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Using a 'happy place' to help children and youth overcome chronic complex pain

BC Children’s experts provide guidance on how managing thoughts can be one tool to help children free themselves from debilitating pain.
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Javed Gill’s happy place is snowboarding on Grouse Mountain – and with guidance from BC Children’s Hospital, it’s helped him overcome more than 10 years of complex chronic pain.

“My psychologist would ask me to close my eyes and she’d ask me where my happy place was,” says Javed. “I was in the mountains because I really like snowboarding. Then she would tell me to jump into my body, see the nerves and find the pain. I’d see the pain moving through my body and then I was told exhale and see the pain leaving my body. It worked quite well. I’d use that technique wherever I was, from day-to-day.” 

A regular childhood accident triggers a decade of pain

When Javed was just in Grade 2, he fell off his bike and broke his arm, near his wrist. It never quite healed properly and he kept spraining his wrist… or so he thought. But nothing seemed wrong in the X-rays. It turned out, he has complex regional pain syndrome. The initial injury had damaged his nerves so that it triggered more than a decade of pain.

“I’ve played a lot of sports. As a kid, I played more hockey. I was always on a team and I would try to go as much as I could when I wasn’t in pain,” he says. 

“Sports are such a big priority in my life. I would always watch games and want to be part of it. It’s part of my mental health. But sometimes when they were playing street hockey, I couldn’t always go out. Even playing video games at times was too hard.”

Javed had good friends, but being so young, they didn’t always comprehend how his health kept him at home.

“I had some friends who knew what I was going through,” he says. “I don’t know if they quite understood what was going on.”

Susan Bennett, PhD, is a psychologist who works with the Complex Pain Service at BC Children’s Hospital. The pain team has two physicians, a nurse clinician, and a physiotherapist, who partner with children and youth to treat complex chronic pain.

“It feels very isolating to have chronic pain that’s not clearly diagnosed and it can be very frustrating to find the right approach,” says Susan. “It’s important for families to realize they’re not alone and pain doesn’t have to be forever. It doesn’t have to interfere with their lives.” 

Taking charge with the mind-body technique

She says mind-body techniques, including the self- hypnosis that Javed learned, can help the nervous system to reprogram itself and stop pain false alarms. Children and youth are especially receptive to these approaches.   

“We don’t always have medications or medical interventions that we prescribe. In fact, it’s sometimes the reverse. Some youth have been on many medications and it’s a matter of pulling back to what’s really needed to empower the young person to feel that they have some mind and body strategies to really take charge of their pain.

“As it starts to work for them, they get more hope. When they get more hope, they can kind of see the light at the end of the tunnel and that there may be a pain-free time for them.”

Approximately one in five children in Canada experience pediatric chronic pain, according to the Canadian Pain Society. Some have chronic pain with no associated disorder or disease. Or, injuries have healed and should be fine, but they’re not. Chronic pain becomes a problem when it begins to interfere in a child’s everyday life. 

Acknowledging the pain and getting back on track

“The first thing we do is validate the pain is real,” she says. 

“Some can be offended when it seems like you’re just helping them cope with pain, but then they start to see that this is the treatment. We’re getting them back gradually into physical activity, school and their social life. The pain has less control of them and then it happens less frequently and ends up going by the wayside, ideally.”

Both Javed and Susan will be giving presentations on March 5 at a one-day virtual conference, “Partnering for Pediatric Pain,” for health-care providers and people living with pain. Organized by BC Children's Hospital and Pain BC, the conference will allow pain specialists across Canada to explore perceptions of pain and the understanding of the pain continuum in pediatric hospital care. 

“Typically, the children and youth we see have experienced pain for a number of years and have really lost their usual path of life,” says Susan. “We help them get their normal, healthy life back on track. Physiotherapy helps the young people in a paced manner. It’s a gradual way to build up stamina to have some physical activity. We also look at sleep and changes they can make to get better sleep. In my role, as the psychologist, I look at the mind and body connection so they can help themselves to get well again.”

Mastering pain - even if it returns

Javed received treatment at the BC Children’s Complex Pain Service clinic, which included physiotherapy, medication, medical interventions, and sessions with a psychologist to help him master his complex pain. 

Over the years, he went pain free for a year or two at a time, but then fell off a moped and cut his knee badly.  

“That triggered my pain again so I went back to the clinic,” says Javed. “Sometimes I had throbbing in my hands and sometimes I had the pins and needles feeling. My nerve system was sending the wrong signals to my brain.”

With the coordinated mind and body treatments, Javed has now been pain free for nearly two years. He is living in Richmond and is in his second year at Simon Fraser University, where he is majoring in business. 

“I think it’s really important to keep a positive attitude and believe you can get over it. You can still do anything anyone else can do, even with your pain. At times, it may be hard, but persevere and you’ll get through it.”

Susan hopes that the upcoming virtual conference helps health-care providers and patients across the country find ways to partner together to overcome pain.

“It’s really about finding strategies and approaches that work for the patient. It’s a journey. We empower and provide hopefulness and, by partnering with them, help them with their journey.”

More resources

For more information, visit the BC Children’s Pain Service website, the website or see these two PDFs on pacing and ten tips for parents of children & teens with chronic pain.

For information in the upcoming virtual conference on “Partnering for Pediatric Pain,” see the Pain BC website.

BC Children's Hospital; Chronic pain
Children's Health
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