Non-acceptance means we are only making the situation worse for ourselves. We all have periods of doubt about the diagnosis. If this does happen it is important to go back and talk with our doctor.

Compounding this doubt are the anxiety symptoms and how they change. Once we get on top of one symptom, another one takes its place. Any new symptom needs to be checked by our doctor, and sometimes we may feel like a hypochondriac. However, it is more important for us to know what the new symptoms are, instead of continually worrying. If we are told the new symptom is another anxiety symptom, we need to accept the diagnosis and not get caught in the vicious circle again.

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The following is a discussion of the sleep associations that most commonly cause problems.

Feeding. The child who is nursed or fed to sleep learns to need the calming that comes from eating, sucking, and being held. If she rouses during the night, she will call for more of the same. She may also wake seeming “rested” with a burp after 20 minutes, but she will not be establishing dependable routines.

As she loses that newborn drowsiness, begin to keep her awake during feedings (easier said than done for some babies) or purposely rouse her while laying her down so that she knows she is falling asleep in her own bed, not in your arms.

Sucking. Pacifiers help some children settle themselves to sleep. Be aware that their use after ‘about three or four months means that this habit will eventually need to be unlearned.

Rocking. Rocking is a pleasant, calming experience for both child and parent, but it can be a strong sleep association. One alternative is to rock a child to soothe and lull him, but not put him into a full sleep. Or rock until it ceases to be soothing—perhaps at four or five months with the sociable child, or later, as mobility increases, when she squirms to get down to play.

Children love to “nest”—that is, move around in bed until it feels just right. If we confine them by rocking, walking, or whatever, we deny them this winding down pleasure. If you are a “pillow fluffer” yourself, you will understand.

Loveys. Many children become attached to special blankets, stuffed anim or toys. “Loveys” make it easier to sleep without parents. To avoid the pai of a lost or forgotten lovey, make more than one available (buy matchi blankets) or make it so general that a replacement might not be noticed.

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Fiona had been on Prozac (20 mg per day) for six or seven years. Although she credits Prozac for lifting her out of her depression, it left her with a ‘dazed view of the world’. Things did not feel ‘quite real’. Her mind was not clear and she would forget things. Her reactions were delayed and it was hard to keep up with a conversation even though she had previously been an extrovert.

Fiona’s GP wondered to what degree her problems with thinking were due to the Prozac, and brought her off the medication in order to find out. She soon became depressed again, at which time he started her on St John’s Wort (500-750 mg per day). Within two weeks her mood picked up. Her thinking was clearer and she was able to read again. She rates the anti-depressant effect of the St John’s Wort on a par with that of Prozac, but she feels that she is now ‘part of the world again’. With her newfound clarity she has restarted therapy and is contacting old friends and having lunch with them. She has even initiated ‘play groups for adults’, where friends come over simply to do fun things like painting or throwing medicine balls around. These get-togethers remind her of the ‘co-operative games of the 1960s’. T never got to play them then,’ she observes, ‘and I want to play them now.’

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