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Montefiore in the News

March 26, 2022

Health

Reasons for their fright differ and may change. Experts offer these tips for parents.

By Daryl Austin March 26, 2022 at 9:00 a.m. EDT 

Health & Science illustration for the story about children who is afraid of the dark, 0329. Daniela Martín del Campo for The Washington Post (Daniela Martín del Campo for The Washington Post)

If your child is afraid of the dark, they’re not alone.

“It’s very common in children and adolescents alike,” says Thomas Ollendick, a distinguished professor emeritus at the Child Study Center at Virginia Tech who has dedicated much of his career to understanding fears and phobias in children. He says a fear of the dark is among the three most recurrent he encounters.

“One review of 29 studies published over 40 years on the psychosocial treatment of nighttime fears in children found that children presented with a fear of the dark in 72 percent of the studies,” said Simon Rego, the chief psychologist and director of the cognitive behavioral therapy training program at Montefiore Medical Center in New York.

The fear is so common that Gene Beresin, a professor of psychiatry at Harvard Medical School and executive director of the Clay Center for Young Healthy Minds at the Massachusetts General Hospital, called it?“a normal phase of development.”Lessons for my children about fears, real and imagined

A fear of the dark occurs for reasons such as biological predispositions and evolution, as night is when ancient humans were most vulnerable to predators, experts say. Some children have had negative nighttime experiences they associate with the dark such as wetting the bed or nightmares, while others struggle with more general fears and anxieties that are exacerbated by darkness or solitude. Limited visibility plays a part as well.?“When we cannot see well, we feel more vulnerable,” says Joe Bienvenu, an associate professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine. 

Reasons can change

The reasons a child may be afraid of the dark can change. “Different things contribute to a fear of the dark for different age groups,” said Wendy Silverman, the director of the Yale Child Study Center Program for Anxiety Disorders at Yale School of Medicine. “For young kids ages 2 to 4, seeing shadows and hearing noises is enough to make them think of monsters and boogeymen. For kids ages 5 to 7, starting school may develop separation anxieties from their parents which can translate into not wanting to be alone at night. Kids ages 8 to 12 catch bits and pieces of the news and may hear scary stories about burglars and violence from other kids in the neighborhood.”

The common thread linking every age group — and the most frequently cited contributing factor of this fear — is excitable imaginations.?“Children have active imaginations and are still developing their ability to differentiate fantasy from reality,” says Mari Kurahashi, a director in the Division of Child and Adolescent Psychiatry at Stanford School of Medicine.

“Children who are old enough to let their imagination run wild, but not yet old enough to distinguish their imagination from reality,” are especially prone to a fear of the dark, Rego says.

A fear of the dark, though common, can still disrupt sleep cycles of children and parents alike through frequent nighttime interruptions or even impediments to everyday life. Beresin said that unmitigated fears can become phobias that could “involve panic attacks … heart palpitations, hyperventilation, dizziness, nausea, shakiness, feelings of terror and impending doom and intentional avoidance of the object of fear — in this case, a refusal to go to bed.”

How parents can help

Parents can help alleviate a fear of the dark through a variety of proven practices.

Limit exposure: Parents can handle overactive imaginations by limiting exposure to scary stories and images and by giving children something more enticing to think about instead. Beresin says parents could find bedtime stories that are fun and stimulating to a child’s imagination and choose books that specifically address a fear of the dark. Doing so, he said, “has proven to be an effective technique in helping kids tackle fears of the dark.”

 Add a comfort item: Coupling bedtime stories with comfort items such as a stuffed toy can also be helpful as these items can be?“transitional objects” between a parent and child. Tamar Chansky, a psychologist in suburban Philadelphia and author of “Freeing Your Child From Anxiety,” said that children often see soft comfort items as extensions of themselves that can help them build a relationship with oneself, “through the ‘middle person’ of their stuffed animal.” “The goal is for kids to increasingly be able to reassure themselves,” she said. “Hugging a comfort item is a concrete way for kids to self-comfort even when their parents aren’t there.”

Try behavioral therapy: Another technique parents can use is cognitive behavioral therapy (CBT). “The best evidence-based approach to treat any anxiety is” CBT, Silverman said. She said that the behavioral part of CBT involves helping a child confront the fear that scares them. “The more they associate with their fear, the less power it has over them,” she said. “By contrast, the more they avoid the thing that scares them, the more it governs their life.”

Silverman said that children can be helped through fears with a comfort item or a night light, but that parents should never eliminate the fear completely by leaving overhead lights on all night or by letting kids sleep in bed with them. “Doing so only prolongs the problem,” she said.

Instead, parents should slowly increase the length of time a child spends facing their fear. “Try gradual exposure strategies where the child can have some gradual exposure to being in the dark,”?Kurahashi said.

The cognitive side of CBT comes in helping children reason through their fears.

“If a young child can grasp that the boogeyman simply doesn’t exist, it loses power over them,” Silverman said.?"Cognitive skills can be taught to combat anxious thoughts or images such as talking back to their fears by saying something like ‘that’s not real’ or “there goes my brain trying to trick me again,' ” Rego said.

Teaching myself, and my daughter, to self-soothe

Teach them to self-soothe: Teaching little ones how to self-soothe through affirmations or meditative breathing techniques can also be helpful. “The ideal is for your kids to learn how to comfort and soothe themselves,” Beresin said. 

Be sympathetic and patient: Experts stressed the importance of sympathy and patience when talking to children about fears of the dark.?“It’s important for parents to remain calm, take time to understand, note how common it is to have a fear of the dark, and convey a sense of confidence that the child can successfully manage the fear,” Rego said.

Rachel Busman, a senior director for Cognitive & Behavioral Consultants and the former director of the Anxiety Disorders Center at the Child Mind Institute, said parents should keep conversations positive and light.

“Parents in general should avoid intense conversations at bedtime," she said. “They should give reassurance through physical comfort when a young child is distressed and brief statements of comfort.”

“Be compassionate, but smart about this,” Chansky said. “Take your child at their starting point, and gradually move forward. They will get there.”