Worst hit were those children who experienced neglect or loss. But even for well-cared-for kids, there have been issues around socialisation.
Anxiety, she contends, is essentially awareness of death. Living with “the idea you could go to the supermarket, catch something and die, or give it to another family member and they would die” has had a significant impact.
If this is a Covid hangover, will things settle? Joss isn’t convinced, suggesting we are now in anxious-making times, “blindsided by life on a daily basis” and parenting “in a much more anxious way” as a result.
Another factor is social media. Before its advent, therapists posited the view that being a teenager is feeling like you’re being watched all the time. Now that they actually are Joss regularly sees teenagers with acute social anxiety. “It limits the way they live, they won’t do things they enjoy in case someone might say that they aren’t cool,” she says. “There’s a huge amount of pressure to be a certain way.”
With teenage girls this can manifest in their not eating at school because they are so worried about how people will view them.
“I’ve even heard them say that if you were to accidentally burp, it feels like it would end your life,” she says. “Other teenagers will see you in such a negative way that you’ll be cast out. That’s very scary.”
With younger children, separation anxiety, whether around school or parties, is a common challenge. Her solution is to give them the skills to manage alone. “Things like being able to read the time and know how long they’ve got to stay, or practise asking questions are all crucial. If they’re at a party and they don’t like the food, how can they politely ask if there is something else? Knowing how to do these things makes children feel empowered.”
She was asked to write the book after a publisher heard her deliver a lecture: one year on the copies of her book have landed and Joss is keen about disseminating their content. “If there are things I’ve learnt that can help mothers and fathers find it less stressful to parent, why wouldn’t I share that?
“As soon as your child is anxious, your life is basically derailed. You spend the whole time preparing and planning and putting things in the bag just in case. What if we tell him there aren’t balloons at the party, but there are? What will we do? Whatever it is, as soon as your child is anxious, you become noticeably anxious in trying to prepare.”
For the past 20 years, what children think and feel has become more and more valid. But we listen and are still not really sure what to do
She says modern parents are essentially parenting in a “new frontier” – better equipped to identify problems, but not necessarily to solve them. “For the last 20 years, what children think and feel has become more and more valid. But we listen and we’re not really sure what to do.” School refusal is one problem she encounters regularly. “You know you’re meant to take that seriously. But you’re not sure whether you’re meant to frogmarch them there.”
So what is the best response? To help parents tell their children they’ve heard them and can help, she says. “They’ve said they don’t like the playground so what can we do to make the playground feel more manageable? Our job, once they’ve told us what’s upsetting them, is to put things in place that still mean they do the things we think they should.”
Joss works part-time at a school and says teachers are a crucial part of the equation. “Teachers can be practical and make a safe space for children,” she says. “Part of the thing that stops children from being hyper-vigilant is the feeling they know what’s going to happen next.”
Timetables, or communication about when things might change, can help. Equally, teachers should show kids they can be trusted. “I recommend teachers show their skills. Tell the children they’ve done a first aid course, or they know how to fix something.”
What’s key is children feeling that adults are not helpless – something that also applies to aunties, grandparents and beyond. “This does a huge amount for children’s ability to calm down.”
Joss is scathing of the claim that we are seeing an overdiagnosis of mental health conditions, and an over-labelling of ADHD and autism. She doesn’t dispute that the numbers are rising – “it used to be probably one or two children with a diagnosis in an entire year. Now it’s four or five per class” — but doesn’t think it an issue.
She likens it to having a table “that’s long enough for everybody to sit down at”, even if they don’t in due course need to stay. “Everyone should be allowed to receive what they need. If that can sometimes mean people are over-diagnosed, that’s OK, because eventually they’ll work out they don’t need the medicine or the psychiatry, and they’ll stop.
“Does it matter if every label we give is exactly right? As long as it doesn’t mean that someone else can’t get what they need, I don’t think it does.”
But can diagnosis make a child more self-conscious, or exacerbate their differences? “I don’t think so,” says Joss. “For some children, a diagnosis is the biggest relief they will ever feel. All these years, I thought I was deficient. Now I know what my brain was doing, I can learn things to help me manage better.”
And children don’t want to be labelled, they don’t have to be – it can just be a route to better support. “Nobody has to tell anyone. If the label feels uncomfortable, don’t wear it. Receive the care you can get because of it and never mention it again.”
Everything Joss advises has been successfully applied in real life or, she says, it wouldn’t be in the book. Her experience also means, she says, that she is asked for tips all the time – at the school gate or by friends and family.
“I love it,” she says. “I’m pleased people ask. I really, really believe that if there’s something that you know that works, you should share it. I know how scary it can be for parents when you’re meant to be in charge and you feel that you’re not.”
Nor should people see asking for help as a sign of weakness. “Parents really punish themselves,” she says. But why should parents be knowledgeable about autism, for example? “Sometimes you need someone in the know to explain. You can’t possibly know everything, you’re not a computer.”
Parents are often extremely anxious when they come to see her. “They want me to work at speed, to get their child better as quickly as possible, which puts the pressure on,” she says . She also points out that therapy for children is different from that given to adults, who will often see someone for years. “I often see children for six sessions and that’s it. I have to make their lives drastically, noticeably better in six sessions.”
Her response is to offer tangible, affordable solutions. “If you are doing things consistently and calmly from the book, I think you would quickly see a change in your child.” Even small changes, she says, can bring down our children’s cortisol levels, so they sleep better, eat better, ask fewer questions about what’s coming next.”
She’s not afraid to admit that there’s an emotional toll to her work and that being a mother adds to it. “When you’ve seen a child reveal absolutely awful things you go back to your own child and think I would never hurt you, even by mistake. I would never do anything to make your life less lovely.”
Life is a hectic juggle; a clinic in Mill Hill, speaking slots and podcasts, school work, not to mention managing her children’s diary, which includes cheder. (When we spoke I could hear her son chanting in Hebrew in the background). In fact, she often speaks to parents in the evening. How does she manage it all?
“The therapy room is in the garden so I don’t have to have a long commute,” she jokes. And she likes to be busy. “I’m definitely a ‘do more’ kind of person – and I have an incredibly supportive husband.”
Ultimately, she hopes her book will help both parents and children become less anxious, whether they have a two-year-old or a 25-year-old. “There’s this beautiful cycle of empowerment,” says Joss. “An empowered child makes a parent feel better, which makes them better at parenting, which makes their children happier, which makes them feel empowered.
As she says to parents: “You’re the security guard. You’re the knight in shining armour.” Her book is about helping them find their uniform.
Help! My Child’s Anxiety is Giving Me Anxiety, Saskia Joss, is out now
Joss with her own parent Vanessa FeltzTim P. Whitby/Getty Images