Sunday, October 16, 2011

Helping Children Cope Well (with pain, doctors, dental visits, etc)

"Kids are born remarkably resilient in regard to pain.  Our response to pain is largely a learned behavior that we adopt as we grow older." ~Moses' doctor, just 3 days ago

Several months ago, I mentioned in a comment that we work to help our kids process and deal well with medical visits and physical pain, and another mom asked me to share about how we do that.  Hearing Moses' doctor make the comment I quoted above reminded and prompted me to write about this topic.

There are several things we do to try to proactively teach our kids how to deal with pain and/or medical visits:


(1) We talk about and react to pain realistically, and we teach our kids to do the same.  We do not UNDERstate how something will feel/hurt (i.e., we do not say: "your shots won't hurt a bit!"), and we do not OVERstate what has happened (i.e., "oh my GOODness, that must hurt SO bad", overempathizing, etc.).  Essentially, we are "matter-of-fact" about pain.  If a kid starts screaming over a minor pain, we use a calm voice, and say something like, "It looks like you took a tumble! Let's try not to scream.  Yes, there is blood, but it's only a scratch.  Let's go get it washed off; mommy will take care of you.  I'll get you a band-aid and some neosporin, and you'll be all set to go play more if you want to."  There may be times to ask questions to probe deeper into "what's hurting?", or when the injury itself merits a very serious response (we've had our share of those!), but in normal situations from children's play, or in routine doctor's visits, we do not emphasize or stress out about plain old pain.

And even when pain is very legitimately bad, we talk about it honestly and what the solution will be.  Silas has had stitches twice-- once when he was 2 and had his pinky finger smashed in a door (and the tip was hanging off), and once when he was 3 and had sliced a cut in his finger with a chef's knife.  Both times, this approach of giving real empathy while talking honestly about what would need to happen ("you'll have to get a shot", "you'll have to hold very still while the doctor uses a needle to fix your finger", etc.) enabled him to get the stitches in a very calm and surprisingly strong way.  And he is quite possibly our most emotional and dramatic son (our daughter surpasses him but also responds well to this approach).


(2) Set accurate expectations in advance.  
  • If it's a dental visit, especially if it's their first one, or if the child is visibly nervous, I'll have them lay out on the couch and we'll go through the motions of what the visit will be like.  "There will be a bright light up above your head, they'll put a paper bib on you, and he'll ask you to open your mouth as big as you can.  Can you do that for me?  Then he'll take a funny-tasting paste and clean off your teeth and it will sound kind of like a soft hair dryer.  It will rattle a little bit and might tickle, but you need to hold as still as you can and keep your mouth open so he can do it and get done more quickly."  I'll even impersonate the dentist and show them how he'll sit, etc.  This same concept can be done with doctor's visits.
  • Or, if they'll be getting shots, we tell them & talk about it in advance.  (Remember #1-- we don't do hysterics, so if they start to freak out, we help them calm down & then talk about what it will feel like, or share about the last time we parents got shots, and what it felt like.)  "Yes, I think you'll need to get 2 shots at this visit.  It'll hurt at first, but they'll give you a bandaid, and then it will be over with.  It might feel sore for a little while, but it will keep you from getting sick.  Would you rather get them in your arms or your thighs?"  (Because we live overseas, we all get a lot of shots.  All of us.  A lot.  Kids really can be good troopers about this.)
  • Or, if we're going to have to wait for a long while, we'll bring a backpack and talk at home before we leave about how we'll probably be in a small room with other people and need to be quiet and have something to do.  
If we don't know what a procedure will be like, we ask enough questions or look things up on the internet in advance so that we can help our kids to anticipate what will happen and what they'll need to do.

(3) And of course, we listen to their concerns.  None of this that I've written should be taken to mean that we do not listen to genuine fears or worries.  We absolutely do!  If they're concerned about something, we want to talk it through with them.  But at some point, if there's an unavoidable visit, check-up, procedure or shot, after we talk it through, we wrap it up with realistic expectations, and end on a good note.  "Yes, we'll get shots, but then we can all come home and snuggle and watch Princess Bride."  Or, "I know it's frustrating to you that you have to deal with itchiness and red skin from eczema, and don't know anyone else who does.  I'm sorry; I wish you didn't have to mess with all that.  But I AM thankful for these creams that help keep it under control."  We just try to talk realistically about pain, and then look on the bright side of things. 


Our experience has been, and the doctor I quoted above seemed to support this idea, that kids tend to feed off of what their parents have taught them to do in stressful/new situations.  A melodramatic mother often breeds children who overstate their pain and are underprepared to deal with normal medical situations that could easily be anticipated & faced realistically, if they were just given the skills of how to do so.  Conversely, a calm, in-control mom and dad can teach their kids to deal well with pain or uncomfortable situations.  Of course shots will still hurt, or a skinned knee will still bring tears to the eyes, and some children will be more emotive than others, but they will be more measured in their response to pain if they know that they will be heard, and that their needs will be met by a loving and competent mom, or the doctor/dentist she trusts.

I should admit that it is somewhat instinctive for me to go into a kind of "stealth" mode when a medical crisis happens-- I typically become more efficient and calm during a crisis.  And I can't take credit for that initial response; maybe it's a personality thing, or maybe it's learned from my own parents.  So our initial response to a crisis might differ based on our personality & experiences, but my point here is that I think we can all work to help our kids cope well with regular medical situations that they encounter, despite our (or their) initial internal reaction.  


I hope these ideas are helpful to you as you think about teaching your kids about how to deal well with pain.  Thoughts/comments?  Do you have tips/experiences you'd like to share?



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