Book Review

Three books for children: when kissing a boo boo is not enough

GrrrOUCH! Pain is like a grouchy bear

Morgan C (2011). Renfrew, ON, Canada: General Store, 29 pp. ISBN: 978-1897508848 (Paperback: $12.95 CDN).

Imagine a rainbow: a child’s guide for soothing pain

Miles B (2006). Washington, DC: Magination Press, 32 pp. ISBN: 978-1591473848 (Paperback: $9.95 USD).

Be the boss of your pain: self-care for kids

Culbert T, Kajander R (2007). Minneapolis, MN: Free Spirit, 56 pp. ISBN 978-1575422541 (Paperback: $8.95 USD).

Reviewed by Linda Thomson

printable version (PDF)

When I was a teenager I was injured in a catastrophic ski accident and spent many months in the hospital. I, along with my doctors, nurses and parents, never knew that there was anything I could do to help myself with the pain other than a shot of morphine. There are millions of children who live with pain and most have never learned a strategy to help them cope with their discomfort. Now when kissing a child’s boo boo is not enough, parents and children have these books along with numerous web resources such as The Coping Club (reviewed in Pediatric Pain Letter, 2011, Vol. 13, No. 2) to help.

GrrrOUCH! Pain is like a grouchy bear won the Children’s Literary Award from the Elementary Teachers Federation of Ontario and the Pain Awareness Award by the Canadian Pain Society. The book combines whimsy, humor and rhyme to invite children to engage their imaginations to help them help themselves with pain. It begins with the feelings that pain may cause - being lonely and scared, wanting to cry or needing a hug. Although it may feel like the pain is in charge, the book cleverly lets children know the pain doesn’t have to win. The prose is paired with a beautiful and subtle illustration by Crystal Beshara of a girl dancing with a prosthetic leg.

The author, an elementary school teacher who had her own experience with pain following a motor vehicle accident, goes on to suggest fun ways to change the way children think and feel about the pain - imagine the pain is like a grouchy bear, a slithery snake or a speeding train. Readers are asked to make up their own ideas of what the pain is like or perhaps draw a picture of their pain. Children are invited to soar above the pain like a kite or drift far away on a raft. Using their imagination to relax and to fall asleep is also encouraged. Children are reminded that they are brave, stronger than their pain and that their parents are very proud of them. The book could also be used to help children who are trying to understand the painful illness a parent may be experiencing and that when a parent is in pain he or she may seem like a grouchy bear.

The story of GrrrOUCH! Pain is like a grouchy bear is told from a child’s perspective. Although the book is marketed for children 6 to 10 years of age, much younger children would also enjoy the wonderful rhyme, the opportunity to use the magic of their imagination, and the beautiful illustrations in this book. It is definitely a book that children would demand their parent read to them again and again.

Imagine a rainbow: a child’s guide for soothing pain was written for children 4 to 8 years old. The book teaches children how to utilize visual, auditory and kinesthetic imagery and breathing techniques to help themselves with pain. The poetry of Imagine a rainbow empowers children to use their own imagination to help cope with pain.

The beautifully illustrated pages by Nicole Wong guide the reader or listener to use imagery such as snuggling with a puppy, wrapping oneself in a rainbow, or riding a cloud to ease the pain. Brenda Miles, the author, suggests using a calm, gentle breath to move the leaves on an imaginary tree. Breathing slowly and deeply, imagining the view from the clouds, and feeling the warmth of the sun right where it aches can also be used to reduce discomfort. The book takes children from the ocean that is whispering “be brave” through the clouds to a tree house in the sky where children can dream, feel safe and not scared inside.

Laughter can be a highly effective coping strategy. Imagining a purple hippo in a tutu doing ballet would put a smile on a child’s face and then sending their laughter to just where they need it most would help their ouchies.

There is a section especially for parents in Imagine a rainbow. Having worked as a pediatric neuropsychologist, the author knows that pain has a very real psychological dimension. Children’s understanding of and reaction to the pain affects both the sensory and suffering components of the pain experience. The resource section encourages parents to explore the book together with their child, expand on the imagery, using all of the senses, to imagine the scenes and ideas in the book and then have the child create his or her own images. Parents are then taught how to help their child combine deep breathing with imagery. Using the strategies of deep breathing and imagery, combined with comprehensive pain management can help children and families cope with procedural, chronic and recurrent pain.

Be the boss of your pain: self-care for kids is one of four books in the Be the boss of your body™ series that was awarded a 2008 GOLD Mom’s Choice Award in the Juvenile Level 2/Body, Mind, and Spirit Category. These self-care books were written to help children take charge of their health and are filled with ideas, activities and skills. There is also a Be the boss of your body kit that includes such items as a biofeedback card, a stress ball, a pinwheel, an acupressure tool and stickers.

Be the boss of your pain lets children know that they have the natural talent and power to take charge of their pain, although not replacing the need for the involvement of health care professionals. The authors list the signs and symptoms that should warrant contacting a health care professional. By teaching the self-care skills outlined in this book, Culbert and Kajander have given children a gift that they can use the rest of their lives. Children who feel confident about their role in their health and wellness handle pain much better and have set the stage for lifelong wellness by balancing mind, body and spirit.

The book explains that an individual’s mind, body and spirit are all connected and work together to keep a person healthy. Suggestions are given for keeping each aspect balanced. Pain isn’t good or bad, but it is important because it is a signal that something is wrong in the body, mind or spirit. The book lets readers know that they have some control over the pain messages going to their brain and outlines the things that turn the volume up and what they can do to turn the pain volume down. The book is also a workbook with pages for children to write descriptions of their pain, how pain gets in the way of fun stuff, how they would like to feel and what things they could do when the pain is under better control.

This colorful and kid-friendly book then goes on to teach children specific skills that they can use anytime, anywhere, forever because they now own those skills. With practice children will get even better at effectively using the skills anytime they want or need to.

The first skill is belly breathing. Using the diaphragm to breathe relaxes muscles, calms nerves and releases endorphins, the body’s own opioids. The second skill the authors call “Imagine That”. This skill engages children’s imagination to imagine favorite things, places and fun things to do. Children could imagine changing their thinking about the pain like changing a channel on the television. Imagining a master control room with switches, then imagining what the pain looks and feels like and then changing it can be very effective. Children may decide to throw the pain away or squeeze it into a stress ball. Using the biofeedback card with the “Imagine That” exercises will demonstrate to children how their body changes when they practice these imagination techniques.

The important third skill is positive self-talk. Changing negative thoughts into more positive ones will help children be their own best coach. The fourth skill of aromatherapy is discovering that essential oils such as lavender, peppermint or rosemary may be helpful in easing discomfort. Learning and utilizing important acupressure points is the fifth self-care skill outlined in Be the boss of your pain. Stimulating specific acupressure points can reduce and relieve pain in different areas.

Other suggestions for self-care addressed in this book include eating well, adequate rest and sleep, exercise, connecting with people, spending time with friends and caring for the inner spiritual self. This book, written by a physician and pediatric nurse practitioner skilled in developmental and behavioral pediatrics, biofeedback and medical hypnosis, is an excellent resource for older elementary students, tweens and even teenagers.

I love the sing song rhymes of GrrrOUCH!, especially for young children. Parents will find the note to parents section in Imagine a rainbow particularly informative and full of ideas for helping them help their child more effectively manage their pain. Be the boss of your pain is especially good for helping older children understand the interaction of mind, body and spirit and how that can affect their pain. This book also teaches children specific self-care skills that they will be able to use for the rest of their lives.

The experience of pain involves an interplay of thoughts, beliefs and emotions. It is this interaction of mind, body and spirit that enables us to increase or decrease pain. These books, written especially for children, their families and their caregivers, are wonderful resources to help children control what they never knew they could by tapping into their own inner strengths and imaginative ability. The side effects: increased confidence, mastery, self-efficacy and self-esteem are priceless!

Cite as: Thomson L. Three books for children: when kissing a boo boo is not enough. Book review: GrrrOUCH! Pain is like a grouchy bear, Imagine a rainbow: a child’s guide for soothing pain and Be the boss of your pain: self-care for kids. Pediatric Pain Letter 2012;14:28-30. www.childpain.org/ppl