A reader asked:
I’m not sure if this counts as a social skill but I could use help. I’m autistic and I’m struggling with using self harm as stimming (picking, scratching, hitting), as well as severe self destructive behavior during meltdowns. As my mental health is worsening, I’m resorting to these behaviors more and more– and more publicly. I know I shouldn’t be hurting myself around people… Any advice? skills? ideas for replacement behaviors? (I know I need therapy, I’m working on it, just need help now)
Some things that come to mind:
It might help to reframe how you’re seeing the problem:
- The main problem isn’t that you’re hurting yourself around people.
- The main problem is that you’re hurting yourself and that you’re suffering.
- Don’t forget that you matter.
- And that shame is not a cure, and you can’t solve your problems by telling yourself off
- If you focus on figuring out what’s wrong, what your needs are, and how you might be able to meet them, it will probably make things easier
I’m wondering based on how you’ve framed this question if you generally try to avoid all forms of conspicuous stimming in public:
- If so, stimming on purpose might help
- Because for a lot of us, if we avoid stimming until it becomes physically unavoidable, it tends to come out in self-destructive ways
- (eg: if I try to avoid stimming, I almost always end up picking my scalp. If I use stim toys when I feel the need to stim, I don’t)
- Do you have any stims that work for you that aren’t self-destructive? Can you do those on purpose more before you get to the point of self-harm?
Some specific stims that work for some people:
- I’ve found Neoballs neodymium magnets effective as a substitute for picking, and I know they have worked for other people as well. It meets a lot of the same sensory needs.
- Rocking can be helpful (and it’s often not actually as conspicuous as it feels)
- Sensory Squids has a lot of stimming suggestions
- If you bite yourself, it might help to have something else to bite. For instance, a Teething Bling necklace (which looks acceptable for adult jewelry) or a Chewy Tube (which looks more like therapy equipment, but it’s very, very good for chewing).
- Some people use music or stimming apps to reset themselves
- Listening to music a lot or wearing noise reduction headphones can also help
Sometimes people harm themselves during overload as a way of reorienting:
- Pain can be really orienting, but it’s not the only thing that works
- One thing you can do instead is to grab onto a solid object and keep holding it until you feel more grounded.
- Some examples of things to hold onto: poles, posts, shelves, shopping carts
- It can also help to hold onto another person or to hold their hand, if you have someone who is ok with that
- Deep pressure can also help with this. It might help to get under a heavy blanket, to wear a weighted vest, or to clasp your hands together, firmly rub your arm, or something else similar
- Therapy brushes work for some people who have this need (they’re also often used nonconsensually in ways that hurt children. That’s not something that should ever happen. But they do work for some people.)
- It also might help to use hard stim toys such as marbles, or a wooden baby toy such as this one (which, in my experience, people don’t read as a baby toy when I use it).
It also might help to work on identifying and avoiding triggers:
- If you feel like you’re nearing the point of a meltdown, it can be tempting to try to convince yourself that you can push through and be ok through sheer force of will
- That tends to end poorly
- *Even if it sometimes works*, it’s not worth it
- It might help to err very heavily on the side of assuming that you need to leave or take a break if you feel like you might be heading for a meltdown
Some specific situations
- Do you get overloaded in crowded rooms? If so, it might help to avoid the center of the room and stay on the sides.
- It also might be a good idea to stay near the door so that you can leave easily
- Or so that you can ask people you’d like to talk to to hang out with you outside the room
- Even more generally speaking, the center of a room can be an overloading place even if it *isn’t* crowded
- If you get overloaded in classes, it’s probably a good idea to sit in the back near the door so that you can leave if you need to
- (If you have a diagnosis, your doctor might be willing to write your school a letter saying that you need to be able to take sensory breaks. That can help make it easier to do this in some situations)