Table 3 Communication and use of metaphors to explain nociceptive pain. Adapted and reprinted with permission from http://www.paininmotion.be/pne4kids [6]

Therapist: “Have you ever cut your finger while helping your parents with cooking? Or have you ever scraped your knee in a fall?”

Child: “Yes, I once fell with my bike and had a big injury on my knee.”

Therapist: “And did that hurt?”

Child: “Yes, very much!”

Therapist: “Well, I’ll explain to you what happens in your body from the moment your knee was damaged to the moment you actually felt pain.

When your skin is damaged, the privates at the beginning of the electrical cables wake up and multiply (Fig. 1a). As these privates detect potential danger, a message is sent via the electrical cables to the lieutenant who is positioned at the elevator (Fig. 1b).

The lieutenant who receives the message looks at it and then decides whether or not the message is important enough to forward to the general in the computer room (Fig. 1c). When the lieutenant decides that the message is important enough, he contacts the general via his walkie-talkie to ask if the message can be sent via the elevator to the computer room. If the general is not too busy, he tells the lieutenant that he can receive one or more messages.

When the message arrives in the computer room and the general is still not too busy (e.g. processing other messages from other parts of the body), he will put the message into several different computers so that the its content can be analyzed in more detail. Each computer has its own task in this analysis; one computer checks from which region the message comes (e.g., your knee or your finger), the other checks whether a similar message was previously received. Another computer analyzes the possible cause (e.g., you drove down a slope too fast). Again another one looks at the environment you are in at the moment (e.g., in the middle of a busy road or in a quiet place in the woods), and another one looks at the possible consequences, such as what thoughts and feelings you experienced along with a similar message (e.g., anger, sadness, shame, …) and what you then did (e.g., cry, scream, laugh away, refuse to get back on your bike or you got back on your bike very quickly, …). When the general, based on the analyses of the computers, is convinced that the message is dangerous, he will create pain. That’s the moment you felt pain.”