A few months ago I was working with a 10 year old girl I’ll call Jennifer (as always, names and details changed). I was initially working with Jennifer on helping her reduce her anxiety about being around her peers.   However something else which was quite noticeable about Jennifer’s challenges was this:  she struggled to show almost any positive emotion.  Jennifer rarely smiled in sessions, and despite me doing a great deal of play, games and rapport building with her, found it almost impossible to talk positively or enthusiastically about any of her interests.   

When I asked Jennifer’s Mum about how she acted at home,  she told me that Jennifer frequently looked unhappy or anxious at school and around other children too – and had been like this for some time.   

Some children smile less frequently, and/or show less enjoyment, interest, excitement or happiness in their words or faces than other kids.  They have a “blank”, sad or worried expression on their face a lot of the time, often stay quiet when something positive happens to them, or talk much less enthusiastically or positively about their interests compared to other children.

Take a moment to remember a time in the last few days in which you felt stressed, frustrated or worried.   Reflect for a moment on your body in that moment.  Your heart rate had sped up a little, you were breathing a little quicker, your body temperature rose slightly and your muscles were more tense than usual.   You might not have noticed these things at the time because you were focused on whatever problem you were managing, but it was there in the background. 

This reaction is a deep seated physical response for humans, and happens for kids too.  Whenever they perceive some kind of danger, threat or problem, their bodies react by increasing what can be called their “physiological arousal”- either just slightly (eg they might say they have a headache because they’ve had tense shoulders for example at the end of the day) or a significantly (they might hyperventilate, experience heart racing, or rigid body which makes them scream/yell or stops them even being able to talk). 

All children and teens will act in unhelpful ways at times. They will be unkind, frustrated, forgetful, rude and mean.  They will exclude others at times, talk defiantly, fail to tell the truth and act angrily.  This is just part of being a young person - and a human being. Most parents know their kid and teens do this - we see this behaviour in our children at home ourselves. 

However, sometimes this challenging behaviour happens at school and we don’t know about it. Of course any major or significant behaviour problems are usually bought to our attention (for example: when a teacher calls, in school reports, or when there is a note about a time out/detention etc.)

One of the important questions I ask the children and teens I work with is this: “would you please tell me about your friends?”.    

This question sometimes surprises them (and their parents).  When they made an appointment to see a psychologist they were expecting questions about feelings, emotions and life challenges, not necessarily about who they hang out with.  But it’s essential for me to know about young people’s friendships because when it comes to young people’s mental and emotional health – research shows peer relationships are vital.

For example, studies show that children and teens who have good friendships report increased happiness compared to children who don’t have these friendships.  Other studies show that young people with positive peer relationships are less likely to act in disruptive and challenging ways.  Other studies suggest that young people with stable friendships are more likely to achieve better school results.  There have also been numerous studies showing that young people who experience genuine and long term bullying (i.e. not just “unkind” behavior) are more likely to experience mental health issues as adults.

12 year old Tyler* and his mum came to visit us concerned about something they called his “twitch”.   To show me what they were talking about, they bought along an iphone video of Tyler playing his xbox while this twitch was happening.  Basically Tyler’s “twitch” consisted of him tightening up one half of his face in a tight wink while swallowing hard at the same time.  This had been increasingly happening to Tyler for several months.  Now it would happen for hours at a time while playing his game, and also at times of stress at school.  Tyler felt embarrassed about it, and his Mum felt worried for him – their GP had recommended they come and see us.

Tyler’s “twitch” is usually called a “tic” by psychologists.  Tics are defined as a “sudden, rapid, recurrent, nonrhythmic motor movement or vocalization.”  Tics can be simple – involving just one movement/noise – or complex – which are movements or vocalisations which involve a range of actions/noises.