Calming Self-Injurious Behavior with a Simple Touch
By Tal Badehi
The hardest part of treating people with autism spectrum disorder (ASD) is observing self-injurious behavior. It is especially difficult for the individual's family and caregivers to witness self-harming with such aggression when they do not always understand the reason or cause of the trigger.
Therefore, I take my clients' needs very seriously, and I work on a one-on-one basis, using personalized techniques to help identify the cause, lessen the distress, and prevent self-injury. Mary (not her real name), is one of my clients. She has an ASD diagnosis complex needs. Before Mary attended my sessions, she would often display reparative self-injurious behavior, involving hitting herself incessantly around the eyes and temples. The hitting was affecting her vision and could eventually lead to blindness. Mary's caregivers had no choice but to make her wear a protective helmet (made from foam-like rubber). It covered most of her head, leaving only a small opening at the front of the face, and causing Mary to sweat a lot.
The Shiatsu Treatment
Mary takes part in weekly Shiatsu sessions. As she comes to the treatment and lies down on the Shiatsu mat, she keeps banding her head. During the Shiatsu session, Mary becomes relaxed, and the beating stops for short moments. Therefore, I remove Mary's helmet during the sessions so she can get some relief from it and I can get to treat around the head and neck. I place myself in a position that allows me to protect Mary's head if she tries to hit herself.
I have noticed Mary sometimes lift her hand towards her head but holds herself and stops the movement before the strike. Witnessing this made me think that her self-hitting might not be voluntary and that she is trying to stop herself, with little success. I wondered how I could assist her in taking control of her movements.
As I had already learned, people with autism experience different sensory-regulation than neurotypical people do, so I thought Mary might be hitting herself to pacify some sensory stimuli around her eyes and temples. Assuming so, I tried placing my hands on Mary's temple and forehead and just stayed there, seeing what happened. I was astonished to see the self-hitting immediately stop. Not only did it end, but Mary started smiling and laughing! She seemed to enjoy the touch on her sore temples very much.
What Happened Here?
In my understanding, either Mary felt pain around her afflicted temples and eyes, or she required the stimuli of touch in those areas. She was not able to satisfy these need without hitting herself forcibly and perhaps exacerbating the situation in the process. The relaxing effect of Shiatsu, combined with placing hand on the sensitive areas, probably calmed this urge and allowed Mary some relief from her self-injurious behavior.
I am glad to have found a way to help Mary. It required out-of-the-box-thinking, as in the beginning I assumed Mary could control her movements. Realizing her actions were involuntary took me on a different approach and helped me find a possible solution for her problem.