializing in children’s play, play therapy, and parenting. He is the author of Playful Parenting and co-author, with Michael Thompson, Ph.D., and Catherine O’Neill Grace, of Best Friends, Worst Enemies and Mom, They’re Teasing Me. Dr. Cohen leads Playful Parenting workshops for parents, teachers, and child-care professionals. He lives in Boston, Massachusetts, with his wife, Liz. They have two grown children.

Excerpt. © Reprinted by permission. All rights reserved.

Chapter One

Childhood Anxiety:

Alert, Alarm, Assessment, and All Clear

Sometimes we can cajole her into trying something new, but other times she is just a shaking, sobbing mess.

—Mother of a seven-year-old

The Faces of Anxiety

A typical day at a community pool is filled with swimming lessons and diving competitions. Amid the laughter, splashing, and chatter, each group of children probably includes one or two who struggle with some form of anxiety. Perhaps in the youngest class a three-year-old boy sits in his mother’s lap, thumb in his mouth, face buried in her shirt, while a teacher patiently tries to coax him into the water. In another class, a six-year-old girl steps happily into the pool, splashes her feet, then bursts into angry tears when a few drops of water land on her face. In the hallway a nine-year-old boy engages in a fierce debate with his mother:

“You know you’ll have a good time as soon as your class starts. You enjoyed swimming last week.”

“I just want to go home, I hate swimming!”

A twelve-year-old realizes as she begins her dive that one of her competitors is the top-ranked diver in their age group. She feels butterflies in her stomach and hesitates, spoiling her well-practiced dive.

The youngest child at the pool is anxious about separation from his mother, while the six-year-old is scared by the physical sensation of water in her face. The boy in the hall is eager to swim when he imagines it at home, but gets scared and tries to avoid it once he is at the door. Ashamed of his fear, or perhaps unaware of it, he covers it up with anger. The oldest child has performance anxiety marked by worried “what if” thoughts: What if I mess up? Each of these children is anxious, yet each is anxious in a different way.

So what is anxiety? That’s a tough question, because we use so many different words with overlapping meanings to describe it. Anxiety is sometimes regarded as milder or vaguer than fear, but an anxiety attack is the same as a panic attack, and that can be quite severe. Anxiety can be an emotion, a physical state, or troubling thoughts and beliefs. Stress usually refers to prolonged anxiety, while worries and obsessions are anxious thought patterns. Nervous habits and compulsions are anxious behaviors. Dread and terror suggest extreme anxiety, but these words are also hard to precisely define. Most children get anxious once in a while; others are anxious most of the time. Some are anxious and don’t even know it. It’s confusing! We’ll have to settle for a rough guide rather than a precise definition.

You may have noticed that my imprecise definition of anxiety is not based on a list of anxiety disorders. That’s because I don’t think diagnosis is especially useful in childhood anxiety. I’d rather understand the impact of anxiety on children’s thoughts, bodies, emotions, relationships, and behaviors. The opposites of worry, anxiety, and fear are also hard to define. The opposite of danger is safety, and the opposite of anxiety is security—or is it confidence? Or relaxation? What’s the opposite of fear? Fearlessness, courage, or calmness? The opposite of worry is trust that all is well. Again, it’s confusing.

The Positive Side of Anxiety

Whatever words we use, we usually focus on the painful side of anxiety, the side that makes children miserable and leaves parents helpless. But anxiety has a positive side as well. A little bit is necessary for our mental health, our success in life, and even our survival. A healthy dose of anxiety drives us to avoid danger, take effective action, and perform at our peak. Complete relaxation isn’t very useful for activities that require alertness and muscle control, like taking a test or diving into a pool. Anxiety only becomes unhealthy when there is excessive distress or excessive avoidance, like the anxious children at the pool.

Too much anxiety and you’re “worried sick.” Too little and you get nothing done, or you fail to take necessary precautions. We need fear when we are in danger, because fear galvanizes us to call for help, run, hide, or fight for our lives. Of course, that only helps us when our lives are really in danger. Fear when a tiger is actually chasing you is crucial for survival. Fear of a tiger in a zoo is excessive. Fear of a story about a tiger is really excessive.

Healthy anxiety also keeps us from acting immorally. Our conscience uses anxiety as a reminder that we will get in trouble or feel guilty if we do something morally wrong. Again, this anxiety can get out of hand, creating guilt or shame when we haven’t done anything wrong.

We don’t have time to think things through carefully when we are in real danger. We need a fast system, and anxiety is faster than the speed of thought. If that sounds impossible, consider that we often feel uneasy before we know why. We all have a little bit of “Spider-Sense,” the superpower of the comic book hero Spider-Man, which warns us when something feels wrong before we have time to process all the information carefully. Spider-Man wouldn’t call it anxiety, but that’s basically what it is: a signal to look around carefully for danger and prepare for action. Healthy anxiety shows up really fast, does its job, and then steps aside to let slower and more logical thought take over. With excess anxiety, that reasonable side has trouble stepping in.

Too much anxiety doesn’t kill us; it just makes us miserable. Well, it doesn’t kill us right away. Stress has terrible effects on health, but in a dangerous situation it’s safer to have too much anxiety than too little. That may be why so many children have excessive anxiety. As parents it’s hard to get the balance just right. We want our children to worry enough about a test that they study for it, but not so much that they refuse to go to school. We want them to check their homework for errors, but not to be such perfectionists that their papers are in tatters from repeated erasing. We want them to wash their hands, but not for five minutes at a time. We want them to know what to do in case of fire, but we don’t want them preoccupied with the possibility of a fire every time they enter a building.

Many anxious children worry that they aren’t smart, because they know they act irrationally at times. I always remind them that it wouldn’t be very smart to have no anxiety. Intelligence doesn’t protect a person from troubling emotions. In fact, many anxious children are highly intelligent—it takes a lot of brainpower to think of the things they worry about! Anxious children also need to know that they have emotional strengths. It’s common in childhood for vulnerabilities in one area to be balanced by strengths in another.

I met recently with the parents of Constantine, a boy with significant anxiety. They described him as imaginative, creative, joyful, and funny, with a long attention span—when not in his anxious state. This list is quite typical of children with high anxiety. Their parents and teachers often say they are mature for their age, verbally precocious, sensitive, and able to relate well to adults. We often encourage anxious children to take more risks in life, but on the bright side, we don’t have to worry that they will be extreme risk-takers and thrill-seekers.

The Suffering Caused by Anxiety

When anxiety reaches too high a level, the suffering can be intense. Rob, a nine-year-old boy, sent me an email between therapy sessions: “Lately I’ve been getting very worried about dying and that hurricanes will reach here. I’m having a really hard time dealing with it and I wanted to tell you before Thursday. I’m getting really, really worried. I feel really tense inside. I’m having trouble falling asleep and just enjoying life. I wish that there is a way to solve this. I’m urgent to find a solution quickly. Can you help me find any solution?”

Anxiety causes a range of suffering from mild to moderate to severe, and from occasional to frequent to nearly constant. The distress of childhood anxiety can take many forms:

• Physical sensations, such as pounding heart, shallow breathing, tense muscles, butterflies or churning in the stomach, trembling and sweating, hot or cold skin.

• Frequent urination, gastrointestinal distress, or incontinence.

• Anxious thoughts, pessimistic beliefs, and worries. What if something bad happens? If only I had done something differently. I know my teacher hates me.

• Rumination, in which the same thoughts or images are repeated over and over with no resolution.

• Cognitive inflexibility, which involves a fear of risks, avoidance of anything new, or an intense reaction to changed routines.

• Nervous habits such as nail biting, hair pulling, fidgeting, or chewing on clothes.

• An emotional state of alarm, apprehension, panic, dread, or always feeling on guard.

• Fears of specific things—real or imaginary—such as dogs, bugs, or monsters under the bed.

• A tendency to perceive the world as generally threatening or dangerous.

• Avoidance of anything that arouses fear or anxiety, and extreme emotional upset when avoidance is impossible.

• Behavior patterns such as shyness, clinginess, indecisiveness, perfectionism, compulsions, or an attempt to completely control one’s environment.

• Escalating demands for reassurance, with increased feelings of desperation. When reassurance is given, however, it is often rejected.

You can see that anxiety can affect children’s bodies, thoughts, emotions, behaviors, and relationships. This means that every child’s anxiety will look different and feel different.

Consider two children, Mara and Cal, in a movie theater. Mara sits with her parents. Suddenly a picture of a shark fills the screen, along with scary music. Mara feels strong physical sensations in her body; that is anxiety. She thinks, I have to get out of here and What if that shark comes after me? Those thoughts are anxiety. She runs for the exit; that is anxiety. She has trouble falling asleep that night and when she does she wakes up with nightmares—more anxiety. The next time her family goes to a movie she doesn’t want to go, even though she understands there will be no sharks in it. That avoidance is also anxiety, and it may spread to other activities that Mara used to enjoy.

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4.6 out of 54.6 out of 5
173 global ratings

Top reviews from the United States

Thursday Rain
5.0 out of 5 starsVerified Purchase
Helped us more than any expert we saw and within weeks! Thank you Dr Cohen!
Reviewed in the United States on January 30, 2014
My daughter is 5 and has had severe anxiety, particularly related to separating from me. We''ve seen experts since she was 2.5 as the anxiety was so bad it was affecting her sleep. She''d wake hourly (and scream, panicked) to make sure I was still next to her. My daughter is... See more
My daughter is 5 and has had severe anxiety, particularly related to separating from me. We''ve seen experts since she was 2.5 as the anxiety was so bad it was affecting her sleep. She''d wake hourly (and scream, panicked) to make sure I was still next to her. My daughter is visually impaired and has sensory processing issues. She was legally blind for the first couple of years of her life and relied on me for navigation and to feel comfortable in the world (with her separate sensory issues). Not an easy case. We had kindergarten assessments coming up and a mom I met whose daughter also suffers from anxiety recommended this book. It''s helped us far more than any therapist/doctor/child educator we spoke with and it helped us within weeks. Seriously, my daughter has NEVER gone to a friend''s house alone, or to a class alone (save for preschool - but I went with her for months while we desensitized her to it) or even let me go to the bathroom alone at good friends'' homes. Yet last weekend she went and did two kindergarten assessments with new teachers and new kids in new places WITHOUT ME for over an hour each time and she came out BEAMING!
In our case my daughter was scared I''d "disappear" and I really needed to see this from her perspective. Instead of saying there was no need to worry about that, I loved her, of course I''d be back, I really thought about it and realized if I thought she might disappear if she went to a particular place, of course I''d NEVER let her go. I''d be terrified just like she is! I conveyed this to her and told her Daddy wouldn''t let me go places if I thought I might disappear, my parents wouldn''t, my friends wouldn''t. Also to really test the matter, for a whole week, I tried disappearing with her assistance, using magic words, etc. It never worked. So I suggested even though she worries I might, maybe she doesn''t need to believe those worries.
I also pretended I was very worried she might leave me and go to the North Pole. Dr Cohen teaches you to empower the child and to make it fun. And we practiced being a little bit scared so she learned that just because you might feel a little unnerved it doesn''t mean everything is going to get worse. This is keeping your child at their edge.
I feel like no matter what your situation, if your child is anxious, there will be information and ideas to help in this book. You do have to figure out how to adapt tactics and strategies to your family/situation...but that''s the playful part and it''s honestly fun. With mind blowing results. As all the kids went off with the teachers and my daughter went with them, (with NO apparent anxiety at the second school), I wanted to jump up and down with amazement. Dr Cohen, you have changed our lives and I''m telling EVERYONE about your book. Thank you. Thank you. Thank you.
101 people found this helpful
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Rose Saldana
5.0 out of 5 starsVerified Purchase
Anxious kid? This can help!
Reviewed in the United States on April 27, 2021
I bought this book after dealing with an increasingly anxious preschooler. My daughter that always been an anxious kid, and this got even worse with us facing a global pandemic, having to idolate ourselves, and missing out on interactions with people we know and love. Add... See more
I bought this book after dealing with an increasingly anxious preschooler. My daughter that always been an anxious kid, and this got even worse with us facing a global pandemic, having to idolate ourselves, and missing out on interactions with people we know and love. Add to that the passing of her grandma, and we''ve had some extremely difficult behaviors.

This book hasn''t completely erased our issues - I''m sure there is no book out there that could! But this book has a lot of excellent analogies, metaphors, and strategies on how to cope and help your child cope with anxious behaviors. We had a few therapy sessions, but those did very little for us. Instead, me reading this book and putting the strategies into place has nearly eliminated my daughter''s anxiety attacks. She has been willing to try new things and is no longer fearful of many of the things that caused her terror before.
4 people found this helpful
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Jessaquata
3.0 out of 5 starsVerified Purchase
Good for mild to moderate anxiety
Reviewed in the United States on August 3, 2018
I would say this book is more for mild to moderate anxiety. My daughter has severe anxiety. I''m aware of the tools in this book and it isn''t at the level we need.
8 people found this helpful
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Amazon Customer1
5.0 out of 5 starsVerified Purchase
LOOOOOOOOVE
Reviewed in the United States on January 22, 2018
I absolutely LOVE this book. I am an LCSW and a mom and the techniques in this book have made me a better clinician but more importantly a better more confident parent. Im about to read it again!
9 people found this helpful
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Erin Canterbury
4.0 out of 5 starsVerified Purchase
Great strategies for calming an anxious child
Reviewed in the United States on March 29, 2017
I read and listened to this book cover to cover. Even though I myself have anxiety I was at a complete loss how to deal with my daughter''s crying and angry outbursts at going to bed. Reading the book gave me insight into what we were doing wrong and now hopefully through... See more
I read and listened to this book cover to cover. Even though I myself have anxiety I was at a complete loss how to deal with my daughter''s crying and angry outbursts at going to bed. Reading the book gave me insight into what we were doing wrong and now hopefully through love and acceptance I can better guide her inner strength to come out. Highly recommend.
6 people found this helpful
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David Barnhard
5.0 out of 5 starsVerified Purchase
Great book for anyone with anxiety
Reviewed in the United States on May 21, 2019
I got this book to help my girlfriend with her anxiety and it''s definitely showed me how I can help her and how I''ve been contributing to her anxiety.
5 people found this helpful
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Jessica
5.0 out of 5 starsVerified Purchase
understandable book that is easy to implement
Reviewed in the United States on June 7, 2016
This is an incredibly helpful, understandable book that is easy to implement. Love it!
5 people found this helpful
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Carmen Borrell
5.0 out of 5 starsVerified Purchase
Good book
Reviewed in the United States on February 2, 2021
Very informative
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Top reviews from other countries

Raa
5.0 out of 5 starsVerified Purchase
Helpful book for my cautious toddler
Reviewed in the United Kingdom on June 16, 2019
This book has helped me help my cautious toddler! Lots of easy to understand information and ideas to support little worriers of all ages.
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June
5.0 out of 5 starsVerified Purchase
Very useful
Reviewed in the United Kingdom on January 18, 2019
Brilliant book. Give you loads of ideas about how to reduce your kids’ anxiety or even your own’s .
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K L Briggs
5.0 out of 5 starsVerified Purchase
Very helpful
Reviewed in the United Kingdom on September 6, 2018
Great book very helpful if you have an anxtious child.
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Omoge
4.0 out of 5 starsVerified Purchase
Good ideas
Reviewed in the United Kingdom on March 15, 2014
As a therapist and a parent I found the ideas, pictures and metaphors in this book very u s eful.
2 people found this helpful
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Debbie Semple
5.0 out of 5 starsVerified Purchase
One of the best books I’ve read about anxiety in children and how to support them.
Reviewed in Canada on January 30, 2019
Hands down, one of my favourite books I’ve read on anxiety in children and how to support them. Provides the reader with an understanding of what is happening inside the brain when anxiety strikes, and how to guide and support your child through this, while being respectful...See more
Hands down, one of my favourite books I’ve read on anxiety in children and how to support them. Provides the reader with an understanding of what is happening inside the brain when anxiety strikes, and how to guide and support your child through this, while being respectful and sensitive to your child’s emotions. Good for both professionals and parents. I recommend this book to all my clients with anxious children!
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