Navigating Emotional Challenges: Supporting Crying Children in Therapy

Challenges at work

Hello, doctor.
I am encountering a child who is "crying continuously" and there is no space for intervention.
I attempted to establish a relationship through play therapy, but due to the child's constant crying, there is zero interaction.
The child completely ignores me and even tells others not to let the teacher be nearby—how is that possible? This situation is different from previous experiences with children who had separation anxiety, where they would cry for a few days but improved with companionship, reassurance from parents, and a sense of safety (like promises that they would be picked up).
I want to attract the child to stay indoors for safety, but now the child even lies on the floor or runs away (possibly running from the auditorium to the school gate, and even threatening to jump down to go home).
If I try to hold the child, they struggle continuously, which could lead to injury.
Even trying to soothe them together with another person is ineffective.
I wonder if the child will eventually tire from crying; it must be exhausting for them, yet I am unable to provide proper assistance.
Connecting this to personal issues, as a teacher, I face one challenging child after another, dealing with stubborn behaviors or complex family situations that frustrate parents.
I find myself feeling helpless and unsure of what to do.
Since I am also a highly anxious person, I hope to serve well in this job, but how can I stabilize myself to provide better quality assistance? My classmates say that I suffer from showing my anxiety; despite having the capability, I often feel mistrusted, which frustrates me.
I am actively seeking various resources and trying hard, but it seems that my lack of confidence makes life feel unhappy.
How can I help myself while also helping the children? Thank you.

SIN, 30~39 year old female. Ask Date: 2013/09/13

Dr. Ding Shuyan reply Psychiatry

Hello, your anxiety may stem from your actual performance at work not meeting the standards you have set for yourself.
This gap can lead to frustration, and facing new tasks each day may cause worry about not achieving the desired level of performance.
This psychological torment can indeed be quite daunting.
Conversely, approaching daily work challenges with a sense of joyful anticipation would be a much happier experience.
In my experience, simply engaging in self-reflection and slightly altering our mindset can make a significant difference in our lives each day.

Counseling or medicine serves individuals, and since we are dealing with people, there is always uncertainty involved.
In some cases, despite our best efforts, the outcomes may still be unsatisfactory, leading to frustration and confusion.
In other cases, when we approach situations with a calm mindset, the improvements can be quite evident, and clients may express immense gratitude, leaving us puzzled about what we did right and why the results were so effective.
The individualized treatment plans designed for unique cases cannot guarantee success.
Even the most experienced and compassionate practitioners will encounter cases that do not succeed.
When evaluating our performance at work, rather than focusing solely on the success or failure of client treatments or their progress, it may be more beneficial to assess our value in this role.
This perspective allows us to strive for our best without being overly concerned about the outcomes.
There are many facets to evaluating our value; results are just one aspect, and the process can sometimes be equally important.
Clinical progress is one measure, but the feelings of the clients themselves or their family members and other significant relationships are also integral to our value.
Finally, self-evaluation is crucial, as it relates to our personality and value system.
My suggestion is to observe our peers and their standards for self-evaluation regarding work performance, akin to the concepts of statistical averages or medians, using the standards of the majority as a reference.
If your self-expectations are indeed too high, consider easing those nearly harsh standards.
Additionally, we are merely transient figures in the lives of others; in truth, we are not that important.
The issues faced by an individual child arise from a multitude of factors, including genetic predispositions, family upbringing, and environmental stressors.
Whether improvements can be made is certainly not solely the responsibility of the practitioner.
Taking on the responsibility for whether a client's most severe symptoms can improve is an unbearable burden.
This point may warrant further discussion, but that is my personal perspective.
Lastly, seeking help from a trusted professional to help you regain your composure and continue on the path of helping others should also be considered.
Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2013/09/13

More Info

Navigating the emotional challenges of working with children who exhibit persistent crying can be incredibly daunting, especially when traditional methods of engagement, such as play therapy, seem ineffective. It’s essential to recognize that children express their emotions in various ways, and persistent crying can often be a manifestation of deeper emotional distress, anxiety, or even trauma. In your situation, it appears that the child is not only crying but also exhibiting behaviors that suggest a significant level of distress, such as running away or expressing a desire to leave the environment.

First and foremost, it’s crucial to create a safe and supportive environment for the child. This means ensuring that the space is free from potential triggers that could exacerbate their anxiety. If the child is overwhelmed by the presence of adults or peers, consider reducing the number of people in the room or providing a quieter, more controlled environment where the child feels less threatened. Sometimes, children need time to acclimate to their surroundings before they can engage.
Additionally, it may be beneficial to incorporate sensory activities that can help ground the child. Activities such as playing with playdough, using fidget toys, or engaging in simple art projects can provide a non-verbal outlet for their emotions. These activities can serve as a bridge to establish rapport without the pressure of direct interaction. Allowing the child to express themselves through these mediums can sometimes lead to breakthroughs in communication.

It’s also important to validate the child’s feelings. Acknowledge their distress by saying things like, “I can see that you’re really upset right now, and that’s okay.” This validation can help the child feel understood and may reduce their anxiety over time. Children often need reassurance that their feelings are normal and that it’s okay to express them, even if it’s through crying.

In terms of your own emotional well-being, it’s vital to recognize the impact that working with emotionally distressed children can have on your mental health. As someone who identifies as having high anxiety, it’s understandable that you might feel overwhelmed in these situations. Consider implementing self-care strategies that can help you manage your anxiety. This could include mindfulness practices, such as deep breathing exercises or meditation, which can help you remain calm and centered during challenging interactions.

Seeking supervision or consultation with colleagues can also provide you with additional support and strategies. Discussing your experiences with fellow educators or mental health professionals can help you gain new perspectives and techniques for managing difficult situations. Remember, you are not alone in this, and sharing your experiences can foster a sense of community and support.

Lastly, it’s essential to set realistic expectations for both yourself and the children you work with. Progress may be slow, and it’s important to celebrate small victories, such as moments when the child engages even slightly or shows signs of calming down. Focusing on the process rather than solely on outcomes can help alleviate some of the pressure you may feel.

In conclusion, working with children who exhibit persistent crying requires patience, empathy, and a willingness to adapt your approach. By creating a safe environment, validating their feelings, incorporating sensory activities, and taking care of your own mental health, you can enhance your ability to support these children effectively. Remember, it’s a journey, and every small step forward is a success.

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