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Dr. Eli Lebowitz is a renowned expert in the field of childhood and adolescent anxiety and serves as the Director of the Program for Anxiety Disorders at the Yale Child Study Center. His expertise includes extensive research on the development, neurobiology, and treatment of anxiety and related disorders, with a focus on how generations and families influence these conditions.

Dr. Eli developed SPACE (Supportive Parenting for Anxious Childhood Emotions), a pioneering parent-based treatment program for childhood and adolescent anxiety. This method — proven effective in randomized controlled trials — shifts the focus from children to parents, helping them modify their behaviors to treat their children’s anxiety issues, including separation anxiety, social and generalized anxiety, fears, phobias, panic disorder, and OCD.

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Here’s a glimpse of what you’ll learn:

  • [04:23] How Dr. Eli Lebowitz entered the field of research and treatment for childhood anxiety
  • [08:32] What makes childhood anxiety disorders different from adult anxiety?
  • [12:47] Addressing childhood anxiety without blaming parents
  • [13:29] The impact of children’s anxiety on families
  • [16:44] How parents can accommodate their children’s anxiety
  • [24:54] Common bedtime struggles for children with anxiety
  • [26:30] A playful approach to helping anxious children cope
  • [35:23] Treating anxiety in children by reducing accommodating behaviors
  • [37:24] The value of self-control in overcoming anxiety and OCD

In this episode…

Navigating childhood anxiety can be a daunting task for any parent, especially when facing inadequacy and guilt for failed treatments. How can you support your anxious child effectively without inadvertently reinforcing their fears and anxieties?

According to Dr. Eli Lebowitz, a specialist in childhood and adolescent anxiety, the key lies in understanding and adjusting parental behaviors toward this condition. Dr. Eli highlights the importance of reducing accommodations that may exacerbate a child’s anxiety while providing supportive, confidence-building communication. When adopting this approach, rather than forcing your child to engage in distressing activities, it’s best to recognize your accommodating behaviors to adjust your perspective.

In this episode of the Inspired Insider Podcast, Dr. Leigh Weisz and Dr. Jeremy Weisz are joined by Dr. Eli Lebowitz, Director of the Program for Anxiety Disorders at the Yale Child Study Center and creator of the SPACE treatment. They explore strategies for managing anxious children, tackling bedtime separation anxiety, and addressing parental disagreements in treatment. Tune in for insights and a “magic tip” for streamlining bedtime routines.

Resources mentioned in this episode:

Special Mention(s):

Related episode(s):

Quotable Moments:

  • “Child anxiety disorders are adult anxiety disorders in a smaller package.”
  • “All mammals are born very ill-prepared for life.”
  • “Anxiety problems do start in childhood.”
  • “As accommodation gets more and more, children’s anxiety gets worse rather than better.”
  • “Any anxiety can be separation anxiety.”

Sponsor for this episode

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Cofounders Dr. Jeremy Weisz and John Corcoran credit podcasting as being the best thing they have ever done for their businesses. Podcasting connected them with the founders/CEOs of P90xAtariEinstein BagelsMattelRx BarsYPOEOLending TreeFreshdesk, and many more.

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Episode Transcript

Intro 0:15 

You are listening to Inspired Insider with your host, Dr. Jeremy Weisz.

Jeremy Weisz 0:22 

Dr. Jeremy Weisz here host of inspiredinsider.com where I talk with inspirational leaders and founders.

Dr. Leigh Weisz 0:29 

I am Dr. Leigh Weisz. I am the host of The Coping Podcast where I feature top experts on topics like raising healthy children, parenting and much more. Before we formally introduce you, Dr. Eli, we always like to mention past episodes of our podcast to check out. On The Coping Podcast. I featured my colleague Ben Kessler in a fascinating episode we appropriately called Technology Addiction in Kids and Teens HELP!. I also featured Dr. Michelle Cutler, where she answered questions about the July 4th mass shooting that occurred here in Highland Park.

Jeremy Weisz 1:06 

And Dr. Eli, since you’re an industry game changer, some of the ones on Inspired Insider or some past guests who I consider industry leaders and game changers have transformed industries. I had the co-founder of Pixar on Alvy Ray Smith, he talked about the early days of starting Pixar, he told some great George Lucas stories, Steve Jobs stories, I had Mois Navon on, one of the founding engineers at Mobileye. Eli I don’t know if you’ve heard of Mobileye before, but they held from Israel, and they talk about how they helped move the autonomous vehicle industry forward, self-driving cars, and their journey to be acquired by Intel for $15.3 billion. So it’s an amazing, there are a lot of ups and downs in that journey. This episode is actually brought to you by Rise25. At Rise25 we help businesses give to and connect to their dream 100 relationships and how do we do that we actually help you run your podcast, we’re an easy button for a company to launch and run a podcast we do the accountability, the strategy and the full execution of the podcast, we call ourselves kind of the magic elves that work in the background, to make it look easy for the hosts in the company so they can develop amazing relationships and create great content. For me, the number one thing in my life is relationships. And I’m always looking at ways to give to my best relationships. And I found no better way over the past decade to profile the people and companies I most admire on this planet and share with the world what they’re working on. So if you thought about podcasting, you should if you have questions, go to rise25.com. If you check out other episodes, you can see, I’ve tried to answer every possible question there is about what do you do when you’re starting or launching a podcast, so check those out. Here’s the interview. We are very excited to introduce Dr. Eli Lebowitz. He studies and treats childhood and adolescent anxiety at the Yale Child Study Center, he developed a methodology called SPACE. And SPACE stands for supportive parenting for anxious childhood emotions.

Dr. Leigh Weisz 3:07 

Unlike many of the traditional treatments for childhood anxiety, SPACE is a parent-based treatment program that helps parents change their behaviors in the service of treating their children’s anxiety. So it’s what I typically call in my practice the behind-the-scenes way of treating a childhood problem. And it’s really through the parents alone.

Jeremy Weisz 3:27 

And some of the anxiety problems that are treated with SPACE include separation anxiety, social and generalized anxiety, fears, and phobias, panic disorder, OCD, and many, many more.

Dr. Leigh Weisz 3:40 

And Dr. Lebowitz is the author of the book Breaking Free of Child Anxiety and OCD, which I have here. And it is a wonderful informative book. And thank you so much for joining us today.

Dr. Eli Lebowitz 3:54 

Well, thank you so much for having me on. Those are some tough acts to follow in terms of the previous guests that you’ve had. So I’m honored to be on; thanks so much.

Jeremy Weisz 4:04 

You got it. This is awesome. So I just wanted to start first with how would you even we’ll talk about some specific examples for parents are listening, we’re gonna go into really specific examples. And but I want to start with how did you get into this area of research and treatment to begin with?

Dr. Eli Lebowitz 4:23 

Yeah, this story goes back quite a few years at this point. When I finished my dissertation, I did a PhD in psychology and trained in psychoanalysis, which was the thing of the day and a little bit of cognitive behavioral therapy that was just kind of getting started. And I was working in a large Children’s Hospital and I was actually working in two clinics. One of them was an anxiety and OCD clinic where the treatment that was delivered was cognitive behavioral therapy. And I also worked in a parent guidance clinic for parents of youth with really severe behavior problems, delinquency, aggression, vandalism, and things like that. And one of my jobs in the anxiety OCD program was to try to screen incoming new families and try to figure out would these be a fit for treatment? So what did I do? I had a very easy method, it wasn’t very complicated. I would mostly just ask, does your kid want? How do they want to do this treatment? And when parents said, yeah, or the kids said, yeah, absolutely, I want to do this, we’d say like, great, you’re a good fit for this treatment. And when parents said, well, they don’t really want to do it, or the kid wasn’t really very motivated, I’d say, well, you’re not a really good fit for this treatment. And I don’t think we’re going to be able to help you. But I got really frustrated over time. Parents would say to me, and it’s so reasonable, they would say to me, yeah, my kid is too anxious to do the kind of treatment that you’re talking about, cognitive behavioral therapy, that’s a really demanding treatment, it requires a lot of motivation, it means doing exposures to the things that you’re afraid of. The parents would say, well, of course, they’re anxious. That’s why we’re here. So do you not treat anxious kids with your anxiety treatment, like what is going on, it didn’t make sense to them. And I have to admit, it didn’t make a lot of sense to me either. Because on the same day, that I was saying to those parents, oh, sorry, I don’t think we’re gonna be able to help you, I would walk down the hall to the parent guidance clinic, and say, to the parents of a kid with conduct disorder or Oppositional Defiant Disorder, oh, we don’t need your kid to come in. We’re gonna work with you. Because that’s a lot for a long time. That’s been the go-to approach in the externalizing problem world and the behavior problem? Well, it’s like, we’re going to work with parents, these kids are often not ideal candidates for therapy. They’d rather be setting fire to the police station. And so we would work with the parents and say, hey, we’re gonna give you the tools. And it just really drove me to think a lot about why do we not have more to offer to parents of kids with anxiety? Like, why is there so little to offer there because when parents, when researchers tried to work with parents in the past, in the treatment of child anxiety, they all did the same thing, basically, almost everybody, and that was to try to train the parent to do cognitive behavioral therapy to their child. And it turns out that that is not the best approach. Because if your kid doesn’t really want to do CBT, with their therapist, they are definitely not going to do it with parents.

Dr. Leigh Weisz 7:50 

I was gonna say they definitely are not gonna want to do with their parents.

Dr. Eli Lebowitz 7:53 

Exactly, exactly. I mean, who can get your kid to do anything better? You or somebody? Literally anybody else on the planet, usually, right. And so it turned out that that wasn’t really the best approach. And so I really got to thinking a lot about like, what can we do with parents, and that was like, part of what, what really led to this development?

Dr. Leigh Weisz 8:15 

That makes a lot of sense. I really like how you conceptualize anxiety in children is not just a child problem, but you’re also very careful not to blame parents. And I agree. Can you share more about how you understand this system between the parents and the kids?

Dr. Eli Lebowitz 8:32 

Yeah, I think it’s actually a really important point, because what we’re really trying to do is change the way that we think about child anxiety disorders, for the longest time, the way we thought about child anxiety disorders, is basically adult anxiety disorders in a smaller package in a smaller person and a younger person as though it’s exactly the same phenomenon. And that works to a degree, because in fact, yeah, child anxiety, in many ways, is very similar to adult anxiety, you do have worries, your fears, you have avoidance, all of those things that you have in adults. But what that really misses, is that actually child anxiety is not quite the same as adult anxiety. And the reason it isn’t is deeply rooted in our biology, in our basic makeup as lay our species, right, this isn’t just an abstract idea. It’s deeply rooted in our biology, especially and in particular, in our biology as mammals. Because pretty much all mammals are born, very, ill-prepared for life. Right? Like we’re not able to survive as mammals without somebody else. Of course, we’re not able to feed ourselves. So we’d all die off if nobody fed us, but we’re also not able to protect ourselves. Why is that important? Because we have been shaped to respond differently to fear when we’re young when we know I mean, no, I’m putting in quotes because this is like evolution. But we basically know like, I can’t deal with these threats on my own. Right? If you imagine a grown-up, who is facing a threat, let’s say somebody is like, I don’t know, yelling at them on the street, what do they do, they do the classic fight or flight, right? Maybe they confront that person, maybe they avoid them? Well, if you walk up to somebody’s baby, and you scare that baby, which to be clear, I’m not encouraging you to do, I don’t actually recommend that. All of my preliminary pilot research indicates that it will not make you many friends, start walking up to people’s babies and scaring them. But if you did, that baby is not going to fight. It’s not going to flight. What is the baby gonna do? It’s gonna cry, right? We all know, it’s gonna cry, because that is a way of alerting somebody else, meaning that insured run, we respond differently to fear. So if you have an anxiety disorder, meaning you have chronic fear activation in the wrong context, what are you going to do, you’re going to chronically activate somebody else, you’re going to activate your parent, you’re going to look to them to protect you, to soothe you, to comfort you to reassure you to defend you, right, it’s all directed toward the parent. And in that sense, child anxiety disorders really are interpersonal phenomena. They’re not individual phenomena. It’s not like having a sprained ankle that lives just in your foot or a dental cavity that lives in your mouth. It is something that exists between parents and child, because that is our system. Exactly. That’s how our species evolved to deal with fear. That’s actually the part of child anxiety that most differentiates it from adult anxiety. But it really changes how we think of these problems and how we work with parents when we realize just how interpersonal of an issue it actually is.

Jeremy Weisz 12:19 

I’d love to talk, actually, about a couple examples. You mentioned anxiety and social anxiety, I was actually talking to a friend at a gathering a couple weeks ago. And he just said, it’s really tough for me to be here because I have social anxiety. And he’s had it since he was a kid, and I’m glad he felt comfortable sharing that with me, and that he got out of the comfort zone. But I’d love to hear some examples from you and you have one or how it affected siblings. Yeah, you could talk about that.

Dr. Eli Lebowitz 12:47 

Yeah, and by the way the example of your friend is such a classic example. Because these problems, anxiety problems, they do start in childhood, right? Like that is so typical, you could meet somebody, maybe they’re first diagnosed with anxiety, they might be 55 years old, they might be 65 years old, 45 years old. But you ask them, when did this problem start? Nine times out of 10 they’re gonna say it’s been my whole life. Right? Maybe I didn’t get help. I never got treatment. Nobody knew about it. But when did it start? It started when I was a child, because, like these problems start when you’re really small. So in that sense, it’s really typical. And yeah, the social anxiety will often, like all the anxiety problems, affect the parents and the family because of their tendency to look to parents. And because of parents’ natural tendency to accommodate those anxiety problems, meaning to just change what they are doing, because of what their anxious child is experiencing, because they don’t want them to be anxious. And in social anxiety, a lot of times we’ll see a really big impact on siblings as well. For example, I worked with a family where there was one child who had pretty severe social anxiety so felt really overwhelmed in social situations. Now, I’m not just talking about the kid who doesn’t want to get up in front of everybody and start belting out songs out loud, right, like that’s what we call normal. But I’m gonna bet a child who, just like walking, walking down a hall is flooded with thoughts about what’s that person thinking about me? Am I walking funny? Do they think I’m stupid, cute, you know, won’t go to any event. Now, where do the siblings come in?

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