Habits

What’s the difference between a bad habit, a nervous habit and a compulsive habit? When should a parent be concerned about a child’s habit?

Bad Habits
Everyone has bad habits. Leaving one’s dish on the table is a bad habit – one that many kids (and adults!) have. Calling a sibling “stupid” or some other insulting name can be a bad habit. Slamming the car door too hard can also be a bad habit. A bad habit is any repetitive behavior that needs improvement. That behavior can be a small, annoying behavior or it can be a more serious problematic behavior. For instance, a teen might have a bad habit of calling home past midnight to say that he’ll be out later than expected, or, he might have a really bad habit of forgetting to call home at all and just showing up at 3 in the morning.

Parents can help their children overcome bad habits by using normal parenting techniques like teaching, rewarding and disciplining. If the child’s bad habit is interfering with his health or functioning, however, then professional intervention is a good idea. For instance, a child who is chronically sleep-deprived due to going to bed too late or who is doing poorly in school due to chronically getting up too late, may benefit from counseling or other appropriate therapy.

Nervous Habits
Nervous habits are bodily behaviors that aim to discharge stress or tension. Twirling one’s hair, biting one’s nails, rocking back and forth, shaking one’s feet while seated – all these actions are examples of nervous habits. Talking rapidly, running to the bathroom urgently, gulping down food, giggling inappropriately – these, too, can be nervous habits.

If a child has a nervous habit he or she may benefit from learning better techniques for stress reduction. There are children’s classes and groups for yoga and mindfulness meditation that can be helpful. Alternative therapies can also help. For instance, herbal medicine can come the system down and Bach Flower Therapy can relieve stress and tension. Parental nagging to stop the nervous habit, on the other hand, does not help at all – if anything, it might increase the nervous habit. If the habit is bothering the child or parent, a consultation with a mental health professional may be helpful.

Compulsive Habits
While bad habits and nervous habits occur to some extent in almost everyone, compulsive habits occur only in those who have various mental health disorders. Eating disorders often involve compulsive activities like weighing oneself or cutting food into tiny bits. Certain kinds of psychotic disorders also have compulsive symptoms.

Compulsive habits are most characteristic of the anxiety disorder called obsessive-compulsive disorder (OCD). This sort of habit is more ritualistic than the habits we’ve discussed so far. For instance, someone with a “nervous” habit might tap her feet while waiting in a long line. However, someone with a compulsive habit might tap her feet exactly 13 times – not because she is tense, but because she is attempting to reduce truly anxious, troubling feelings. Tapping exactly 13 times – not one less or one more -is a compulsion. A compulsion is a specific action whose purpose is to calm the anxiety associated with troubling obsessions (thoughts or sensations). There are many, many types of compulsive habits. Washing one’s hands a certain number of times is a common compulsive habit that often results in red, chapped, even bleeding skin. Counting steps, saying certain words or numbers, checking things repeatedly, praying in a specified way not characteristic for others who practice the same religion – all of these can be compulsive habits. The child who engages in these or other compulsive habits is a slave to the habit – he or she MUST perform the action or else suffers overwhelming anxiety.

Compulsive habits do not tend to go away by themselves. Instead, they get worse and worse over time and spread into more and more styles of compulsive habits. The sooner a child receives professional treatment for compulsive habits, the sooner the child will be able to lead a normal, healthy, compulsion-free life. If you think that your child’s habits may be compulsive in nature, arrange for an assessment with a mental health professional (psychologist or psychiatrist). Treatment can help!

Picking at Skin

There are different ways to pick at one’s skin.  Some people, including children and teens, pick at the skin around the nails of the hand. Others pick at little scabs or sores that may be anywhere on the body (such as insect bites, blemishes, or injuries). Some create little sores by scratching themselves or irritating normal surface “bumps” on the skin and then, they pick at the newly formed sore. Some pick at their scalp. “Dermatillomania” is one name for this condition, although each type of picking has its own distinct name.

Lack of Control
Picking at the skin is an impulse control disorder. It has been compared to trichotillomania – a condition in which one pulls out one’s own hair from the eyebrows, or the eyelashes or from the scalp. It has also been likened to OCD (obsessive-compulsive disorder), a disorder in which a person performs ritualistic behaviors in order to reduce anxiety. Dermatillomania has also been considered to be a sub-category of Tourette’s Syndrome – a condition in which a person has compulsive tics (movements and sounds that just MUST be made, even though they serve no constructive purpose. No matter which way we categorize skin picking, it is always seen as a behavior that is related to tension release.

Stress and Dermatillomania
Skin picking occurs more frequently when a person feels stressed. It also decreases when a person is feeling more relaxed and in-control of their lives. Therefore, treatments aim to reduce tension and build emotional stability. Skin pickers often do not have healthy ways of handling their stressful emotions. Psychotherapy may be helpful – especially with teens and adults. Children may benefit from art therapy. Techniques like EFT (emotional freedom technique) can sometimes be helpful. Meditation and relaxation training, as well as hypnosis, have all been helpful in addressing this disorder. For adolescents and adults, there are also support groups that can be helpful. The workbook “The Habit Change Workbook” by Claiborn and Pedrick, takes a cognitive behavioral self-help approach that can also make a positive difference. Psychotropic medications like anti-depressants are sometimes used as part of the treatment. Each person who picks at his or skin has different psychological needs and therefore treatment is individualized to address those needs.

Getting Help
Skin picking can make a person feel out-of-control and ashamed. It is often done in hiding and it is rarely spoken about. People are embarrassed and therefore don’t even talk to their doctor about it. Therefore, people don’t get the help that is available for this highly treatable disorder. If you think that your child may have this disorder, or even if you are just concerned about seeing picking behaviors on occasion, do consider arranging for a mental health assessment. A professional will let you know whether treatment is necessary or not and if so, help design a treatment program that can help way beyond stopping this symptom.

Pulls Out Hair

Hair-pulling in children and adolescents may be perceived as a harmless habit. After all, if your child likes to pull, say 3-5 strands of hair a day, it shouldn’t make much difference to his or her scalp and hair health. The amount of hair that falls off naturally probably exceeds the couple of strands kids and teens pull for fun anyways. When should hair pulling become a concern?

Hair-pulling behavior can range in severity from mild to severe. There are those who ritualize hair-pulling for aesthetic purposes, e.g. getting rid daily of the strands that don’t fall obediently with the rest, or hair considered as “dead”. There are others who pull hair strands when they’re frustrated or upset. And then there are those who suffer from an impulse control disorder called trichotillomania – compulsive hair-pulling that can be so bad, sufferers end up with permanent patches of baldness.

What’s Behind Compulsive Hair-Pulling?
Like many impulse control disorders, compulsive hair-pulling is caused by a feeling of incredible tension and anxiety. For some reason, hair-pulling relieves the tension and anxiety. Once the hair-pulling is done, the child or teen with trichotillomania feels an immediate sense of release, gratification and even pleasure. This dynamic of “tension-behavior-relief” is what makes hair-pulling addictive, progressive and after a while, very difficult to resist.

Hair-pulling in trichotillomania is often concentrated on the hair on the head, although sufferers may also focus on eyelashes, eyebrows, moustache and beard, and hair from other places of the body. Hair-pulling can be of individual strands, although more serious versions of the illness have patients pulling clumps at a time.

Are There Serious Health Effects?
At first, hair-pulling may not cause any physical harm to hair follicles and the scalp. If compulsive hair-pulling can be stopped early, hair growth resumes normally. But in severe cases, repeated hair-pulling can irreversibly damage hair follicles, inhibiting the ability of hair to grow, resulting in permanent baldness.

How can Parents Help Kids and Teens with Hair-Pulling Problems?
There are many ways parents can assist their children with compulsive hair-pulling.

First, it helps to understand that compulsive hair-pulling behavior is an impulse control disorder. This means that it won’t go away by simply telling your child to stop. In fact, unless your child is too young to understand the impact of his or her condition, your child likely already wants to stop — except that he or she can’t seem to quit.

What parents can do is address the tension and anxiety that causes hair-pulling behavior. Hair-pulling is essentially a coping mechanism, a way to get relief from stress. This is not as irrational as it sounds, and may have a biological basis. When our bodies feel pain, such as after the hurt caused by hair-pulling, our brain releases natural pain relievers that makes us feel good. It’s this feeling that people with trichotillomania like and chase, not the act of pulling hair. Although reducing stress will help the child have less intense episodes of hair-pulling, it will not cure the condition. A cure generally requires therapy. However, parents can reduce stress by being careful not to yell at the child or use harsh discipline, help manage the child’s academic load by consulting with teachers as necessary, limit the amount of marital conflict they display in front of their child and so on. In addition, they can teach their child healthy ways to release stress such as through exercise, the use of natural remedies like Bach Flower Remedies (consult a practitioner for best results), use of aromatherapy (consult a book or a practitioner for ideas), use of yoga, breathing techniques, EFT (emotional freedom technique) and other self-help strategies.

It’s best if parents can see professional help for their child who is pulling hair. Professionals can set up a cognitive-behavioral therapy to help decrease hair-pulling.

At the end of the day, compulsive hair pulling is not really about hair, nor about beauty and appearance. It’s about internal regulation and emotional management. If symptoms persist or worsen despite the interventions listed above, then parents are recommended to consult a psychologist or psychiatrist.

Twirls Hair

Children (and adults!) have “nervous habits.” These are often little useless movements or actions like rubbing the forehead, cracking knuckles, nibbling at fingernails, shaking legs back and forth, rocking back and forth and so on. Hair-twirling – taking a strand of hair and wrapping it around a finger – is a popular nervous habit from infancy onward.

If your child engages in hair twirling, consider the following tips:

Nervous Habits Reduce Feelings of Stress
Those who understand the human energy system can often describe how a nervous habit contributes to feelings of soothing and comfort. For instance, when people bump into something, they’ll often instinctively rub the injured part of their body. This is because humans are wired to help themselves heal without even knowing how or why they are doing it. They rub the injury instinctively – not because they’ve been told to do it. The rubbing activity brings increased blood circulation to the area and also brings energetic healing to the wound. Indeed, the whole business of “hands on healing” has to do with the energy stored within our bodies that can be transferred through hands to another part of our own or another’s body. In a similar way, rubbing the head, nibbling fingers and so on, initiates energetic healing that reduces stressful feelings and increases calm.

Children and teens engage more in their favorite nervous habit when they are more stressed. This increased stress may be due to outside pressure like school exams or internal pressure like fatigue. Tired children will often curl up on their mother’s lap and twirl their hair. The twirling activity acts like a pacifier, calming their internal agitation, exhaustion or fear.

Hair-Twirling is Not Hair Pulling
Some children will not only twirl a strand of hair, but then they will pull it out of their head. This habit is called trichotillomania. It is a mental health disorder which is a type of impulse disorder. Hair-pulling is a compulsive activity – one that is very difficult to stop without professional assistance. Hair-pulling, like hair twirling, occurs more often when a child is experiencing stress, but it’s real purpose is to reduce anxiety.  In other words, hair-pullers have more internal pressure than simple hair twirlers have. Moreover, hair-pulling leads to feelings of helplessness and shame when left untreated. Hair-twirling usually doesn’t bother the person who does it. Hair-pulling is best treated by a child psychologist.

Helping Your Child Stop Hair-Twirling
Toddlers frequently engage in hair-twirling and as they become a little older, they just as frequently grow out of the habit. Therefore, the best thing to do for young hair twirlers is NOTHING. However, if your child is still twirling her hair when she is six or older, you can help her in a few ways. Nagging is not one of them. Besides being detrimental to the parent-child relationship and to the child’s development, nagging is also completely ineffective as a deterrent to hair twirling! What helps more, is reducing the child’s stress and re-directing her behavior.

Stress-reduction for children and teens can often be accomplished with Bach Flower Therapy – harmless vibrational remedies (water) that are available at health food stores. The Bach remedy Agrimony is particularly helpful for those who have bad habits. However, a consultation with a Bach Flower Therapist can be most helpful – read up on the descriptions of the 38 remedies to pick the ones that most fit the profile of your child (you can find more info online and on this site). Up to 7 remedies can be mixed together in one “treatment” bottle and used until the twirling subsides. If twirling begins again, start giving the remedy mixture again. Continue off and on in this way until the twirling has stopped completely.

Anything you can do to reduce stress in the house will be helpful in a general way. Quiet parenting techniques and a happy relationship with your spouse can only help. However, a child’s hair twirling can certainly happen even in a very low stress environment and even when she is very emotionally secure. It’s really more a matter of personal stress style, inherited tendencies and so on.

You might try giving your child something to hold in her hands when you notice she has been twirling. The hands, as discussed above, have energy centers that can help regulate stress. Holding or playing with something in the hand is a more socially acceptable soother than hair twirling. You can get your child a worry stone (a smooth stone for rubbing) or a fidget toy of some kind. Always give her something to DO with her hands instead of just asking her to stop playing with her hair.

In order to break the habit, you can also give your child a hairstyle that makes twirling very hard to do – tight braids or very short hair. It takes about 21 days to break a habit, so after that period, you can probably go back to her old hairdo. However, NEVER give a child a hairstyle that she doesn’t like as this can actually be traumatic for her.

If the hair twirling won’t stop and it bothers you or the child, consult a psychologist. A professional can offer techniques that are used for more intense issues like trichotillomania but that will also help with hair twirling.

Habits and Nervous Behavior

Everyone has some bad habits. And everyone engages in their bad habits more often when they are feeling tense or nervous. For instance, a teenager or adult may have taken up the “bad habit” of smoking cigarettes. The smoker will almost always be smoking more often when feeling anxious. Younger children can have habits like picking their nose, biting their nails, or twirling their hair. (You can learn more about these bad habits and how to help them by reading articles under the category Nervous Habits on this site). Some kids crack their knuckles, chew their pencils, or nibble on their shirt cuffs. Some rock back and forth in their chairs. In fact, there is hardly a limit to the type of bad habit that a child can “invent!”

If your child has some bad habits or nervous behaviors, consider the following tips:

Nervous Behavior Means the Child is Nervous!
Whether it is pacing back and forth, pulling out hairs, or shaking one’s leg, the purpose of a habit is to release some nervous tension. If you can address the tension directly, the habit will most likely go away (or at least diminish) all by itself. Instead of telling your youngster to stop shaking his leg, offer him something for his “nerves.” Now this doesn’t mean that you should offer him a stiff drink! (That’s a bad habit that a lot of adults are into!). There are plenty of healthy, child-safe “stress busters” that you can offer your child. For instance, your child might be calmed by the right herbal tea. A herbalist or naturopath might be able to prescribe a herbal mixture that reduces your child’s overall level of tension or “nerves.” Herbs can be prepared as bedtime tea’s or they can be taken as syrups or even lollipops when they are made by a professional herbalist. Some herbs are available in tincture or tablet form from your local healthfood store. All herbs are medicinal so make sure that you consult a professional before giving your child herbal medicine. Less medicinal than herbs are essential oils. These, too, are available at healthfood stores. Aromatherapy – the use of essential oils to calm nervous tension – is less medicinal than herbal medicine, but still a little medicinal (for example, some oils need to be avoided in pregnancy or when someone has epilepsy). Therefore, it is adviseable to check with a professional aromatherapist before preparing oils for your child. However, once you learn which oils are safe and how you can prepare them for your child, you will find essential oils to be a delightful way to calm your child’s stress, help him sleep and reduce his nervous habits. A calming treatment that is not medicinal in any way is Bach Flower Therapy. The Bach Flower remedies are essentially water. They do not affect the body – rather, they affect the emotions. They help a child feel less upset, worried, angry or sad. They can help with excess nervous energy, anxious feelings or other “nervous” symptoms. You can read descriptions of the remedies on-line and choose the ones you think are most appropriate for your child or you can consult a professional Bach Flower Therapist. Always include Agrimony in your Bach Remedy mixture when you want to treat a nervous habit; Agrimony is the remedy that helps reduce nervous behaviors. In addition to natural therapies (and these are only a few of the treatments that are available), you may find that psychological counseling can help reduce your child’s anxiety and stress. Obviously this intervention is most important when your child is really stressed and nervous. However, your child who is just “the nervous type” (not very, very anxious), may benefit from psychological interventions as well. Most appropriate for the average child is EFT (Emotional Freedom Technique), mindfulness meditation for children, CBT (cognitive-behavioral therapy) self-help workbooks and other psychoeducational tools. Exercise is another great way to reduce nervous energy: enroll your child in active sports, gymnastics, yoga, swimming – make sure your child is physically active daily!

Refrain from Telling Your Child to Stop His Habit
Telling a child to stop doing whatever he’s doing not only DOESN’T help, but it also hurts. Your child isn’t trying to be “bad” when engaging in a nervous habit. It’s almost like it is happening outside of his conscious awareness. Rather than telling him to stop, simply re-direct him to another activity. Interrupting habits helps to break up the strong neural pathway that is beginning to develop. For instance, suppose your child is sitting in a chair wildly kicking one leg back and forth, back and forth, back and forth. Don’t tell the child to stop! Instead, ask him to please fetch you something from another part of the house. This will interrupt his habit and anything you can do to interrupt the pattern will be quite helpful.

Never Humiliate or Mock Your Child for His Nervous Habit
Some people try to “shame” their child out of their nervous habit. Even if you manage to cure a child this way, the cost is way too great. Don’t do it. There are better ways to cure a habit. For instance, if your child has a habit of nose-picking, DO NOT tell him he is disgusting! Instead, follow the steps you’ll find in the “Nose-Picking” article on this site.

Get Your Doctor’s Advice if a Habit is Persistent
Pediatricians have seen it all. Ask your child’s pediatrician for advice on how to help your child with his nervous habit.

Try to Reduce Stressful Events in Your Child’s Life
This can be a hard one. You might really WANT that divorce, even if it causes your child to become unravelled. However, do what you can to limit the stress your child is exposed to on a daily basis and you’ll find that his nervous habits diminish. Refrain from yelling at anyone or engaging in any kind of conflict. In fact, try to stay in a good mood when your child is around.  Nurture your own mental health by taking good care of yourself. This will help you be happier and calmer and this will only be good for your child. Getting help for yourself or your marriage or even your divorce, can be an important step in calming your household and supporting your child’s mental health.

Stalking

Have you ever been so enamored of a celebrity that you wanted to know what they were doing every single minute of the day? Or did you ever have an ex in your life that you couldn’t let go of, and you hungered to know details of what he or she was doing in life after your relationship ended? Intense curiosity about others is a normal phenomenon experienced by millions of people every day. Usually, people don’t act on their feeling of “wanting to know,” but sometimes they do. When someone closely tracks another person’s activities it is called “stalking.”

Young people are just as capable of stalking as adults. What can you do if you discover that your own child is involved in this activity?

What is Stalking?
Stalking refers to tracking the behaviors of another person in such a way that the person feels harassed and violated.  Stalking, an invasion of another person’s privacy, can take many forms. For instance, stalking behaviors  include spying on someone’s private mail or phone conversations, following a person wherever they go, watching a person’s comings and goings, sending unwanted correspondence or gifts, forcing unwanted relationships, and even threatening and attacking the object of one’s obsession. Very recently a new brand of stalking has surfaced — cyberstalking — which is stalking behavior conducted over the internet.

Stalking is a criminal offense punishable by law.

How Do Kids and Teenagers Engage in Stalking Behavior?
Stalking behaviors can range from mild to severe. In some cases, kids and teens don’t even realize that what they are doing may be considered stalking. In other cases, they may be fully aware that their behavior is unacceptable, harmful,  and even illegal but they continue to do it nonetheless.

Obsessing about and following celebrities is the more common type of stalking behavior among young people. Teens can get so attached to a matinee idol or rock band, for example, that they devise creative means to find out where their favorite stars hang out, and sneak inside the hotel they are staying in or the restaurant where they’re eating. This kind of behavior in young people may or may not be considered a criminal offense; some celebrities do encourage these accidental “spottings” (even announcing it on their microblogging sites!) for the sake of publicity. But in any event, any excessive adoration is unhealthy, and can cause significant problems at home or at school.

But there is also the more serious type of stalking behavior happening among young people today, one that is more malicious and ill-intentioned. With the ease of modern  communication and networking, young people can easily find ways to attack someone that they have issues with, or force embarrassing public confrontations. Pervasive harassment through sms, emails, blogs and social networking sites, for example, are fairly common among young people. Worse, some kids and teens are unaware of how they are actually victimizing other people with their actions. They underestimate the destructive impact of their behavior.

What can Parents Do?
Stalking behavior should be treated as a serious matter. Not only can stalking cause severe problems in relating and working, stalking is a criminal offense that can result in arrest and/or commitment to a juvenile facility. Children and teens must know when to draw a line between acceptable ways of relating and violation of other people’s rights. Remember, even if a fixation or obsession is manageable at the moment, it can easily turn unhealthy.

If you’re a parent whose child engages in stalking behavior, consider the following tips:

Evaluate the Gravity of the Situation
As mentioned, stalking behavior exists in a range; with some behaviors more understandable and acceptable than others. Find out where your child is in the stalking spectrum so that you may know if guidance and education is sufficient, or stronger interventions are necessary (such as assessment and treatment by a mental health professional). Signs of seriousness include the presence of delusions (e.g. the belief that the other person is in love with the stalker), lack of empathy for the other person’s feelings, severe anxiety if stalking behavior is not fulfilled, and intrusions of the obsessions into everyday living causing problems at home and/or school.

Explain to Your Child Why Stalking is Wrong
Perhaps your child is simply unaware that what they are doing is wrong. Educate your child about the impact of stalking behavior on not just the stalker, but also on the target. Psychologists have conceptualized stalking as a form of mental and emotional assault (sometimes even physical), that can be traumatic to its victim. But even if the target of the stalking is unaware that he or she is being followed or watched, common courtesy and ethics demand that stalking be stopped. Moreover, obsessing, even without stalking, is an unhealthy habit for a person and should be replaced with more wholesome activities. If your child seems fixated on someone to the extent that other activities are being neglected, try to arrange a consultation with a mental health professional to help address the problem.

Make Them Aware of the Risks of Stalking
Aside, from getting arrested, stalking can also put a person at risk for various negative consequences. Following celebrities around, for example, can result in being crushed in a throng of people, especially if the celebrity sighting is accompanied by fan hysteria. A person also does not know how a victim of stalking will react to finding out that they are being followed; stalking also puts person at risk for being victims of assault.

Give Them Sensitivity Training on Issues of Privacy and Boundaries
At the end of the day, what you want is to enhance your child’s sensitivity to the basic rights of other people. Take all opportunities to teach your child about the importance of boundaries and private spaces. Differentiate between information that should be kept to one’s self, and information that should be kept in private. Tell your children that in the same way they don’t want to have their secrets broadcast to strangers, they also don’t want to intrude on another person’s private correspondence and activities. Let them also understand the line between being friendly and being creepy. Training in social skills can help eliminate stalking behavior.

Deal with the Feelings Behind the Stalking Behavior
Obsessively following or communicating with another person can be a dysfunctional way of coping with unpleasant emotions. For example, the inability to let go of a lost relationship can cause a person to obsess on an ex-girlfriend or ex-boyfriend. Boredom over one’s plain and unexciting life can cause teenagers to want to follow celebrities around. If you can teach your child to better manage their negative emotions, you can give them more functional coping strategies than stalking. Again, treatment by a mental health professional can be the most effective way to help your child if he or she is obsessing or stalking. Keep in mind, too, that stalking and obsessing may be symptoms of a mental health disorder. A psychologist or psychiatrist can help.

Understanding Self-Harm

Hurting oneself on purpose seems to be an odd thing to do, yet the practice is growing in popularity among today’s teens. There is a reason for this: self-harm is a “harmless” way to reduce feelings of anxiety and angst. Due to the ease of modern communication among teenagers, word has caught on that this strategy works. It is cheap, easy and always available – unlike other methods of stress relief like drinking alcohol, taking drugs or even accessing counseling services! As a result, this disorder is highly influenced by peer behavior; when children learn that others they know are hurting themselves, they often experiment with this stress relief strategy themselves. Unfortunately, self-harm is a very dysfunctional behavior that often causes feelings of deep shame, helplessness and inadequacy in much the same way as other addictive behaviors do. For instance, bingeing and purging (overeating large amounts of food and then vomitting or using laxatives) also temporarily dispels anxiety but then causes those same painful emotions of shame, helplessness and inadequacy. Some people feel that self-harm is a cry for attention or help. Parents are naturally distressed to learn that their child has been hurting him or herself. Nonetheless, there is some comfort in knowing that self-harming actions are not necessarily related to suicidality. The goal of sufferers is to inflict minor pain, release endorphins and communicate to family members. Suicidal teenagers don’t practice self-harm; they practice killing themselves and sometimes succeed.

What is Self-Harm?
Self-harm is any action taken to cause oneself pain. Some people hit themselves – slapping their head, their face, their limbs or their body. Some people burn themselves. Some bite their skin or pick at it till it bleeds. Some use a sharp object to make small cuts on themselves – most commonly on their arms but also on other parts of the body.

Understanding the Paradox: Why Do People Do It?
When we are pain, such as when we experience a cut or burn, our brain releases natural pain relievers – endorphins – into the body. The chemicals associated with pain relief are also managers of mood. Hence, cutting and other methods of self-harm does bring some form of temporary relief to a person in distress. This temporary relief can get so addictive, that self-harm becomes a person’s first line of defense against emotions he or she can’t handle.

Experts also believe that there are psychological reasons why self-harm makes sense to the people who do it. Many times, cutting becomes some form of displacement. When emotional pain is too much to bear, “transforming” the emotional pain to physical pain makes it more manageable. Engaging in self-harm is also a way of validating that the pain one feels is real. There’s no evidence of inner distress, but seeing scars and burns are an acknowledgment that one is suffering.

In some cases, people engage in self-harm as an unconscious way of punishing themselves or a cry for attention. There are also situations when self-harm is an attempt to “feel something”; too much pain or trauma can numb one’s self. For people who engage in self-injury, self harm is better than feeling nothing.

Is Self-Harm a Suicide Attempt?
Not usually. However, people who self-harm are at additional risk for becoming suicidal. Therefore, parents need to take self-harming behaviors seriously.

While many who engage in self-harm report that they have no plans to kill themselves (they just want the temporary relief self-harm brings), they are always mentally unhealthy. Healthy people don’t hurt themselves. The mental health conditions typically associated with suicide attempts (e.g. clinical depression, Post Traumatic Stress Disorder, severe anxiety) are often the same conditions that trigger self-harm. It is possible that self-harm activities are not suicidal in and of themselves, but if people are left alone to wallow in progressive mental illness, self-harming tendencies can progress to actual suicidality. Parents and mental health professionals are therefore recommended to take the cautious view and always treat the underlying emotions and mental health conditions of those who engage in self-harm.

What can Parents Do to Help a Child Who Engages in Self-Harm?
First off, be alert. Children and teens who self-harms take extra pains to hide what they are doing; you need to be a conscious and attentive parent to spot what’s going on. Symptoms of self-harm includes persistent wearing of clothing that hide common targets of self-harm such as the wrist, the upper arms and the chest; frequent “accidents” that explains injuries, a high need for privacy, implements like cutters, ropes or lighters in the bedroom, and symptoms of depression.

When you’ve confirmed that your child does engage in self-harm, it’s important that you raise the issue with him or her instead of hoping the behavior will go away on its own. Provide unconditional acceptance and a listening ear. And most importantly, arrange an appointment with a licensed mental health professional.

Bad Self-Image

Have you ever visited the “mirror room” in a circus? You know, the one where there are many different kinds of mirrors, each one reflecting an unreal and exaggerated version of the viewer, making the person look so much taller, smaller, fatter or skinnier than he or she really is?

For people with Body Dysmorphic Disorder or BDD, every day is like staring into a circus mirror. Except, people with the condition don’t realize that what they are seeing is a distortion – they believe their distorted reflection is real. They consider themselves physically flawed, although no one else would agree with this assessment. They preoccupy themselves about a perceived flaw in one or more of their features or body parts — their nose is too big, their eyes too small, their skin too light or too dark. They feel ugly — both from the inside and out.

While most people have some issues with their appearance — indeed, the beauty and fashion industry preys on our insecurities — the obsession about perceived physical flaws among those with BDD is excessive. In fact, most of their perceived flaws simply don’t exist, or if they do, they are barely noticeable. However, sufferers are absolutely convinced that they are deformed or ugly and feel shamed just by being in the presence of other people; they are often so anxious that they can’t work or enjoy life. Some are so intent on fixing their imperfections that they risk multiple surgeries and unproven treatments.

Body Dysmorphic Disorder often comes with other mental health conditions like clinical depression, obsessive-compulsive disorder, impulse control disorders like trichotillomania, anxiety disorders and eating disorders like anorexia and bulimia.

What causes Body Dysmorphic Disorder?
BDD is more common than most people realize; it is believed to affect 2 in every 100 members of the population. It is most prevalent among teenagers and young adults, mainly because it is during these times that the pressure to present a “beautiful” front is most intense.

A family history of BDD or obsessive-compulsive disorders increases the likelihood of the condition developing in a person. This implies that BDD has an organic origin, such as chemical imbalance in the part of the brain that controls emotions and habits. Traumatic experiences, like physical and sexual abuse, can also trigger Body Dysmorphic Disorder in those who have the genetic vulnerability for it.

What Are the Symptoms of Body Dysmorphic Disorder?
The following are some of the signs parents should look out for:

  • Low self-esteem
  • Excessive pre-occupation with physical appearance
  • A pervasive belief that one is ugly or unattractive despite assurances and evidence to the contrary
  • A feeling of shame or self-loathing related to one’s body
  • Frequent examination of the body parts they consider as flawed
  • Eating disorders
  • Use of many cosmetic products or procedures, exercise regimens, with no pleasure at results
  • Social withdrawal or social anxiety
  • Inability to function because of preoccupation about appearance

What Can Parents Do?
If you see signs that a child or teen may have Body Dysmorphic Disorder, it’s best to consult a mental health professional. The obsessive-compulsive nature of the illness, as well as the pervasiveness of the perceptual disturbance make simple assurances ineffective. Counseling, therapy and medication are known to help. If the illness is accompanied by dysfunctional eating and exercise habits, then the help of a medical doctor, eating disorders specialists or psychiatrist will also be helpful.

Helping Your Child Cope with Traumatic Events

All parents want to protect their children from things that can unsettle or harm them. But sadly, there are many things in life that even the most conscientious of parents can’t control. Our children may witness or experience traumatic events despite our best efforts to shield them. When this happens, they may have difficulty bouncing back. Sleep disturbances, sadness, anger, fear, or other symptoms of trauma may plague a traumatized child long after the traumatic event has ended.

What is a Trauma?
Trauma is a psychological reaction to highly stressful events, particularly those that threaten life or safety. When an experience is considered traumatic, it means that the coping resources of the person witnessing or experiencing it are not enough to deal with the impact of the event, and some degree of psychological shock or breakdown occurs. Events that most people consider traumatic include vehicular accidents, crimes, natural disasters and physical or sexual abuse.  Although parents may think that trauma results only from catastrophic events like war or rape, it can actually occur as a result of more normal and common events. For instance, a child can be traumatized by being chased by a dog, by a harsh reprimand from a teacher, from a threatening bully, or from being laughed at while giving an oral report. What makes an event traumatic differs from person to person, as individual coping abilities must be taken into account. Personality factors, psychological profile and past history all play a role in producing a traumatic reaction. A trauma response often includes symptoms like reliving the event over and over again (obsessing about it; experiencing intrusive thoughts), panic attacks, nightmares, numbing and fog responses, avoiding people, places and things that trigger a memory of the event, depressed and/or angry mood and increased nervousness (startle response).

How can Parents Help Children Cope with Trauma?
Parental support is critical when a child is dealing with trauma. Unlike adults, younger children don’t yet have the ability to understand what they are going through. Not only is the original event traumatic, but their trauma symptoms too, can be traumatic. For instance, physical symptoms like tremors and nightmares, mental symptoms like obsessions and hallucinations, and emotional symptoms like fear and anxiety can be overwhelming for a child to be experiencing.

The first line of business is to help children manage their emotions. Encourage them to talk about their feelings. A traumatized child may talk about the same thing over and over again, and this is okay. The content of the sharing is less important than the process of getting things out. If a child finds difficulty in expressing what he is going through verbally, either because of age or because of the trauma, then consider non-verbal ways of venting emotions. Letting it all out can also be done using drawings and pictures, clay sculptures and toys, play-acting, and story-telling.

Second, give your child a rational explanation of the traumatic event, that is appropriate to his or her age. The more information the child has, the less he or she is likely to generalize the event to other situations. For instance, knowing that a car crashed because it skidded on the snow can help a child feel safe in cars with good snow tires and in cars driving on dry roads. Without this information, the child may conclude that all cars are dangerous at all times. (While this is in fact true, the healthy state of mind is one of sufficient denial that a person can comfortably drive and be driven at all times. Phobic and traumatized people, on the other hand, over-exaggerate the likelihood of a catastrophic event occuring again, such that they can’t live in a normal way.)

When a child is suffering rather mild symptoms, parents may find that self-help interventions are sufficient. For instance, learning how to do EFT (emotional freedom technique) with the child may complete calm the youngster’s nervous system. However, parents may prefer to take their child to a child psychologist who practices EFT or EMDR. Both of these techniques are used to rapidly heal the trauma of one-time events. If the child is experiencing many symptoms of trauma, it is essential that parents DO NOT try the self-help approach. Instead, they should take their child to a mental health professional who is specifically trained in the treatment of post-traumatic-stress-disorder (PTSD). PTSD is the name for the cluster of symptoms that occur in reaction to a traumatic event. The “p” in this label for “post traumatic” points to the fact that trauma symptoms can suddenly occur months, years or even decades after the original traumatic event(s). The mind/body seems to wait for the “right time” to release the memory of the event(s).

Technqiues like EFT and EMDR can also be used as part of a longer therapy addressing more chronic forms of trauma (such as being subjected to chronic bullying, physical abuse or incest). These and other interventions are specifically designed to heal both the memories and the bodily reactions and return the child to his normal state. In addition, the Bach Flower Remedy called “Rescue Remedy” can help reduce temporary and chronic symptoms of trauma and is especially effective for home-management of symptoms inbetween psychotherapy sessions.

The good news is that children respond well to treatment of trauma. They can experience a complete healing of their symptoms and a return to “normalcy.” In fact, children are often even happier, calmer and more mature after trauma therapy than they were before the traumatic event(s) occurred.

Afraid to Sleep in Own Room

Kids of every age can be afraid to sleep in their own room. This can cause stress for the whole family. Parents get frustrated – especially if the child is no longer a toddler or pre-schooler. Siblings may be disturbed by the distress of the fearful child. Bedtime can be a nightly struggle and difficult experience for the child who is afraid.

If you have a child who is afraid to sleep in his or her room, consider the following tips:

Separation Anxiety is Normal in Very Small Children
Toddlers and pre-schoolers like to be near their parents at night. This doesn’t mean that they are suffering from clinical anxiety. In this age group, anxiety about being in one’s own room apart from parents, is perfectly normal. Of course, it’s annoying and inconvenient for parents! Parents would like their kids to just go to sleep quickly and easily and stay that way until the appropriate hour for waking in the morning. For very small children, this is not the most common scenario. Most young children need help settling down to sleep in their own beds and many need some sort of nighttime parental comfort as well. However, most of them outgrow these needs over time and do go to sleep happily in their own rooms.

Daytime Anxiety and Nighttime Anxiety are Related
While there are some children who are ONLY fearful at night, they are in the minority. Most kids with nighttime fears have experienced or are experiencing other fears as well. The tendency to be fearful or anxious is a genetically inherited trait. The child is not at fault for feeling afraid. He or she can’t help it! And he or she is suffering from it. The child needs YOUR help to learn to manage anxious feelings.

Saving the child from those things that he fears actually increase fear over time and causes it to spread. For instance, if a child is afraid of dogs and the parents are careful to prevent the child from ever having to deal with a dog, then the child’s fear of dogs will remain, and even intensify over time. Moreover, it is very likely that other fears will also develop. The reason for this phenomenon is that the child’s brain can never survive the fearful stimulus, since it is always avoiding that stimulus. You can’t master the fear of dogs when you are never allowed to be in the presence of dogs. What has to happen is that the child is helped to experience “survival” in the presence of a dog and this helps build confidence that dogs can be tolerated. The learning that something fearful can be tolerated allows the child to tolerate other anxiety-provoking things as well.

The trick is to HELP the child feel comfortable enough to be with the dog so that he can stay there long enough to feel he has “survived” the experience. Helping the child is a step-by-step process. For instance, the first step might be staying with the child while the child sees a dog that’s safely secured in a cage (at the pet store for instance).  A next step might be holding the dog tightly on a leash, a distance from the child who is being held by an adult. A next step, might be to bring the dog a bit closer while being held on the leash. And so on.

These same ideas can be applied to helping a child overcome fear of sleeping in his or her own bed. A gradual process is easiest on the fearful child, allowing him or her to build confidence step by step. For instance, when putting the fearful child to bed, sit on the bed or lie down with the child for a few minutes until the child is able to fall asleep. A next step might be to sit beside the child until the youngster falls asleep. A next step might be to sit by the door of the child’s room, then just outside the door of the room, then in the hallway and then somewhere else on the same floor as where the child is sleeping and, if the house has more than one storey,  then being on a different level of the house than the child.

Making it Easier for the Fearful Child
Not only does the child have to face and survive whatever he or she fears, but the child needs to feel comfortable during the process. If the child ISN’T comfortable, it is very unlikely that facing the fear will actually happen. Some children have only a minor fear of sleeping alone in their rooms. But others are intensely fearful. Those with relatively minor levels of fear, may be able to just “build up their emotional muscles” by experiencing the step-by-step parental withdrawal program described above.

However, children with intense fear may just panic as soon as the parent attempts to leave the room. Panic is an overwhelming sense of anxiety accompanied by all sorts of very uncomfortable physical and emotional symptoms. Children who throw a big tantrum may actually be experiencing feelings of panic. They need help in managing such strong reactions. But what help do children receive? Keep in mind that adults have access to powerful medications to take the edge off their own anxiety. Children, on the other hand, are left for the most part to tolerate their feelings without relief.  Fortunately, there are some forms of alternative medicine that can be safe for children and that can help gently lift intense fear out of their system.

For instance, Bach Flower Remedies can gently melt away the tendency to be fearful. The remedy Aspen is suitable for fear of the dark. The remedy Mimulus is suitable for fear of separation from parents (fear of being alone). The remedy Rock Rose is good for relieving symptoms of panic. A Bach Flower Practitioner can make a remedy bottle containing the most appropriate flower remedies for your child or you can read about the remedies and choose those that you think may be helpful, or you can try any one or all of the three mentioned here. The pre-mixed remedy called “Rescue Remedy” can also help with nighttime panic. If using only one remedy, drop 2 drops of it into a bit of liquid (any kind), 4 times a day until the anxiety has lifted. If using more than one remedy, put 2 drops of each in a Bach Mixing Bottle (one ounce glass bottle sold where Bach Flower Remedies are sold in health food stores) that has been filled with water. Add a teaspoon of brandy to preserve the bottle. Give four drops four times a day until the anxiety has lifted.

Essential oils can also soothe nighttime anxiety. Consult a professional aromatherapist for a suitable preparation and dose whenever using essential oils since they are slightly medicinal. Essential oils like lavendar or chamomille might be useful.

Herbal remedies can also soothe fear. However, always consult a professional herbalist for correct herbs and dosage since these are medicinal. Teas that you can purchase ready-made in health food stores and supermarkets are likely safe for children, but of course, they are far less potent. Nonetheless, giving the child a bit of chamomille tea or “sleepy-time” teas may help calm his or her nervous system.

Homeopaths, accupuncturists and naturopaths may also be able to help.

Get Help if Necessary
Parents cannot always solve the problem themselves. If you’ve tried to help your child in various ways but nothing is making a positive difference, consult a child psychologist or other mental health professional. This person can teach your child more skills for coping with and reducing fearful feelings. With the proper help, your child WILL soon be sleeping alone in his or her own room without fear.