“Jonathan” limped into our clinic, with severe and relentless knee pain that had plagued him for more than a year. While his tissues and bones had healed, pain subsisted with no good reason. Jonathan’s pain was very real but, like a false alarm, was not serving a purpose. He was sleep deprived, failing his classes after years of stellar performance, and had resorted to his bed after years of outrunning his peers in cross-country.
Jonathan, who “had it all” before pain, found himself contemplating giving it all up because of pain. Quickly, I learned that before his struggle with pain, Jonathan was like many of my other patients. He was in the habit of sacrificing ZZZs for A’s and burning the candle from both ends. He wanted to become a collegiate runner and world-renowned surgeon. “No pain, no gain,” right?
As a psychologist in the Pain Treatment Service at Boston Children’s Hospital, I see firsthand how unrealistic performance expectations may be contributing not only to anxiety and sadness, but also to a growing epidemic of stress-based or stress-exacerbated chronic pain syndromes.
It’s healthy for kids to challenge their minds and bodies on a consistent basis by engaging with a variety of activities and learning opportunities. And, upholding high expectations for our children to succeed can help instill good work ethics.
However, with 1 in 5 children currently being diagnosed with chronic pain during adolescence and research demonstrating links between daily stress and chronic pain, parents must ask a critical question: What separates a happily busy child from a pain-vulnerable, overly-stressed busy child?
Undoubtedly, children are at risk for significant psychological and physical burn-out when their school, activity and home schedules are so packed they don’t have time for the basics — sleep to restore their bodies and minds, unstructured time to relax, and opportunities to connect with family during an evening meal, for example. Even more problematic than the sheer number of hours devoted to extracurricular activities and homework are the reasons why children are overly busy. It turns out that when children perceive external pressures to perfectly and easily succeed, they are more likely to suffer stress-based consequences.
Fortunately, there is a rising call for a widespread change – energized by collaborative efforts of parents, educators and students – to promote psychological and physical health above resume building, perfect grades, and intensive club sport participation.
Whether your child suffers from chronic pain at this time or not, I encourage all parents to consider how to help your child find balance, resilience, happiness, and health in a culture that consistently pressures children to perform.
Below are five targeted tips for parents to consider while their children are in the midst of a busy school year:
1. Ensure your child is engaged in activities that really matter.
Children whose schedules are jam-packed with extracurricular activities that they think will make parents happy or will “beef up” their college application benefit less from their participation and burn out faster. Parents can help their child evaluate the motivation behind their choice of activities and support their child in finding ways to step back from activities that don’t provide intrinsic satisfaction.
2. Change your mindset; focus on process not performance.
Research shows that praising a child for effort leads to better outcomes than praising for outcomes. Next time you want to praise your child, try saying, “Your love for learning everything about World War II is so cool” or “Wow, you spent a lot of time on that,” as opposed to “You are so smart” or “You finished that so quickly.” How you communicate about success can shape your child’s personal and long-term view of success.
3. Celebrate failure.
How you communicate about failure can be just as powerful as your messages about success. Remind your child (and yourself!) that falling short is not only a golden opportunity for growth, but also for learning how to sit comfortably in failure. The less scary failure is the more exciting risks and challenges become. Use yourself. Given an example of when you failed, and not only survived the fall but grew stronger from it.
4. Watch for hidden messages.
The pressure to succeed can sometimes come from parent’s explicit assertions. Parents may say, “I think you’d really like going to my alma mater,” or “Wouldn’t it be great if you could make varsity soccer in your sophomore year!” never realizing that their children internalize these messages as benchmarks they must reach for parent approval. While often well intentioned, these messages can be a source of persistent stress for children and lead to a fear of failure.
5. Risk swimming against the tide, and bring others with you.
Parents often harbor fears that their child won’t have the best opportunities if they scale back. We urge all parents to remember that reduced pressure and a balanced approach are likely associated with better long-term outcomes. It will “take a village” – enlist other like-minded parents to speak up and advocate with schools, coaches, and others. Remember that protecting your child’s physical and psychological health is the end goal.
Jonathan recently reached out to me to share a portion of his high school commencement speech. His words gave me the chills: “My pain centers me. If I’m feeling stressed, down, lazy, or tired, my pain will tell me. I’ll ask myself, what caused this spike in pain, and then reflect on my day, evaluate what needs to be done, and look to implement that change in the coming days. When I find that solution, I add it to my coping ‘tool box’.”
Pain gifted Jonathan the opportunity to build his “coping tool box” for handling the challenges life hands him. But, my hope is that other kids don’t have to learn the hard way.