Pain is a tough topic.
Pain is scary. Pain is messy. Pain is loud, and demands attention immediately.
Talking with children about pain is especially difficult. It is all too easy to minimize or negate another person’s experiences of discomfort, especially if we ourselves are uncomfortable. Instead of teaching children to recognize, understand, and cope with pain, they are often told, “It doesn’t hurt that bad” or “toughen up, that couldn’t have hurt.”
Pain demands attention immediately.
Witnessing a child in pain brings to the forefront our own conflicted feelings, and lack of language for dealing with our own pain. Medical professionals whose practice often includes causing pain are especially vulnerable to not recognizing or acknowledging a child’s experience.
I wanted to share some direct and simple ways to explore pain with the children in your life. After all, pain is such a fundamental human experience. Teaching them to understand and cope with it can truly enhance their development.
It starts with Trust.
One of the most important things to a child who is experiencing, or potentially experiencing, pain is that their caregivers trust them. You can show you trust by listening attentively, acknowledging experiences, and offering a glimmer of hope
Acknowledging pain can often go a long way. Many kids who are hurt –by a skinned knee, unexpected tumble or IV poke– just want to know that their pain is heard and recognized. Sometimes a simple, “that looked like it really hurt you” is enough for a child to begin to calm. Most of the time pain can even be acknowledged without words. A touch, or hug, could be enough for a child to “feel felt.”
Helping a friend after a tumble. When parents model empathetic behavior, children learn to be empathetic towards each other, too.
Because going to the doctor’s or hospital is an experience almost all parents will face, it’s important to remember that not everyone in the medical field is empathetic about pain in children. If, while at a doctor’s visit, you hear someone use language that minimizes or dismisses pain, or fails to acknowledge that a procedure (vaccination shot, IV, blood draw, blood pressure cuff, etc.) might be painful, they may be instilling mistrust with your child. It can be helpful to ask a medical professional to explain a procedure in simple, but concrete terms to you and your child. Once you have acknowledged something might be painful you can move on to making a plan to manage it.
Name it. Tame it.
Bestselling author and leading neuropsychiatrist Daniel J. Siegel talks about helping children connect experiences, like pain, that are processed on one side of their brain, with the narrative tools that help us understand those experiences on the other side.
Naming the pain often allows for an easy path to reducing it. You can help children name and tame their pain by having them describe what they are feeling in more descriptive terms: Is it hot, cold, fast, slow, throbbing or dull and heavy? If your child has fallen down on the playground they may be too upset to tell you where or how they’re hurting at first. You can help them out by asking them to point to the pain, and asking them what would help the pain go away.
For example if your kiddo has fallen down and scraped their knee they may describe it as burning hot, and stinging. A simple response could be, “would you like to put something cool and soft on it to help it not be burning and stinging?” This response shows that you heard (used the words they used) and reminds them that something can be done to reduce the pain. Using this technique I have heard children describe their pain in ways that would make poets jealous, but more importantly they were able to take their descriptions and turn them into actions and plans to help relieve their pain. This process can be empowering for children, and provides a sense of accomplishment and self-utility.
Make a plan and help them carry it out.
Pain and the prospect of pain can be much scarier when you have no way to deal with it. Having open dialogue about pain and discomfort can help to establish plans about what to do later when the plan is needed. Here are some ways children I work with have told me they intend to deal with their pain: watch a video on Netflix (distraction), squeeze their parent’s hand (action), take deep breaths (self-soothing), sing Let it Go (re-engagement). An important thing to remember is that none of these plans means that they are not feeling the pain, rather that they have something they can do to help them get through it easier.
Children look to adults to be calm, emotionally regulated, and honest when facing pain.
Once a child starts to feel pain, it might be difficult for him or her to remember the ways that they deal with getting hurt; it can help to have a reminder from a caregiver or even a little coaching. Most of all, children look to adults to be calm, emotionally regulated, and honest when facing pain. A child who’s just fallen off the bike they’re learning to ride, might first need you to attend to their pain before giving them advice or reflection on not falling off in the future. Connecting their pain to a solid narrative can really be helpful: “I saw you leaning really far to the side, then you put your leg out, then you fell on your hand and knee.”
Reflection
After a painful ordeal it can be therapeutic to talk about what caused the pain, how intense it was, and what helped to make it go away (or more bearable). These conversations often yield important clues about how a child wants to be taken care of when they’re in pain, and can reveal whether they feel that adults were honest with them.
For further reading I highly recommend:
A Child in Pain by Leora Kuttner, Ph.D.
UC Davis Medical Center’s document on what to do when your child is in pain
Post by Jonathan Iris-Wilbanks, MA, CCLS
Photos by Meade Peers McCoy and Jaime Greenberg
