Helping Children Understand Pain: A Compassionate, Child-Centred Approach at Nurture

In the world of paediatric healthcare, one of the most important—and most overlooked—areas is how we educate children and their whānau about pain. At Nurture Paediatrics, we believe that children experiencing pain deserve to be heard, understood, and supported with high-quality, developmentally appropriate pain education. We see children not as small adults, but as unique individuals with developing brains and emotions, whose experiences of pain are deeply influenced by their environment, relationships, and understanding.

It’s Not Overreacting—It’s a Call for Help

What some might label as “catastrophising behaviour” in children—intense fear, worry, or avoidance—is often a misunderstood cry for help. Children do not “overreact”; they respond based on the emotional and cognitive resources they have. When they feel pain, especially from injury, it can be confusing, frightening, and overwhelming. Their response is not irrational—it’s protective. We must stop dismissing these expressions and start interpreting them as invitations for education, connection, and care.

Understanding Pain Is the First Step to Easing It

Pain is not just about tissue damage. In fact, it’s a complex output from the brain that is influenced by many systems: the nervous system, thoughts, emotions, environment, sleep, past experiences, and more. This is what we call pain neuroscience education (PNE)—teaching about the biology and psychology of pain in a way that makes sense to each individual.

At Nurture, we use child-centred metaphors and analogies to make these abstract ideas real, relatable, and empowering.

Introducing the Pain Control Console: The Cockpit Analogy

One powerful metaphor we often use with children is the idea of their own pain control console—like the cockpit of an aeroplane. In this cockpit, there are many dials and switches that can turn the intensity of pain up or down. These include:

• Sleep dial – Poor sleep turns pain up; good rest helps turn it down

• Emotions dial – Feeling anxious or scared can increase pain signals

• Movement dial – Too much or too little movement can affect recovery

• Diet and hydration dial – Fuelling the body well helps pain settle

• Thoughts dial – Unhelpful beliefs (“I’m broken”) turn pain up

• Environment dial – Stressful environments make the cockpit chaotic

• Temperature dial – For some children, hot or cold affects their comfort

• Social connection dial – Feeling supported turns pain down

• Understanding dial – Learning about pain gives children control

By helping children explore their “cockpit,” they can learn how to adjust these dials in small, manageable ways. This analogy puts them back in the pilot seat, giving them agency, confidence, and calm.

Metaphors Make Complex Concepts Simple

Children are natural storytellers and metaphor-makers. Even at a young age, they use symbolic thinking to make sense of the world. At Nurture, we carefully choose metaphors that align with a child’s age, interests, and current understanding. We avoid complex or abstract ideas that won’t connect, and instead, craft explanations that are meaningful and memorable—like fire alarms that go off too easily, muscles getting confused, or pain acting like a guard dog that’s become too protective.

Metaphors act as cognitive bridges, helping children (and their families) grasp the invisible mechanisms of pain and begin to feel in control again.

The Role of Whānau: Healing Happens Together

Pain recovery in children is not a solo journey—it’s a whānau process. We involve caregivers every step of the way, helping them understand what’s happening, how to support without fear or frustration, and how to create a calm, encouraging environment.

Our team takes time to explain not only the “what” of the pain, but also the “why”—why it’s lasting, why reassurance matters, why routine helps, and why your child isn’t “faking it.”

Therapeutic Strategies That Work—When They’re Personalised

Pain recovery isn’t about pushing through or ignoring pain—it’s about rebuilding confidence and safety. At Nurture, we offer strategies like:

• Graded exposure – gently reintroducing feared movements or activities

• Cognitive behavioural therapy (CBT) – helping reframe unhelpful thoughts

• Pacing advice – managing activity to avoid boom-bust cycles

• Relaxation tools – teaching the body to feel calm and safe

• Celebrating wins – reinforcing progress and hope

But none of this works unless it’s tailored to the child’s world. That means aligning strategies with their interests, emotions, cognitive level, and family dynamics.

Why This Matters

Ignoring or dismissing a child’s pain-related fear can have lasting consequences. It can lead to anxiety, healthcare avoidance, school refusal, or even long-term pain conditions. But when we educate with compassion and clarity, when we treat the child as an expert in their own experience, and when we engage their family as partners, we unlock powerful pathways to healing.

At Nurture Paediatrics, We Believe:

• Children deserve to understand their bodies and feel safe in them

• Pain is real, even when we can’t see it

• Empowered children are resilient children

• Education, empathy, and tailored care are the foundations of recovery

Let’s help our tamariki tune their control consoles, take the pilot seat, and fly toward a future where pain no longer controls them.