Self Injurious Behaviors. The magic trump card to stop down any conversation about autism. Three words loaded with emotion for anyone who loves an autistic. You want to protect the ones you love. In this case, the one you love and want to protect is also the very same person who is hurting the one you love and want to protect. It’s heartbreaking and confusing. I get that. I promise.
Self injurious behaviors (SIBs) are often cited by those who view autism as a tragedy. Their child’s autism causes him to engage in SIBs, and they would do anything to make the autism that causes their child to hurt himself for no apparent reason to go away. Personally, I have been told I am “so high functioning” I cannot possibly understand, but I do understand because I am an autistic who engages in self injurious behaviors. I’m a head banging, skin biting, hair pulling, mystery bruise getting autistic. I see SIBs from the inside out, and while I can’t vouch for other autistics, for me, the awful part of SIBs is seeing the pain it causes those who care about me. This hurts more than any physical pain. It even hurts more than the root causes that drive me to SIB in the first place.
Self injurious behaviors are not the same as self harm. I feel self harm is a much more concerning issue than SIBs because it encompasses emotional torment (although there is overlap of self harm and SIBs in some cases). If you or someone you care about is involved in self harm, I urge you to seek help
That said, I encountered years of professionals wanting to equate my SIB to self esteem issues, chiefly because of preconceived notions related to my gender. I have my frailties. I am overly sensitive and internalize criticism. I have PTSD related body image issues. My baggage has outgrown its suitcase and demanded a steamer trunk, but it’s my baggage. I own it, I examine it, and I deal with it on a daily basis. My SIBs predate my baggage and will be around should I ever manage to leave that Trunk of Very Bad Things by the side of the road.
On a small scale, my SIBs are not that big a deal. I bite my fingers while trying to process phone calls. Under the table, my nails dig into my leg during a meeting. The actions are discreet, but it took me until my late teens to get my head around the concept that open self regulation via SIBs only left me more vulnerable to those who did not have my best interests at heart. These acts are not a lack of control. I am exerting some small control over my surroundings. Often, I can’t avoid an overstimulating environment. Processing auditory input is difficult for me under the best circumstances. Throw in multiple voices, ambient noise, and fluorescent lights, and it becomes near impossible. Pain works as a filter. Enough pain, and the ambient noise dulls to a roar so that I may at least fake my way through a conversation without tears. These are minor acts that may result in a bruise or a little blood, but no real damage.
Most self injurious behavior stems from what I think of as forced passing attempts. This is a bit of a misnomer because I’m openly autistic, not passing as neurotypical. It’s commonplace for even friendly environments to be sensory land mines, and for people who think they are sensitive to my needs to be miles off target. The world is full of occasions that feel like assaults. Sometimes willful, often inadvertent, and rarely within my verbal ability to act upon in real time, there are demands that I Fit In, Play Along, be a Good Sport, and not be Unreasonable. However, the inconvenient nature of my needs does not make them disappear. Those occasions damage me, chipping away at what is already paper thin defenses until there is nothing left.
Then I break, and the self injury gets ugly.
I take care of others. I try to take care of myself, but in reality, particularly as a parent, there are times when my needs go out the window. I schedule downtime, but life ignores my schedule. I have too many people whose needs must be met at once. I need to maintain composure and stay strong, but with no time to recharge, I become too agitated to properly self regulate. I fall into scripted speech that parrots verbatim criticism and verbal abuse from my past. These aren’t my thoughts, but echolalia voicing my disgust as I hit my head over and over until everything stops. Self injurious behavior during a meltdown always seems to start with the delusion that I’m actually circumventing a meltdown. (I even have the words “Prevent Meltdown” written in my notes.) During, I know this is bad, really, really bad I know for days I will pay in headaches and neck problems, but there is no amount of will power that can stop it from happening.
The best you support you can provide to someone with self injurious behaviors is an open mind. Don’t dismiss possible triggers. If someone communicates to you that an environment or activity is overwhelming, even if that communication is not speech, pay attention to them. Plan ahead. Do not put the ability to handle an event or environment into a success or failure framework, because when you care about someone, you will put yourself in harm’s way to not fail them. Remember that what may seem trivial to you, might be painful to someone else. Adapt to their needs, adjust your perspective, and accept them as they are.
It's Bridget's Word 
So well written and clear – thank you for sharing what I can only imagine was a difficult post!
The part about “listen to someone when they tell you their needs” is what strikes me the most – letting go of my need to be “right” or “know what’s best” and support someone in the way and time that they ask.
Seems to me that’s just good global advice too.
Thanks for making me think!!
Thank you. I’m sure you are more than up to the task. You’ve always listened to me. 🙂
Great post, Bridget. Thanks for sharing it.
Thank you!
I have a series of blog posts about autism and SIBs and a post about the many diverse motives people have for engaging in these behaviors. Would you mind if I linked to this post in my list at http://speakingon.wordpress.com/2012/08/13/from-the-sanguinary-files-part-three-the-anecdata-of-pain/ ?
In particular I am intrigued by your distinction between SIBs and emotional self-harm, which is not a distinction I’ve found in any other source (although the whole point of my blog series was to assert that such a distinction is badly needed). Thanks!
Feel free to link to this post. Thanks for reading!
I added you. I think you’ll find, as I was pleased to discover, that there’s a really impressively wide diversity of motivations on this issue. It really does show the flaws and harms of the prevailing therapy model.
Thank you for sharing all this. As much as I try to be open for my family, this is just one area I struggle understanding. I learned from your perspective and insight. It really helps. Thank you again.
I’m so glad to hear that. Frankly, if I was looking at me from the outside, without knowing what’s going on in my brain and body, I’d find it incomprehensible and disturbing. It looks so much worse than it is.
This was very brave to write, Bridget, and so I will be brave enough too to say I agree and know what you mean. It freaks people out so we have to be careful because of misunderstandings, but yes, being “high-functioning” doesn’t make this go away. Also, I just also want to say for those who get freaked out by it, it’s not as bad as it looks. I mean I get the impression I can do my hand bite head punch thing with more impunity than the freaked out onlooker could, because if I am doing that, my head already hurts a lot and the bonk feels better than the first pain. In other words, I do not do these things without being in pain already. I have spoken to people who do the thing called “self harm” and they are talking about emotional turmoil which is different from the physical sensory overwhelm dinosaur-roar thing that makes me do what I do. Prevention is key, so I do it less now, because I have become more of a powerful person who can control large swathes of environment (own office, person nearest the classroom lights, etc.) but agree that following Bridget’s advice you can help those with less power in life (children, people who do not communicate fluently in any modality at this time) also to do it less because they will have less of a reason. Thanks again, Bridget. Ib
Oh my goodness. Thank you so much. It wasn’t easy to write, and I was a little afraid my gut feeling could be off. What if my experience was nothing like other autistics (that has happened a few times)? Having someone else say ‘me too’ feels better than I thought it would. Thank you.
One way we are totally different is your magic ability to know all about time, like you are a psychic clock-person. I am the opposite. I am so the opposite that I kind of think time is a fake thing invented as a scam. Five minutes and two hours feel exactly the same to me if I don’t concentrate, peer at watches repeatedly, set alarms, etc. But I think it is perfectly to be expected that otherwise similar people will have areas of difference. If I have a “splinter-skill” it is probably the ability to repeat conversations so precisely that the listeners know exactly who each speaker was. Not useful in anywhere near as many contexts as knowing what time it is, but comes in handy when someone say misses a meeting and wants something more entertaining than notes. 😉
If I could give it away, I would. Others constantly incorrectly estimate the time needed to do things, and I have to keep my mouth shut and rely on their inaccuracies when I want to scream “Wrong, wrong, wrong!”.
I wish we lived close by. I could just ask you stuff. Best I can do is, well, longer than a movie but not the whole day. And I might still be off.
*putting you on my blogroll*
Squee. 🙂
Oh me too. On the blogroll you go, Bridget. Loved this piece and appreciate the issue being talked about because I think people get sidetracked when they see their child biting or punching themselves and suddenly everything becomes about that and not about the thing (s) that caused the need for SIB in the first place.
Woo hoo! Thanks! I’ve been blown over by all the supportive feedback.
Yep, you are now on my blogroll, too, Bridget! Excellent writing.
Oh, Paula, thank you so much!
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just a quick note of thanks for that blog. i have a son who is autistic, so i am always on the lookout for an insight into the autistic mindset, even knowing that when you’ve met one autistic, you’ve met one autistic. very enlightening
Thanks for reading!
Awesome. Just a note: As I was reading this, my son set a big bottle of milk on the table, the table wiggled, I got a little dizzy and couldn’t read… bit my knuckle, kept reading. 😉
Then I got so happy about reading this that I jumped up and down and flapped my hands. Just saying…
*giggle* That made me do the happy fingers in a loose fist flap. 🙂
Thank you so much for writing this. It demystifies self-injurious behavior and also attempts to put to rest the myth that only “low functioning” people self-injure. And, takes some of the drama out of all of it.
Thank you so much for this post and from the bottom of my heart thank you for giving me some idea of what my autistic friends and my son might be experiencing. I now know where to send people who tell me that my sometimes self injuring autistic son’s life is tragic or sad.
You are most certainly welcome. I’ve been touched by how many parents have been open and accepting to this.
Thank you again xx
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((Bridget)) thank you, hon, thank you. You are courageous. And at a time when you have no extra spoons. You’ve gone a huge way in explaining this really important issue in a way that makes so much sense. And like everything else about autistic behaviors, there’s a reason, there’s always a really good reason.
I had to laugh at Ibby’s comment about time – my son is the same way – I am sure he thinks I’m making it up!
Thank you. You have encouraged me from the get go. When I was ready to give up on writing it, you gently reminded me to keep going. Also, I’m nearly sure it was a negative comment on your blog that spurred me to write this. (I may go stalk your blog tonight to find it.)
The time thing has been used by armchair psychiatrists looking to undiagnose me. Ironic, no?
I think he is right. Hehe.
Jack is right that Brenda (and also Bridget) are making up Time. The armchair quacks are right about … Well. I’ve had right about enough of them.
Thank you so much for your willingness to be so candid about a topic that is, in many ways, taboo. I am the Mother of a 5th grader who is a high-functioning autistic boy. WHile he is verbal, he does not yet have the insight to articulate the “whys” of some of his behaviors. This post gave me amazing insight and will help me be a better Mama! My son’s skill is connected to his visual memory. If you need to know where the closest Target is located, he will not only be able to give you the location, but also share if the item you need could be purchased at a different store that is either closer or, better yet, on sale! It is such fun to shop with him!!! 🙂
Thank you, Heather. Nobody here likes to shop (me included). Could you pick up a few things on my list while you’re out. 😉
Interesting. Came here from Quiet Hands; a comment mentioned this post. I was sort of thinking as I began reading that I don’t really have any SIBs… but if digging your nails into your legs is a SIB, so is digging your nails into your palms trying to concentrate, or distract from pain. Apparently as a young kid, I used to chew on the area of my right index finger just below the nail. Every so often, I’ve had the impulse to repeat the behaviour. The rare times I have, it feels good.
So, you know… it looks like I have a few SIBs myself. It’s something to think about.
Thank you very much for your post, and exposing yourself like this. It means a lot to those of us who are just beginning to explore some of the deeper aspects of our condition (was only officially diagnosed as Aspie last March, though we’d known for a few years that I pretty much was, and I’m in my mid-thirties). And, judging from the comments, also to the parents of children who are showing this kind of behaviour. Helping people understand that we *need* to do it, and *why* we need to do it, is huge.
*cheers you – quietly*
😉 tagAught
Thank you, and welcome to the club. I am still learning to accept myself. Undoing years of programming is not an overnight process.
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Thanks so much for sharing 😉 ill pass this along to my co-workers.. We need all the insight like this to work with our kiddos.. Thank you -erin
Thank you. There is so much out there from Autistic adults. I am but a blip on the radar. Feel free to email me for suggestions of other blogs. 🙂
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May I include a link to this in a website I’m creating? It’s for parents/anyone who want to know more about autism and is a doorway to AUTISTIC voices/bloggers and neurodiversity friendly parents/professionals. The website is under construction but the facebook page (Autistikids) is up and running – full of links to the same type of posts. I can be reached at autistikids@gmail.com if you have any questions. Thank you!
I am so sorry for the delayed response. I have been under the weather. You most certainly may.
I hope you’re feeling better! Thanks – I put it on the “behaviors” page. If you have time to check out the site (autistikids.com), I’d love feedback. If you know of posts that might add value, I appreciate your input. Take care!
According to multiple reports, via SI.com, Heat forward Michael Beasley, in his first game back with Miami after signing as a free agent this summer, had an incident in his first game. Despite scoring nine points and adding two rebounds, Beasley reportedly required “medical treatment” after punching himself in the head out of frustration. But if you are autistic, you won’t get medical treatment for head punching..what a JOKE.
Tomi, I’m not certain if your point was that I or other autistics should seek medical treatment, or that Michael Beasley is being afforded a free pass because he’s perceived as abled. Since it happened almost an entire year ago, I hadn’t considered the Beasley incident for quite some time, but I think it illustrates how very natural self injurious behavior is and how society shames any action not in a narrow prescribed norm. Beasley was in a high pressure, overwhelming situation. He was in essence, returning to a job from which he’d been fired, and was surrounded by people expecting him to fail, even wishing, failure upon him. That he would punch himself in the head after making what he felt was a sloppy traveling foul makes perfect sense to me. Sadly, Beasley was shamed for this. The punch became the story, overshadowing his performance. Mainstream media reports like this (http://www.cbssports.com/nba/eye-on-basketball/24064008/michael-beasley-requires-medical-attention-after-hitting-himself-in-frustration) made fun of him, and the commentariat was far worse. As far as his medical treatment, it was only a cold compress for swelling, so really the same minor first aid most NBA players need after a game. Basketball is a physical sport, plain and simple.
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