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Mental Health

Fear of Button

05/28/2009

Question:

My four year old son, has a extreme fear of buttons. We have known this for a couple of years. This year as he entered Pre-K it came to a head. His school uniform is a polo with 3 buttons. We addressed this as best we could. We removed the buttons and bought shirts without buttons. Recently he has been overly aggressive with his friends. (it`s now late April, he`s been in school the whole year) When he tries to explain to us why he is "striking" (biting, hitting, etc.) out at his friends he often expresses something like, the friend was invading his space, but of course in a 4 year old`s vocabulary. Reading about stress and anxiety on your site and others I wondering whether the stress of his friends` buttons near him is causing excessive anxiety. How can we find this out? How can we remedy this? I don`t want to put the child on medications if possible. We have to stop the aggressive behavior somehow. Any info you can offer will be greatly appreciated. Thank you.

Answer:

Hello and thank you for your question about your four-year-old son who has an extreme fear of buttons. In this day and age, that must be a very frustrating phobia for him and all concerned. Phobia can develop around any object, situation or person. There's even a phobia of all things English (Anglophobia), which, being an Englishman myself, I can't fully comprehend! :)

Button phobia has its own official name, "koumpounophobia" from the Greek "koumpouno," meaning to button and, "phobia" meaning fear. It was even featured in a recent BBC report: http://news.bbc.co.uk/1/hi/magazine/4849832.stm.
 
OK, as a clinician, I would want to know if this is a straight-forward case of a specific phobia of buttons or if anything else is going on. The only way to know that is for a licensed mental health professional, with expertise assessing pre-schoolers, to do a comprehensive and detailed psychological assessment of ALL the possible psychiatric diagnoses a 4-year-old could have. This should take about 2-3 sessions and, preferably, should be obtained from a cognitive-behavioral therapist whose approach focuses on changing impairing emotions (like phobias) by changing cognitions (unhelpful thoughts/images) and unhelpful behaviors. Cognitive-Behavioral Therapy (CBT) has the most scientific evidence supporting its effectiveness.

To find a cognitive behavioral therapist experienced with assessing young children you can call your local psychological association (just Goggle, "name of your state" psychological association), university, community mental health center, or National Alliance on Mental Illness (NAMI) chapter to ask for names, locations and phone numbers of such mental health professionals.

Currently, I think the three best books for parents of children with anxiety disorders are (not in any order):

1. Freeing Your Child from Anxiety: Powerful, Practical Solutions to Overcome Your Child's Fears, Worries, and Phobias  by Tamar E. Chansky

2. Keys to Parenting Your Anxious Child (Barron's Parenting Keys) by Katharina Manassis M.D. (Paperback - Feb 29, 2008)

3. Helping Your Anxious Child: A Step-by-Step Guide for Parents - Paperback (Dec 3, 2008) by Ronald M. Rapee, Ann Wignall, Susan H. Spence, et al. 

Hope that helps! Best of luck and best wishes.

Related Resources:

Mental Health Services Locator (Center for Mental Health Services)
National Register of Health Service Providers in Psychology
State & Local NAMIs

For more information:

Go to the Mental Health health topic, where you can:

Response by:

Nicholas   Lofthouse, PhD Nicholas Lofthouse, PhD
Clinical Assistant Professor of Psychiatry
College of Medicine
The Ohio State University