“I am wondering if there are a larger number of young people with Aspergers who self mutilate out of depression, anxiety and other pressing emotions more so than typical people. I want to know if there are members with Aspergers on this site that have ever engaged in this activity and what caused it …depression, anxiety, or is it from the Aspergers? Also, is it common for a child with an Autism Spectrum Disorder to physically hurt himself on purpose ...and what can be done to stop him from doing this?"
Self-injury (also called self-harming and self-mutilation) is often a coping mechanism, particularly with the feeling of being rejected. This is a particular problem for anyone who has difficulty in understanding non-verbal communication. For most people, understanding facial expressions, body language, etc., is instinctive, starting as babies before language acquisition. But just as some people having hearing difficulties or are short-sighted or color-blind, others have difficulty with interpreting the non-verbal signs, which most people use continuously (e.g., when to speak and when to stop, whether people agree or disagree with us, whether others find us amusing or dull, etc.). These cues are not understood by many young people with Aspergers and High-Functioning Autism.
The inability to understand non-verbal cues is not immediately obvious, but it is an obstacle that gets in the way of social interaction. However, most Aspergers kids and teens can learn how to cope. Many teach themselves without realizing that they are not getting all the information available. But it gets more difficult in adolescence when fitting in with friends becomes more important. The give and take of a social interaction requires a skill in picking up non-verbal messages that Aspergers kids and teens struggle with, even though their understanding of what is being discussed will be as good as anyone’s. As a result, many of these young people get isolated and bullied.
By the time they reach adolescence, most “Aspies” will realize they are fundamentally different compared to their peers at school, but unless diagnosed, they will not understand why. Being rejected by their peers – over and over again – does serious psychological and emotional damage to young people with Aspergers. Not surprisingly, many become severely depressed and may resort to self-injury.
As frightening as it can be for moms and dads, self-injury among youngsters with Autism Spectrum Disorders is not all that uncommon. However, not all self-injury means the same thing on every occasion, nor is it the same in every Aspie.
The first thing a parent should do is decide if self-injury is giving their son or daughter some pleasure, or if the injury is his/her way of trying to tell the parent something (e.g., a younger child may repetitively bang his head against the wall due to an ear infection).
Self-injury can also be triggered by excessive arousal (e.g., certain frequencies of sound may trigger the behavior). This becomes the parent’s job to reduce the external noise and other arousal issues that can trigger the onset of self-injurious behavior.
On the other hand, the youngster with Aspergers or High-Functioning Autism may be using the behavior to bring on a heightened sense of stimulation to the body. A child like this needs training in sensory integration to normalize the senses.
Other kids and teens will engage in self-injury as a social means of getting attention or as a means of avoiding doing a task. In this case, the attention-getting behavior should be ignored, and the youngster who uses the behaviors to avoid getting out of a task should be encouraged to finish the task.
The trick to any unusual behavior is to do a "functional analysis": What happens before, during, and after the behavior? Is this a routine behavior (i.e., something learned)? What environmental stressors are present during the behavior? What, if anything, controls the behavior? Answering these questions will give you a means of managing the behavior in most cases.
Self-harming behaviors are actions that the young person performs that result in physical injury to his own body. Typical forms of this behavior may include:
- biting oneself
- burning oneself
- cutting oneself with a knife or razor blade
- hitting oneself with hands or other body parts
- picking at skin or sores
- scratching or rubbing oneself repeatedly
- pulling hair
- punching walls
The cause of self-harming behaviors in Aspies remains a mystery. It is thought that these behaviors may be caused by:
- a chemical imbalance
- ear infection
- seeking sensory stimulation/input
- sinus problems
- sound sensitivity
- to escape or avoid a task
Why does self-injury make some Aspies feel better?
They feel a strong, uncomfortable emotional state, don't know how to handle it, don’t have a name for it, and know that hurting themselves will reduce the emotional discomfort very quickly. They may still feel bad, but they don't have that panicky-jittery-trapped feeling (it's a calm, bad feeling).
What are some of the signs and symptoms of self-injury?
Red flags for cutting or self-injury include:
- Changes in eating habits. This could mean being secretive about eating, or unusual weight loss or gain, as eating disorders are often associated with self-harm.
- Covering up.
- Frequent “accidents.” Someone who self-harms may claim to be clumsy or have many mishaps, in order to explain away injuries.
- Indications of depression. Low mood, tearfulness, lack of motivation, or loss of energy can be signs of depression, which may lead to self-injury.
- Unexplained wounds. A self-harmer may have fresh or scars from cuts, bruises, or cigarette burns, usually on the wrists, arms, thighs or chest.
What can be done to prevent self-injurious behavior?
Cause: self-injurious behavior is driven by a chemical imbalance or a medical condition
Intervention: treat the child with appropriate medications
Cause: self-injurious behavior is driven by attention-seeking
Intervention: use tactical ignoring of self-injurious behavior; give child attention for appropriate behavior when it occurs; encourage other behavior that makes the self-injurious behavior impossible to perform (e.g., encourage the child to manipulate toys, which keeps the hands occupied and prevents face-slapping)
Cause: self-injurious behavior is driven by frustration
Intervention: teach “frustration tolerance”; give the child constructive things to do to prevent boredom; teach coping skills and relaxation techniques
Cause: child is seeking sensory stimulation/input
Intervention: find a replacement behavior that will meet this need in a less destructive way (see “What can the Aspergers child or teen do instead of self-injury?” below)
Cause: self-injurious behavior is driven by sound sensitivity
Intervention: provide ear plugs; remove child from the source of the sound; remove the sound or reduce the sound level
Cause: child wants to escape or avoid a task
Intervention: provide an escape route for the child (e.g., a safe ‘time-out’ room/corner); provide an alternate task and give options (e.g., child does not want to pick up his room, thus he can pick another chore from a ‘chart of chores’)
One theory suggests that Aspies that injure themselves do so to release opiate-like chemicals in the brain. Naltrexone is a medication that inhibits the release of these opiate-like chemicals in the brain, and the belief is that this will remove the reason for the self-injury.
What else can be done in dealing with Aspergers children and teens that self-injure?
- Don’t judge. Avoid judgmental comments or telling the Aspie to stop the self-harming behavior.
- Encourage. Encourage expressions of emotions, including anger.
- Examine and change. If the self-harmer is your child, prepare yourself to address the difficulties in your family. This is not about blame, but rather about learning new ways of dealing with family interactions and communications that can help the entire family.
- Find resources. Help the Aspie find a therapist or support group. If you don’t know how to find help, encourage your loved one to talk to someone who might be able to help, such as a teacher, a school counselor, or your minister.
- Reassure. Let the Aspie know that you care and are available to listen—and then be available.
- Spend time. Spend time doing enjoyable activities together.
- Understand. It is vital to understand that self-harming behavior is an attempt to maintain a certain amount of control, which in and of itself is a way of self-soothing.
What are some of the DOs and DON’Ts when talking to the Aspie about self-harming behavior?
Talk about the subject of emotional and physical pain. This way the self-injurer can talk about their internal suffering, rather than express it by hurting themselves. Ask questions such as:
- "Do you want to change your self-injury behavior?"
- "How can I help you?"
- "How do you hurt yourself?"
- "How long have you been hurting yourself?"
- "How often do you injure yourself?"
- "Why do you hurt yourself?"
- Try to impose limits. This may increase the Aspie’s self-harming behavior in order for him to feel as if he has control over the situation.
- Tell him to not injure himself. This is his way of coping, a final attempt to relieve emotional and or physical pain, and he will continue to hurt himself as long as he feels it's necessary. Telling him not to will just make him hide it more.
- Keep asking questions if the self-injurer does not wish to talk about his cutting or self-harm. It may cause further alienation and make him feel even more alone and isolated.
What can the Aspergers child or teen do instead of self-injury?
- Bite into a hot pepper or chew a piece of ginger root.
- Break sticks.
- Call a friend and just talk about things that you like.
- Clean your room (or your whole house).
- Crank up the music and dance.
- Do something slow and soothing, like taking a hot bath with bath oil or bubbles, curling up under a comforter with hot cocoa and a good book, babying yourself somehow.
- Draw on yourself with a red felt-tip pen.
- Flatten aluminum cans for recycling, seeing how fast you can go.
- Go for a walk/jog/run.
- Hit a punching bag.
- Light sweet-smelling incense.
- Listen to soothing music.
- Make a soft cloth doll to represent the things you are angry at. Cut and tear it instead of yourself.
- Make a tray of special treats and tuck yourself into bed with it and watch TV or read.
- Make clay models and cut or smash them.
- On a sketch or photo of yourself, mark in red ink what you want to do; cut and tear the picture.
- Paint yourself with red food coloring.
- Play handball or tennis.
- Put a finger into a frozen food (like ice cream) for a minute.
- Rip up an old newspaper or phone book.
- Rub liniment under your nose.
- Slap a tabletop hard.
- Smooth nice body lotion into the parts or yourself you want to hurt.
- Snap your wrist with a rubber band.
- Squeeze ice really hard.
- Stomp around in heavy shoes.
- Take a cold bath.
- Throw ice into the bathtub or against a brick wall hard enough to shatter.
- Try something physical and violent, something not directed at a living thing (e.g., slash an empty plastic soda bottle or a piece of heavy cardboard or an old shirt or sock).
- Use a pillow to hit a wall, pillow-fight style.
- Visit a friend.