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Book Excerpt: When Children Feel Pain

How can parents dealing with their own chronic pain teach children to manage pain in a healthy way? The authors of a just-published book from Harvard University Press offer advice.

Yellow book cover of When Children Feel Pain - From Everyday Aches to Chronic Conditions

By instinct, most new parents will respond quickly when a baby cries. It’s a best practice endorsed by pediatricians to give children a sense of security, a feeling that their needs will be met.

But the parenting road is long and no one really teaches moms and dads how to react when a child is injured, ill or in pain. A new book, “When Children Feel Pain: From Everyday Aches to Chronic Conditions,” takes on this underexamined topic with a goal of improving pain management and illuminating the complexities of pain experienced by kids and teens.

Because many medical conditions are genetic, passed down from parent to child, and because parents’ attitudes and approach to pain can influence their children, chronic pain can run in families, say authors Rachel Rabkin Peachman, a health and science journalist, and Anna C. Wilson, PhD, a pediatric psychologist. Researchers are just beginning to look at how parents and families affect the way a child understands and reacts to pain.

Kids experience pain for any number of reasons, including surgeries, broken bones, and chronic conditions like migraine and sickle cell disease. They need their parents to care and advocate for them, the authors say. But parents also should avoid “catastrophizing.” That’s when a parent reacts with fear and worries excessively about the pain, sending a message that the situation is too much for a child to handle, or something that can’t be managed.

Peachman and Wilson devoted a chapter of their book to the parent-child relationship, particularly when the parent is coping with their own chronic pain. Peachman can relate as she herself manages chronic pain due to scoliosis. A mother of two, she used that experience to inform the book and this tip list for parents we are sharing in the excerpt below:


Though science may indicate that the odds are against parents with pain problems, researchers have identified a variety of positive actions parents can take to prevent the progression of chronic pain in their children and increase resilience.

Take care of yourself. Managing your chronic pain while taking care of your children can feel exhausting and overwhelming. Know that addressing your own physical and emotional well-being will also benefit your child. But keep in mind that caring for yourself does not mean chronic pain should become your central identity. While pain demands attention and getting good treatment can feel like a full-time job, remember that you are not defined by your pain. You are a parent. Perhaps, too, you are a spouse, a son or daughter, a friend. You may have a career or hobbies. Remember to engage with the people and activities that bring meaning and joy to your life, and make you so much more than your pain.

Try not to catastrophize about your own pain or your child’s. This is easier said than done, but once you realize that assuming the worst is a tendency that actually intensifies pain, it becomes more possible to rein it in. For starters, pause to identify catastrophizing thoughts when they pop up (like “I will never get better” or “There is no way this treatment will work”), because this can be a signal to reframe your thought process. 

Make an effort to learn more about pain and how it works in the body; pain education often helps people view their discomfort as less threatening, which can reduce the worry and anxiety that can lead to catastrophizing thoughts. 

There are also education programs for adults that can reduce pain catastrophizing. Beth Darnall, a pain psychologist at Stanford University, has developed an innovative two-hour course that teaches adults how to identify catastrophizing thoughts in the moment and immediately act to tamp them down. The course, which is increasingly available across the country, elucidates how cognitive behavioral strategies, such as reframing your perspective, deep breathing, and muscle relaxation, can reduce anxiety and rumination about pain. Chances are, if you learn to worry less about your own pain, you will also worry less about your child’s.

Label your pain and coping strategies out loud. While clinicians would not recommend that parents moan daily about their pain, it is helpful to let your kids know what you’re experiencing, when necessary, so that they can understand your behavior. This is important because many of the best coping strategies that adults tend to employ may not be obvious to children. For example, instead of hiding the fact that you’re struggling with a headache, let your child know you’re not feeling well by saying, “I think I feel a headache coming on.” Then model a positive coping strategy by saying, “I’m going to take a bath and relax so I can keep this headache from getting worse.”

If your kids know what you’re experiencing, they won’t be left wondering why you seemed upset or left the room to be alone. Similarly, if you often deal with back pain by, say, taking a short walk, clue your children into your approach. They’ll learn that pain doesn’t have to elicit alarm bells, and can be managed calmly.

Model a multidisciplinary approach. For many people with chronic pain, there is no magic pill or one modality that cures all. Rather, most people benefit from a range of treatments that may include cognitive behavioral therapy, physical therapy, good nutrition, stress relief and medication as needed. For parents in pain, consider what pain management behaviors you show your children. Ideally, you are showing them coping strategies beyond taking medication. You might show your children that you make an effort to walk daily or get enough sleep so that you can minimize your pain.

Rachel, for instance, eventually sought out a scoliosis-specific physical therapy called Schroth, which has significantly helped her reduce her pain. Her kids (who are now old enough to understand more) know that when Rachel’s doing her Schroth exercises, she’s putting in the time to strengthen her body and minimize pain. She hopes her children will internalize this approach and follow it if necessary.

Don’t focus too much on your pain. Research has shown that when parents fixate on their own pain, it can make pain worse for their kids. In two separate laboratory studies, parents were told to put their hand in very cold water (a classic pain test), and either exaggerate or minimize their expression of pain while their children watched. Next, the kids underwent the same cold water test and then rated their pain levels.

It turned out that the level of pain that the parents showed influenced how much pain and anxiety their child experienced themselves, with girls in particular being vulnerable to experiencing more pain when it was exaggerated by a parent. The takeaway: If you make a big deal about pain, your kids are likely to follow suit.

Keep yourself – and your family – moving. If you’re able, model movement and exercise, and play physically with your kids. If you’re not able, don’t worry. You don’t need to be your kids’ baseball coach to bring physical activity into their lives. Even from the sidelines, there are plenty of ways to help your kids keep moving, which may lower their risk of developing chronic pain. For instance, encourage them to sign up for school sports or dance classes, assign them physical chores around the house (like taking out the trash), let them play outside with friends or neighbors and consider asking other adult family members or friends to take your kids to the park, go for a hike or shoot hoops in the driveway.

If you find yourself feeling anxious about letting your children play sports, or you fear that their physical activity may cause pain, don’t let your worries stop your kids. Ultimately, if they’re physically (and socially) active, and have permission to be kids, they’ll be more likely to grow into fulfilled and happy adults.

Don’t forget to have fun. When pain feels intolerable and managing the day-to-day feels oppressive, it can be easy to forget about the simple and enjoyable things we can do with our kids. Playing board games, baking or cooking, reading books aloud, watching movies and doing crafts are all opportunities to share positive moments with your children. Making time for these types of activities will let your kids know that even if you have pain, you can still enjoy your life, and your family as a whole can weather stressful times and still have fun together. If you’re having trouble connecting with your kids, or want help managing pain and parenting, seek out a pain psychologist or a pediatric psychologist if you can.

Give yourself a break. There is no question that tackling these tasks may feel overwhelming. Parenting under typical circumstances is hard, and parenting while managing your pain or your child’s pain can feel impossible. So be kind to yourself, and try not to feel guilty for doing the best that you can. Make time for your own sleep, exercise, meals and relaxation – and know that the better you feel, the better off both you and your family will be.

Adapted from WHEN CHILDREN FEEL PAIN: FROM EVERYDAY ACHES TO CHRONIC CONDITIONS by Rachel Rabkin Peachman and Anna C. Wilson, published by Harvard University Press. Copyright © 2022 by the President and Fellows of Harvard College. Used by permission. All rights reserved.