Don’t Make Promises
I met recently with the parents of a teen with chronic pain who has had many medical complications requiring surgeries. Their child has understandably developed a distrust of the medical system. The dad is kind and committed to helping his daughter, and to instill hope, he tells her everything will be okay and that she will eventually be fine. This sounds reasonable and helpful, but as much as it comes from a loving place, it can seriously backfire.
First, if parents or practitioners make promises, teens will become distrustful. They are smart enough to know that adults don’t have a crystal ball and cannot know for certain what will happen. So, if adults make promises that are insincere, then the youth might wonder what else their parents say that is not true and question their future statements.
In addition, telling your child everything will be okay may make them feel like you are not validating their experience. They may perceive that you don’t think what they feel is as bad as it is if you can even imagine they will recover.
Instead, let your child know that you understand they are suffering and feel terrible about what they are experiencing. Tell them you are there for them and will do whatever you can to help them get better. You can tell them that youth with chronic pain can and do make full recoveries, but that you know it will take really hard work and can feel daunting. That is different than a blanket statement that they will be okay.
If your child is scared that something might happen, like vomiting at school, do not promise that this will not happen. I have had so many parents report that they make this promise to their child, in many cases daily, to get their child to go to school. Then what will happen if they do vomit at school? They will not trust their parent anymore and will not have the skills to cope with it.
Validate the upset or fear instead of telling your child that he will fully recover soon or that the realistic scenario he fears will not happen. Then teach them coping strategies. They have a lot of anxiety about whether they will ever recover from their chronic pain. Anxiety is often an exaggerated fear of what might happen, with an underestimation of one’s ability to cope with it if it does happen. Talk about how they could cope if their worst-case scenario did come true.
Many kids who have chronic pain are black and white thinkers. They feel that if they can’t do activities that they desire, they may as well just lie in bed all day. These are all ways in which you can provide hope for your child and help them work towards recovery without making any promises:
- Validate that it is upsetting that they cannot play sports yet, while assisting them in taking small steps towards this goal. It is helpful to guide them into pacing themselves with baby steps towards recovery as a coping skill.
- Come up with ideas together of a low energy activity your child might enjoy doing as a step towards eventually doing more.
- Explain how various modalities of treatment might help them and then let them choose which ones to start with. Assure them that if those modalities don’t work or feel helpful, they can try others.
- It is okay to say that you hope they will fully recover and that the data support that they will if they work hard and find the treatments they connect with.
- You can say that they are more likely to recover if they get to sleep at a reasonable time, do some movement, eat nutritiously, get some sun, and connect with peers.
We all want to fix our children’s difficulties and erase their woes for them. We make promises partially to make ourselves feel better because of our own anxiety that they will not recover. But ultimately, we do our children a disservice by making false promises.
