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Handling the Holidays: Talking with Family & Friends about Chronic Pain

The holiday season can be one of joy and celebration, but for many adolescents with chronic pain, festive gatherings can pose a unique challenge: when connecting with friends and family, how much or how little do you share about your pain?

While there is no single way to navigate talking about chronic pain to family and friends during the holidays, taking a few minutes to think through your strategy can go a long way towards increasing your comfort through the busy holiday season. 

1.  Identify your goals for holiday interactions 
Are you looking forward to using a holiday gathering as an opportunity to educate your family about chronic pain now that you understand it more yourself?  Or, are you cringing at the idea of having to (again) explain your medical history to your skeptical Aunt Gertrude and desperately hoping for an evening that doesn’t focus on your pain?  If you know what you want get out of the situation, you will be able to pick responses that help you to take charge of your own story.
2.  Discuss ahead of time what is (and is not!) o.k. for others to share
Part of what makes chronic pain so challenging is that it affects the whole family.  Parents and even siblings may want to talk about your health with family or friends, even if you’ve decided you want to avoid the issue altogether.  Having an open conversation with parents and siblings before a holiday event can help.  Discuss with your family in advance what you feel comfortable having them share.  If they want to talk more in depth, suggest that they schedule a time to talk more privately with a family member or friend after the holidays have passed.

3.  Be prepared with responses

Caring and concerned friends and family will almost certainly ask how you are feeling if they know that pain has been present for a while.  If you choose not to engage in a long drawn out discussion, it helps to have a quick response and then a question to redirect the conversation.  Below are some common questions with sample answers and redirection to a non-pain topic.

Q: “How are you feeling?”
A: “Thanks for asking, I’m hanging in there.  Have you heard if we are supposed to get snow anytime soon?”
Q: “How come the doctors can’t figure this out?”  
A: “Well, the doctors do understand what’s going on, but it’s not something that a surgery or even medication can just fix. It’s a problem with the nervous system and it just takes a while to get back on track.  Have you taken any good trips lately?”
Q: “I know just how you feel.  Have you tried …[fill in the blank]?”
A: “Thank you. I’m working closely with my doctors on a plan that I feel really good about.  What’s your latest Netflix binge?”
If the person continues to ask (or even worse, tries giving advice!) you can always politely but firmly reply:
“I really appreciate your concern, but right now I want to focus on having fun with everybody. Let’s talk about something else, ok? What’s the latest funny story from your pet?”

4.  Enlist Support

Sometimes you get stuck in tricky conversations, no matter how hard you try to manage nosy or well-intentioned relatives and friends.  Parents, siblings, or friends can help by:

    • Backing you up: “Yeah, she’s been so strong this year”
    • Helping to change the conversation: “What’s the most surprising thing on your wish list this holiday?”
    • Giving you an exit strategy: “Sorry to grab him, but he’s gotta come taste these cookies!”

Having a pre-planned gesture (a tug of the ear, hands on hips) or having a phrase (“I think I’ll grab a glass of water”) can signal to your back up person that you need assistance ASAP!

5.  Plan for Breaks

Sometimes it’s hard to work up the energy or courage to go to a party if you think you might be uncomfortable or get stuck there too long.  Before heading out, talk to a parent or friend about where you could take a break if needed to use some coping skills to re-energize.  Finding a quiet room to do a few minutes of mindfulness, taking a break in the car to relax with some favorite music, or even just popping into a bathroom for five deep breaths can make a difference.  Many people also like to know there is a “Plan B” if things are really tough.  So, together with your family or friends, come up with a non-pain related pre-planned excuse, such as “Oh, we have an early morning tomorrow, so may need to duck out sooner than planned tonight.”  This helps to ensure that you can leave when needed, while not drawing attention to your pain.

Handling the holidays can be tricky.  Not every conversation or situation can be anticipated, but with a clear idea of how you’d like for the holiday festivities to unfold and a few minutes of open communication and preparation with parents, siblings, or friends, the holidays can truly be a time of warm connections and social support.  Cheers to a great New Year!

Blog by Dr. Amy Hale

Amy E. Hale Amy E. Hale, Ph.D. serves as a Clinical Lead of the Comfort Ability Program, a one-day pain management workshop for children with chronic pain and their parents as part of Boston Children’s Hospital Pain Medicine, Department of Anesthesia, Critical Care and Pain Medicine. She is also a pediatric psychologist in the Division of Gastroenterology & Nutrition at Boston Children’s Hospital where she is part of the Functional Abdominal Pain Program, and is a clinical instructor at Harvard Medical School.

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