Self Harm in ASD

[jonathan]

Hi

Is self harming common in teenagers with ASD, my niece is doing it occasionally but when her

mum asks if anything is wrong she says no and she can't help scratching herself?

please help

[TheNeil]

Don't know if it's more common in teenagers but there are several adults on the forum that have ended up self-harming and studies have proven that in adults (sorry, I don't know whether this applies to teenagers too - I would kind of lean towards 'yes' though) that cases of depression are markedly higher in Aspergics (this could be across all ASDs but, again, I'm not 100% sure). As a teenager the social pressures will be greater which, if there's an ASD present, could result in a greater chance of depression and the dangers that that can come about as a part of it.

 

The problem is, asking if something is wrong is very likely not going to reveal the truth about what's actually up (if anything is). It could be that your neice is one of those people who genuinely self-harms for no reason (it does happen but is extremely rare) but it'd be best to try and get her some help, find out if anything is upsetting her etc. (you could always try asking more 'direct' questions rather than a general 'Is everything OK?'). Maybe getting a 'third party' involved so that she could talk to someone who's not connected to her or anyone she knows might be a good idea - it could remove any fear that she has about upsetting people or any possible ramifications that may come about as a result of her opening up (whether this is an option though depends on how her ASD affects her so you may need to either work around that issue or just have to dismiss it altogether and try something else)

[Flora]

Hiya,

 

I have no idea if it is common or not.

 

however, the advice I would give would be for the teenager to be taken to see their GP.

 

Also this link has a list of mental health resources. Further down the page there is 'Young Minds' which may have some useful information.

 

Flora

Edited September 7, 2008 by Flora

[jb1964]

Hi,

 

My daughter is 15 and has self-harmed for several years now - it comes and goes depending on the severity of her anxieties. She head bangs the walls when frustrated and also digs her nails in her arms and face when she's angry.

 

Take care,

Jb

[NobbyNobbs]

as far as i know self-harm is more common in girls than boys, the most common age is the 13-15 age band and anyone with any mental health issue is far more likely to suffer - AS brings on anxiety and depression often and these are bad triggers.

medication is usually the first GP response, as this reduces compulsions and anxiety and raises the mood. she should also be referred for some sort of talking therapy but the waiting lists are long so they use the meds to fill the gap. i found with AS it is harder to understand the severity of actions and this can be potentially dangerous, so safety is a good thing to promote if she wont talk about why she does it - plenty of plasters and antiseptic should be availiable, as well as a good base of knowledge of appopriate treatments - when stitches are needed and so on. this knowledge often creates a 'boundary' where since it would be horrible to have to go to hospital the line to stitches isn't crossed. after that, time and understanding are good.

my favorite stress release activities to stop self-harming (i didn't want to do it but *had* to) were counting rice, beads and anything else that there were lots of, or ripping up fabric - paper didn't do it cos it took no effort.

[Tally]

I don't know about any specific research, but from the autistic adults I have come across, it does seem that self-harm is much more common in autistic women (I simply don't know about men, though the same may well apply). I personally think it has to do with the difficulty we commonly have in expressing emotions verbally. The problem is that it releases endorphins and can become addictive. This is why vigorous exercise can be one of the best ways to handle the urge to self-harm, as it also releases endorphins.

 

Self-harm can also be related to obsessive issues, which are also common in ASD.

 

Working out the cause is often key to preventing it, which is why professional input is so important. In the meantime, distracting her with her interests or redirecting her into physical or creative activity could help.

[harmony]

Hi

Like the others not sure how common self harm is, but my daughter age 12 does pick at her skin. If she has a scratch or spot, she will pick and pick until it becomes infected. She had a few mossie bites in the summer, and because of the picking she has been left with scars. She tells me she has no idea she is doing it. I think she must have a high pain threshold, as the sorness never seems to bother her, it just looks dreadful. Her AS is quite pronounced at the moment, but she has made me promise not to tell anyone except her teachers, so when her arms look really bad, it's on with the long sleeves and out with the antibiotics!

Harmony x

[Diane]

Hi

 

My son is 14 and he self harms when he is really anxious about something. Unfortuanately that is sometimes the only outward signal we get that he is not coping. He does not cut himself but has unexplained bruises on his upper arms which look like he has been biting himself he also runs into things, throws himself down the stairs or falls off things, he will find away to hurt his legs or feet so he cannot walk. As of yet we have had no broken bones but plenty of sprains and strains.

 

When we ask our son if anything is wrong he says no. We have to ask very specific questions or think about what has been happening for him in previous weeks and have conversation around those events. Usually it is because he has misunderstood something or is worried about an event that is happening in the future.

 

Diane

[Cat]

After my then nine year old son had been dragged off the tree that he was busy head butting like a Ram, and had finally calmed down, I tried as best I could to explain that hitting his head that hard off a tree could actually damage his brain. He turned right back to me and said that the pain that he now had in his head was much better than the confused and upset feeling that was making him feel ill.

 

My youngest has been hitting is own head and kicking the poo out of things to the point that he really hurt his feet from being very small. I asked one of the professionals based where we live what we could do to stop this, and they pretty much said offer a less painful alternative but agreed that the external pain that my son said he was feeling was easier for him to deal with than his internal angst. There is very little solid research around self harm and ASD but it appears to be quite common. My eldest is a picker but I think his angst converts more into OCD type behaviour, while my youngest really does need to feel some form of physical pain to help him cope with the feelings inside of his head.

 

Cat

[Tally]

Hi

Like the others not sure how common self harm is, but my daughter age 12 does pick at her skin. If she has a scratch or spot, she will pick and pick until it becomes infected. She had a few mossie bites in the summer, and because of the picking she has been left with scars. She tells me she has no idea she is doing it. I think she must have a high pain threshold, as the sorness never seems to bother her, it just looks dreadful. Her AS is quite pronounced at the moment, but she has made me promise not to tell anyone except her teachers, so when her arms look really bad, it's on with the long sleeves and out with the antibiotics!

Harmony x

 

Hi Harmony,

 

This type of self harm sounds more like it is connected to OCD-type issues than the overwhelming feelings normally associated with self harm. I have come across people who cannot stand any kind of "imperfection" on their skin, and will pick at freckles, spots, bites or loose skin around the fingernails. They will pick until it bleeds, and then pick at the scabs. I don't know what the normal way to treat this type of self harming is, and of course I cannot tell if this is the cause in your daughter's case. But I wonder if it would be possible to re-direct the compulsive skin picking into something less damaging.

[Mumble]

This type of self harm sounds more like it is connected to OCD-type issues than the overwhelming feelings normally associated with self harm. I have come across people who cannot stand any kind of "imperfection" on their skin, and will pick at freckles, spots, bites or loose skin around the fingernails.

I agree that some people can't stand imperfections and so may pick, but I would be very cautious to dismiss self-harm in this case (not saying it is self-harm, but people need to be aware). I self-harm and one of the things I do is to pick at scabs that should heal easily, but I don't let them heal and often make them worse. This is self-harm and not an OCD issue (I do have OCD issues, but that's not what's going on here, and I know quite a bit about it as my brother has severe OCD).

 

In my view self-harm does need to be discussed, but ASD issues make this very complex as "how do you feel" type questions won't help, but I can also understand peoples' concern with asking direct questions. Also, I can feel uncomfortable when people ask me because I don't want them to think that I've let them down and it can be very difficult for me to explain. I can really identify with Cat's post about replacing mental angst with physical pain - and also for me it's a release of that mental angst and I don't feel physical pain at all (at the time - I do after) - but that's very difficult to explain to someone who hasn't been there - how can it make sense that causing more pain helps to reduce pain...

[TheNeil]

As someone else who self-harms, it's true that focusing on the physical pain blanks out any emotional/mental pain. The fact that I hurt my arm, leg or whatever is something that I can understand and control (to a certain degree)(like Mumble I tear at wounds that should heal quickly, leaving a lot of scar tissue behind) but when having to deal with emotional or mental issues, the cause of the 'pain' is far more difficult to understand or identify.

 

So is self-harming merely a 'diversion' away from other issues? Logically it's simply replacing one type of pain (that the person can't understand) with an alternative type pain (that they can). It could be a simple transferance of pain from one form to another or, it could be a way to focus one's mind so much that the 'non-understood pain' is pushed to one side. Sometimes when actually self-harming there's an incredible moment of almost 'nirvana' (I'm not advocating it BTW) but the consequences can be painful for a long time afterwards. Then there are the times when you self-harm without realising it and, for me, it's usually a very good indication of stress and the subconscious trying to regain some semblance of control. However even though it's a good indicator, by the time someone reaches that point, they're usually so 'focused' that they're almost compelled to keep going.

 

I agree 100% that finding out what is causing this stress and the need to 'regain control' (either consciously or subconsciously) is vitally important but most people who have never been pushed to such limits can't understand that it's not simply a matter of 'stopping' - something has pushed you to that extreme and unless the 'something' is addressed, it becomes very difficult (some would argue impossible) to break the connection between the 'something' and self-harming.

 

The obvious answer is obviously to talk about what's at the root of the problem but, especially when dealing with someone with an ASD, being able to even identify what the root cause is can be a very difficult problem. You're potentially self-harming because you have difficulty dealing with the emotional/mental 'pain'...yet somehow you're supposed to be able to answer questions about it. You're struggling to understand and deal with something but people expect you to be able to talk about it and answers questions about it. To discover what the underlying 'pain' is (and therefore be able to identify a solution or course of action) takes time, effort and understanding.

[Mumble]

I would agree that it is a good indication that something (often many things and for me that's where I get stuck because I can't sort the trivial from the real and don't know where to start to talk to someone) is very wrong but it is at a point where I/they may not be able to stop if 'in the act' - it's why prevention has to be better than cure - I have a plan to try not to harm myself because if I can not start, I'm in a better position than trying to stop.

 

I hope the Mods don't mind me putting this up, but the booklet: The Truth About Self Harm from the Self Harm Inquiry by the Mental Health Foundation might be useful.

 

EDIT: Not sure where TheNeil's post that I was quoting from went - looks like I've messed things up again

 

(Edited to delete quote from post which has been removed, and comment referring to it - K.)

Edited September 8, 2008 by Kathryn

[TheNeil]

EDIT: Not sure where TheNeil's post that I was quoting from went - looks like I've messed things up again

Neither do I. One minute it was there, the next minute it wasn't (and I certainly didn't delete it). I'm just glad that you quoted from it otherwise I'd have thought I was going mad.

 

I'm actually quite annoyed at this as I managed to put together a lucid thought for once

[Cat]

I was begining to think that I had imagined reading 'The Neil's post' so it's not just you Mumble we are 'both' seeing things

 

Cat

[Cat]

The Neil it was an excellent post Can we have it back please

 

Cat

[Mumble]

I'm actually quite annoyed at this as I managed to put together a lucid thought for once

I'm annoyed too, because to me it was a non-emotive account of a subject which is difficult to talk about which should have helped people who haven't been there to comprehend some of the feelings and emotions experienced during times of such deep distress.

 

It didn't, as far as I can tell, break any of the forum rules (new or old) as you weren't writing an intention to harm yourself or others. It is when such issues are not talked about and people become scared to talk about them that fear wins over and people have to go into 'hiding' and live with the consequences. As has been referred to in multiple posts on this thread, talking is key but very very difficult. Therefore we need to be able to listen to each other, without judgement, so that we can move forward in our understanding and help each other.

[baddad]

The Neil has been PM'd with the reasons why his post has been moved for consideration of edits. You will of course, appreciate and respect that that dialogue is not a matter for general circulation.

 

BD

[warrenpenalver]

Also, I can feel uncomfortable when people ask me because I don't want them to think that I've let them down and it can be very difficult for me to explain.

Mumble you havent let anyone down if you self harm. Anyone who thinks youve let them down really hasnt any understanding of self harm. No i can understand why you may feel youve let others or yourself down but actually the negative thinking styles and believing youve let yourself down can lead to more self harm in some cases.

 

It doesnt help that the general populations opinions on self harm are often misinformed at best and seriously prejudiced at worst!!

 

 

Self harm is very complex!!! There are many many reasons why someone may start to self harm, many ways of doing self harm and many reasons why someone would continue to do so.

 

You can start self harming for one reason and end up doing it for another.

 

You also have to consider that ANYONE self harming has the potential to become addicted to it due to the bodys natural reaction to release opiates and addrenaline in response to injury.

 

Remember there is both psychological and physical forms of addictions and the bodys chemicals have physical and psychological effects some of which have been described in previous posts.

 

Anybody who is self harming needs professional input to work out plans on how to deal with it.

[hsmum]

Hello,

 

I know the question refers to teenagers, however my nine year old son puts ligatures around his neck, bites his arms and hands, hits his head, pulls out his hair and will pour liquid or soil over himself when he is very angry or upset. He often talks about killing himself and 'breaking himself'. We contacted the mental health team and we were told that in children of H's age, this sort of behaviour is not regarded as 'self harming', but rather an inability to communicate his feelings. I tend to disagree.

[Cat]

I know the question refers to teenagers, however my nine year old son puts ligatures around his neck, bites his arms and hands, hits his head, pulls out his hair and will pour liquid or soil over himself when he is very angry or upset. He often talks about killing himself and 'breaking himself'. We contacted the mental health team and we were told that in children of H's age, this sort of behaviour is not regarded as 'self harming', but rather an inability to communicate his feelings. I tend to disagree.

 

I tend to agree with you. Indicators are that children who self-harm grow into adults who self-harm therefore we need to be finding out what we can do to help our children. Even if this is an inability to communicate his feelings that needs to be addressed and ways of expressing his feelings needs to be found.

 

My son was also 9 when I felt that we had a problem with his behaviour towards himself. Having lived with on suicide watch with one son I do not want to live through that again and so we have tried very hard to find ways to communicate with our son and to find alternatives to him quite literally beating himself.

 

In my opinion if self-harming is ignored then we are not doing our children any favours. Sadly I think that some professionals are as much in the dark as we are. That is why I personally find it invaluable hearing from adults with ASD who do are have self harmed. This may be something that we would rather not think about or discuss but that wont make it go away and knowledge is power or at the very least aids understanding.

 

Cat

[cmuir]

Hi

 

Don't know about teenagers, but my son is nearly 7 and he self harms. My son's consultant has said that he may have a mood disorder on top of having AS (eg Bipolar). Unfortunately, it's unlikely that he'd be diagnosed certainly over the next few years - CAMHS are apparently very reluctant to diagnose this in children. Fraid I can't offer any advice, but hope things get better for her soon.

 

C.

[pearl]

I'm finding this thread very interesting and helpful, because I have only very recently realised that I have been self harming for most of my life. Stumbled across something on t'internet, & finally realised what it was.

 

I guess we have many "walking wounded" here, both AS and NT.

 

And until now I have only been able to tell one other person (you know who you are), but there is so much painful honesty on this thread that I have felt able to post this without being judged. So thankyou

[Tally]

I agree that some people can't stand imperfections and so may pick, but I would be very cautious to dismiss self-harm in this case (not saying it is self-harm, but people need to be aware). I self-harm and one of the things I do is to pick at scabs that should heal easily, but I don't let them heal and often make them worse. This is self-harm and not an OCD issue (I do have OCD issues, but that's not what's going on here, and I know quite a bit about it as my brother has severe OCD).

I'm glad you have such a clear understanding of your own self-harm, but I don't think that suggesting possibilities that don't match your own exerience needs to be considered "dismissive" in any way whatsoever, especially when the alternative I have suggested is a severe presentation of a well-known illness.

[warrenpenalver]

I'm finding this thread very interesting and helpful, because I have only very recently realised that I have been self harming for most of my life. Stumbled across something on t'internet, & finally realised what it was.

I think that can happen a lot especially with something we keep hidden as you have no accurate perception of what is and is not self harm unless you do research.

 

A lot of it can be perception and societys norms. for example binge drinking which is epedemic amongst todays youth could be argued as a form of self harm, and the medical evidence would easily back this, yet society would not consider it self harm but a potentially harmful "fun activity". NOW cutting is defintitely socially accepted as self harming yet medically the risks of shallow cutting are not serious when compared to suffocating on your own vomit or chronic liver failure later in life!!!

 

I used to unknowingly self harm as a child. Well id call it indirect self harm because i would cause accidents aiming to hurt myself (often unsuccessfully as kids bounce quite easily!!!). I never used to think headbanging or punching yourself was self harm either until my psychiatrist said otherwise!!!

[Mumble]

And until now I have only been able to tell one other person (you know who you are), but there is so much painful honesty on this thread that I have felt able to post this without being judged. So thankyou

Pearl, thank you for your post <'>

 

As you say, having a place where people feel safe and non-judged, whether writing about concerns about their children, or their own experiences (either as NT or ASD adolescents/adults) is so absolutely vital, both for their support, for the support of others reading this, and for society's developing understanding of what was (and often still is) a taboo subject. As a comparison, and I hope people don't mind me using these, it wasn't so long ago that people used to hide serious illnesses (and the symptoms of until it was too late) as it wasn't the done thing to talk about them, HIV/AIDS wasn't publicly discussed until particular high profile publicity and in this case, talking openly, and particularly people with HIV feeling that they can talk openly without hopefully being judged, has led to greater awareness and, to put it starkly, a reduction in death rates.

Yes, such a discussion will at times lead to, as you put it 'painful honesty', and that is what I have witnessed here - it is a shame not all posts have been seen like this and have been removed because it may lead to people feeling that they can't be honest. Of course this is a difficult subject to talk about and is going to lead to some tensions, but it has to be better that we try to open up conversation and debate in a non-judgemental way. There will be things written that others don't want to hear - but then, none of us are forcing them to read them if they're not yet ready (and I don't judge them for that - in something I've alluded to earlier it took me a long time to read about and find out about because of my own fears and prejudices) - yet I do think these posts need to be here for when people are ready to read them.

Edited September 10, 2008 by baddad

[jonathan]

Thankyou all for your advice I will pass it all to my sister in law

what would I do without you folks !!!!!!

[warrenpenalver]

Thats the problem with taboos in society generally is that misundertanding and fear of the unknown can cause such a strong reaction.

 

The thing that worrys me about a lot of taboos is the very fact they are taboo often makes the problems worse for those affected by it.

 

Just a simple example is mental health, 1/3rd of us suffer a mental illness at some time in our life yet the public still seems to think "nutcase" or "psycho" of people with mental difficulties.

 

IM sure many of the people on this site have had to suffer the downright cruelty by some people who lack understanding of PDD's and LD's all because the public dont understand (or dont want to).

 

Although i do sometimes just think the seemingly increasing number of nasty scum in this country just means that anything someone else can percieve as a weakness or difference to take advantage of!!

 

 

One thing i am glad of is this site at least everyone on it has some form of understanding so the nastyness you may get elsewhere is not present here.

[Flora]

Thats the problem with taboos in society

 

I quite like taboos...... I have one of a small heart on my left shoulder.

 

Sorry... I'm sure that was a bit crass and way but I couldn't resist.

 

So and I'll just scuttle off back to the silly section.

 

Flo'

[baddad]

To all posting/intending to post on the issue of moderation decisions...

To retain the intent of this thread the post has been split.

Please use the new thread for comment on moderation etc, and this one for it's original purpose

 

Regards

 

BD