I'm A Therapist Working With Children And Families. Here's How COVID-19 Is Affecting Them.

"COVID-19 has opened a Pandora’s box of emotional, behavioral and mental health issues that will be difficult to put back."
"Even the fear of germs, which may have been considered a phobia or obsessional thought for children and adults, is now at least somewhat appropriate," the author writes.
"Even the fear of germs, which may have been considered a phobia or obsessional thought for children and adults, is now at least somewhat appropriate," the author writes.
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As a psychoanalyst and parent guidance expert working in New York City during the COVID-19 pandemic with parents of children and adolescents, and often with the children themselves, it has broken my heart to see the pain and emotional suffering that families are currently experiencing.

Not only am I busier than I have ever been in my long career as a clinician, but the intensity and degree of my patients’ stress has increased exponentially.

The Centers for Disease Control and Prevention noted that 18- to 24-year-olds have reported high levels of anxiety and depression, and nearly a quarter have considered suicide. I’ve also seen this rise in despair among younger children, adolescents and their families in my own clinical practice. COVID-19 has opened a Pandora’s box of emotional, behavioral and mental health issues that will be difficult to put back in the box once the pandemic is under control.

Children and adolescents are faced with so many losses including social isolation, school transitions that didn’t happen, friends moving away without the ability to say goodbye, and family and extended family members getting sick and/or dying. The fears of parents and grandparents dying, which under normal circumstances they might feel and express as a normal part of development that I would treat as an anxious fantasy, has become a reality. Things I might call neurotic before the pandemic are now reasonable concerns.

Even the fear of germs, which may have been considered a phobia or obsessional thought for children and adults, is now at least somewhat appropriate. Children feel less safe, and many adults are having trouble comforting them because they too feel unsafe. Anxiety is rampant in children and the adults who care for them.

I also find myself deeply saddened at children’s loss of developmentally necessary social contact. Children over the age of 3 need social contact with their peers to learn to work through conflicts, participate in group activities and to engage in magical or imaginary play. They need imaginary play with their peers even more in an age of busy and preoccupied parents who feel estranged from play and childlike pursuits.

COVID-19 has made play dates with other children, particularly outside in cold weather, almost impossible with the exception of the occasional sledding adventure when the weather is right. I’ve noticed that things are easier for children who have siblings close to their age who can step in as playmates when the need arises. However, for the great number of only children, the pandemic has meant very little time with other children.

For adolescents, the lack of contact with their friends has been even more challenging because of their need for peer group support to move forward toward independence from their parents. COVID-19 has forced adolescents back in a regressive manner to spend more time at home.

Although there have been some advantages to this, including more time processing feelings with parents and an opportunity for parents to reconnect with their kids before they leave the nest, I have noticed in my practice that in general the social isolation from their friends is causing a great amount of dissatisfaction and depression.

Children also rely on the consistency of routines to feel secure. COVID-19 has replaced certainty with uncertainty, and comings-and-goings have replaced steadiness. Changes to school openings and closings, friends coming and going from second homes or rental homes outside of the city have made for an unpredictable mess for kids. Much of this loss and uncertainty cannot be helped.

Try as parents may, flexibility has become the norm and adapting to the ever-changing reality is a necessity. This leaves children having to cope with change constantly in a dizzying environment that makes finding a secure emotional foundation much more difficult.

The consequences of these changes for children will vary. For children from emotionally and financially secure families, spending more time at home can have its benefits. In spite of the challenges, these families are finding gratitude in the closeness and slowness of the time together. The majority of the families I treat, however, have been struck by financial insecurity, health scares, relationship difficulties, and an inability to balance work and caring for as well as educating children.

This leaves parents emotionally raw, impatient, and resentful of caring for their kids while being expected to “do it all.” Parents are often separated from their support system, either their extended family or their babysitters, due to COVID-19 and the risks of infecting or being infected.

We all thrive on certainty, and children even more so than adults. Children are resilient, but it is likely that the increased stress due to the pandemic will have significant and lifelong effects on children and adolescents.

Some of the healthier ones who have secure, emotionally supportive families that understand and allow for the grief process in the present while providing a clear and hopeful path into the future, pandemic or not, will do fine and may even come out of this stronger. However, a great many children and teens will find themselves feeling more fragile and susceptible to stress in the future.

As a clinician, I predict some of them may find that they have less of a capacity to tolerate frustration, pain and environmental changes, and some of them may even develop a post-traumatic stress response from chronic uncertainty, especially if their families have been hit particularly hard.

If I can offer any advice from what I do in my practice, it’s to help parents become great listeners, to reflect the feelings of their children rather than dismiss, discourage, ignore or deflect sad, angry and painful feelings of loss.

It is a parent’s responsibility to give children and adolescents as much opportunity to express their distress as possible. In becoming containers for children’s emotions, parents become the safe and steady environment that is lacking in the outside world.

Reaching out for help from therapists and parent guidance experts sooner rather than later is another way that parents can assure the best emotional outcome for their children and adolescents. We will all have to get back to some semblance of our old lives, though we may never know the complete safety of a pre-COVID existence, and that steadiness and constancy begins and ends with our own steadiness as adults.

Erica Komisar, LCSW, is a psychoanalyst, parent guidance expert and author of “Being There: Why Prioritizing Motherhood in the First Three Years Matters.” She is also a regular contributor to The Wall Street Journal and a contributing editor at The Institute for Family Studies.

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