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How do you Know When to Push Your Child?

by Carla Friesen (Chronic Pain Coach, Licensed Psychotherapist)


* I don’t know if there is a straightforward answer to this. But I know that it is a common struggle for all parents and even more so for parents of kids who have chronic pain. * How can we help our kids do what they are capable of without pushing them over the edge and causing a pain flare? * Chronic pain behaviour can be confusing. One moment your child might be dancing with friends to loud music and another moment they are huddled up in the fetal position. Your child might be doing art at the table and the moment you ask them to help with dinner, they say their head hurts. They can be boisterous with their friend while playing video games but when you need the trash taken out, they say they are in too much pain. * Another scenario that can be become baffling is how to get our kids to stay at school throughout the day. We don’t know how far to push them, when to pick them up, when to say, “Just stay one more period and then we will talk.” * This can be VERY frustrating as a parent. We can wonder if sometimes our kids are playing us. If sometimes they are using their pain as a convenient excuse any time we suggest something. We start to wonder if we can trust them. * It has been interesting to parent a child with chronic pain WHILE dealing with my own chronic pain because I feel like I have some valuable insight into this conundrum. * I think it is most helpful to look at this problem through the lens of an overwhelmed nervous system. When we have chronic pain, our nervous system becomes sensitized and easily overwhelmed and then sends more pain to protect us from any threat of overwhelm. * Extra requests can be interpreted by our kids’ brains as a threat to their nervous systems. * I know that if I have a severe migraine and try to venture out in the living room and one person requests ANYTHING of me, I will likely turn right around and think “I am not ready for this.” I am so easily overwhelmed when my pain is high. Even if I feel a little better and decide to go for a quiet tea with a friend and my husband texts to say that friends are stopping by to say hi, my pain will flare. Any unanticipated request or demand is too much. * When I am in pain mode, any little thing will cause it to flare. Whereas, on a day when I have no pain, I am able to handle many things that come my way. * Anxiety needs structure to put it at ease. So do our chronic pain nervous systems. * So what is the solution? Let our kids do whatever they feel like it? No. * Their sensitive nervous systems need structure and predictability. It is good to have a routine around chores, time spent at school etc. Structure and routine allow our nervous systems to ease because they know what to expect. However, this routine needs to be built little by little. * When it comes to pushing a child, my suggestion is to develop some structure around it. The best way to do this is to have weekly micro-goals. Each week your child can add a new micro-goal. This is how we help our kids to increase their ability to participate in life and this is also how we add new requests without overwhelming their nervous systems. If your child is working on their weekly goal of walking for 15 minutes/day, don’t all of a sudden ask them to help with dinner and take out the trash. Instead, add those things to their list of upcoming weekly micro-goals. * Requests out of left field cause pain to flare. Unpredictability causes pain to flare. Increased expectations on a day when your child is finally having some fun causes pain to flare. Slow, methodical routine building through weekly micro-goals supports our children’s nervous systems and avoids pain flares. * When I am parenting chronic pain, it doesn’t work to make requests willy nilly. Instead, I need to:

  1. Notice what I think needs to change (daughter should drink more water, pick up her clothes, do her homework earlier in the day

  2. Choose a time to talk to her about it when pain is not elevated (you might even need a weekly check-in time)

  3. Put it on the list of upcoming weekly microgoals

* Remember that when you create a microgoal, it needs to be small and manageable enough that your child will be able to accomplish it every day, even on higher pain days. That is why we call them micro-goals. They are goals which are made small enough that they will not overwhelm the nervous system. * I know that the question of when to push your child is very complex and a few paragraphs of writing doesn’t provide the perfect formula. Each of us is struggling with this question in our own way. * Whether your child is in bed 24/7 or whether they have some days with increased pain and others with less pain, developing a routine of weekly microgoals can help them to participate in life more consistently. So you can make plans and follow through with them. So pain doesn’t rule your lives. * Taking small weekly steps to build a routine with your child can make logical sense but be difficult to put into practice on your own. * That is why I developed a program to help support families through this. Send me an email if you would like support!

~ Carla

The general contents of this website are provided solely for educational and informational purposes and are not meant to provide professional medical or psychiatric advice, counselling or therapeutic services.


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