By Patrick J. McGrath, OC, PhD, FRSC
Question:
My three-year-old son has developed nightmares and fears after seeing a movie at the babysitter's place. The babysitter said that my son was the only one that found it scary. He was upset after the movie about the monsters in the movie and kept talking about them. I have tried to get him to ignore them. We got him a night light and now lie in bed with him. He wants me to stay in his room until he falls asleep. When I get up to go, he wakes up and will get upset if I try to leave. After he is finally asleep, he wakes up with nightmares saying the monsters were chasing him. Instead of getting better over the past three weeks, he seems to be getting worse. He has a great imagination but is a bit anxious. Do you have any suggestions?
Dr. Pat responds:
Some children are more sensitive to experiencing movies or TV as frightening. In addition, a child may become more sensitive if he is under stress or feels unwell. Your son's good imagination is a great advantage in life but may be causing the problem.
He may have been teased by the other children or embarrassed by his fear.
His fear is growing because he does not have the skills to manage his feelings. He can learn these skills but it will take effort by both of you.
First of all, have him tell you more about the monsters. He may be able to do this in words but for many children drawing a picture will work better. Get him to tell you what the monsters look like, what they do, how large they are, and so on. Maybe he can give them names. When you discuss his ideas about the monsters, praise how good he is at thinking these things up.
It is very difficult to face a fear that is so vague that we don't know what it is. This process will help him identify the problem and will allow him to face it. Don't accept that he does not want to talk about it. It will also help him realize that it is his imagination that is creating them and the monsters are not real.
Second, you have to give him the tools to conquer the monsters. Maybe he needs a magic word that will cause them to disintegrate. Maybe the two of you can devise an imaginary laser gun or a special way of tricking them to return to their caves. Have him practice overcoming the monsters. Get him to draw pictures of the battles.
Third, he has to have the motivation to beat the monsters. I would suggest that you have a chart to reward him for successful battles. Maybe he can get special time or a small treat for successes.
Reduce the comfort and sympathy he gets for being afraid. Spend a set amount of time with him at bedtime. Give him all the weapons he needs to do battle with the monsters but he is the dragon-slayer, not you. Everyone knows that adults cannot kill monsters, only children can. Wean him from his dependence on you to fall asleep. Gradually but firmly move out of his room at bedtime.
If he wakes up with the monsters chasing him, comfort him for a few minutes but get him to "kick ass" with the monsters. Have him use the magic word, the laser gun, and anything else to beat them up and chase them away.
Patrick J. McGrath OC, PhD, FRSC is a clinical psychologist and a researcher. He is Professor of Psychology, Pediatrics, and Psychiatry at Dalhousie University and Vice President - Research at IWK Health Centre in Halifax. He is also the CEO of the Strongest Families Institute, which provides mental health care to families across Canada.
Read more "Ask Dr. Pat" columns
If you would like to send Dr. Pat a question, please email us at about.kidshealth@sickkids.ca.
Dr. Pat will respond to as many letters as possible with evidence-based answers. We hope that the column will be interesting and helpful for readers; however, Dr. Pat cannot provide health care through the column. Please contact a physician or other registered health care professional to provide health care guidance or advice.