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Dealing With Self-Harm and Aggression

Friday, February 18, 2022

Dealing With Self-Harm and Aggression

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Self-harm and aggression are unfortunately common in people with disabilities, especially following an upsetting circumstance or situation. It can be incredibly frightening for both the person and their family. Read on to find some resources and next steps when dealing with self-harm and aggression.

Background

Before we talk about how to handle situations when they arise, it’s important to understand a little background information, presented through several studies. It’s also important to remember that people with disabilities deserve to have control over their own bodies and should be respected above all else.

Prevalence: Self Injurious Behaviors (SIB) or self-harm is described as any behavior that is considered injurious to one’s self and is incredibly frightening for the person with the disability and their loved ones. It occurs in roughly 7%-23% of the disability population, particularly in those with an Intellectual Disability (ID), though the rates are much higher in populations of people with significant disabilities, reaching almost 73%.

Causes: There are many studied causes of SIB, but more research needs to be conducted in many areas in order to fully understand why SIB occurs and how to prevent it. Some causes that have been identified so far include sensory issues, lack of control or a feeling of a lack of control, feeling unable to express emotions of anger or frustration, and other factors such as exposure to dangerous bio-chemicals, history of abuse and certain genetic disabilities. It’s important to remember that there is always a cause to the SIB, and it’s no one’s fault when it occurs.

What can I do if my child is engaging in self-injurious behavior, self-harm or aggression towards others?

  1. First of all, remain calm. It’s important to not match the level of anxiety, anger or frustration they are feeling. These are big emotions, and it’s ok for them to be feeling that way.

  2. Protect yourself. If your child is being aggressive towards you or another person, it’s best to distance yourself from them until they can calm down. Things can be replaced, but people can not and you can not protect your child or others around them if you are injured. If you feel like you can not distance yourself safely, then it’s important to take a protective stance, like putting your hands in front of your face or using safe block techniques. The Crisis Prevention Institute (CPI) can help you learn safe block techniques as well as safe restraint techniques, if needed. Restraint should be an absolute last resort.

  3. Protect the person. Using pillows, blankets or other soft items in between the person and what they are using to engage in SIB can be helpful in reduction of harm. For example, you can use a pillow to reduce harm if the person is engaging in head banging behaviors or you can put a blanket over their arms if they are engaging in picking, scratching or pinching.

  4. Use soothing tones, voices or music. While you are intervening, it’s important to use soothing tones, voices or music to help them reduce their anxiety or help them calm down. You can remind them they are safe and that everything will be ok. You can put on some classical music (or music they like) or you can use a weighted blanket or vibrations to help reduce their sensory overload.

  5. Distraction. If it is safe, you can distract them from the behavior by engaging in a fun activity like dancing, singing or art or you can put something in their hands that will help them focus their feelings on something other than the SIB. For example, you can put a vibrating ball in their hands to give them the feeling of movement and distract them from what might be overwhelming their senses. Do what’s best for your child. Each person is unique and what distracts one person might overwhelm another.

Research proven methods for reducing self-injurious behavior (SIB) in the future

Research has been done on the various interventions ranging from psychotherapy to diet and vitamins. Below are some methods shown to be helpful in reducing SIB long term.

  1. Biochemical: Some people’s biochemistry can be regulated through diet and vitamins. Some research has shown that vitamin B6, calcium and a diet rich in fruits and vegetables and low in sugar can help reduce urges to engage in SIB.

  2. Therapy: Like anyone, providing tools and coping strategies to help your child deal with big emotions and sensory overload can help them learn to advocate for what they need to calm down, communicate what they need or engage in self-soothing behaviors.

  3. Communication: Increasing methods of communication can be very helpful in reducing SIB. For example, if your child is non-verbal or finds it difficult to express their emotions verbally when they are experiencing anxiety or frustration, you can use picture cards or a feelings chart to help them express their emotions. Once expressed, you can ask them what they need from you to help them feel better. You can provide them options like would it be helpful for me to stay with you or give you space right now?

  4. Understanding the Functions of the Behavior: Functional Behavior Analysis (FBA) is a tool used to determine the function of the SIB. For example, if your child engages in SIB after being told no and then stops their SIB when they eventually receive a yes, then they have learned that in order to change your mind as the parent, they can engage in SIB. Another example could be that the SIB is helping them cope with an overstimulating situation like loud music or a new environment. By understanding the function of this behavior, we can more easily intervene. Many children will give you subtle signs that they are going to engage in SIB, by paying close attention to these subtle signs, you may even be able to intervene before the behavior occurs.

  5. Medication: Medication should always be a last resort, after all interventions have been tried multiple times and have been proven ineffective. If you’re interested in exploring this route, you should speak to your child’s doctor about the best way to move forward that will still allow your child to enjoy their independence.

Always remember that there is no fault associated with self injurious behavior, self-harm or aggression. Finding out the root cause of the issue can help you better identify how to intervene in the moment. Stay calm and help them use their strategies or coping mechanisms. It’s also important to remember that learning new strategies is hard work and may not be successful the first time. Keep at it, the more time you invest in understanding your child, the easier these situations will become to handle and the less likely they will be to occur.

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