Kleptomania

People often assume that a thief steals for a reason. However, link the truth is that stealing doesn’t always have a practical purpose and not everyone who steals is a “thief” in the true sense of that word. A child may be caught stealing something he doesn’t really want nor need, pharm something he already has, or something of very little value. A child may also steal for the sake of stealing, not because of a need for attention, a desire for revenge or a show of inadequacy. When someone steals without any obvious gain, it is possible that he or she is suffering from a mental health condition called kleptomania.

What is Kleptomania?
Kleptomania is a mental health condition characterized by a strong urge to steal, and a feeling of relief after stealing. It’s an impulse-control disorder, similar to Obsessive-Compulsive Disorder, where the patient suffers from persistent thoughts and repetitive patterns of behavior. Kleptomania usually has its onset in young adulthood, but there are cases of kids as young as 5 years old with Kleptomania.

Are Kleptomaniacs Criminals?
Kleptomania must be distinguished from the criminal act of stealing, or the willful and knowing theft of someone else’s property. People with Kleptomania steal not because they want to, but because they feel they have to. They experience extreme anxiety when they do not give in to the behavior of stealing, and stealing is the only way they can get relief. They know that what they do is wrong, but they can’t help it. In fact, many kleptomaniacs steal things that have little value, such as paper clips or tissue paper rolls. They may also return what they have stolen afterwards, as they are not particularly interested in the stolen object itself, but rather the act of stealing.

How is Kleptomania Treated?
The dynamics behind Kleptomania point to how the condition should be handled by parents, teachers and helping professionals.

It’s recommended that Kleptomaniacs (those who suffer from Kleptomania) not be punished for their stealing, as they have a mental health condition that needs help and healing – not punishment. In fact, many researchers argue that Kleptomania, like all impulse-control issues, may have a physiological origin. Abnormally low amounts of the neurotransmitter serotonin in the brain may be the cause of Kleptomania.

Counseling is an appropriate first response to a child with Kleptomania. Except for really young children, people with Kleptomania are aware that what they are doing is dysfunctional and they are often stressed, even depressed, about what they are going through. Helping a child vent his or her feelings over the inability to control impulses is a good start.

Cognitive-Behavioral Therapy has been known to assist children with Kleptomania in managing their urges and compulsion. Skills in stress and anxiety management are also helpful, as it is stress and anxiety that often compel a kleptomaniac to steal. Gradually sensitizing a child to the impact of stealing on other people can also be a way to help kids with Kleptomania manage their condition.

When therapy alone fails to cure the condition, psychotropic medicine of the type used for obsessive-compulsive disorder may be prescribed.

Obsessive-Compulsive Disorder (OCD)

Parents may wonder if their child has OCD when they notice that the child seems overly occupied with worries and strange behaviors. If the parent has seen something similar in another family member who has already been diagnosed with OCD, he or she may suspect that this child may also have the disorder.  Other parents have no such frame of reference and are simply perplexed by their youngster’s behavior.

Small children are often anxious and ritualistic – they want their parents to give them 10 kisses at bedtime and stay with them the whole night! It’s very difficult for a parent to know whether such behavior is just normal childish behavior or something that requires professional attention. However, when a child starts demanding 24 kisses – exactly 12 on one cheek and 12 on the other – a parent may become suspicious. It doesn’t “feel” or “sound” right to him or her. The only way to know if the child’s feelings and actions are within the normal range is to obtain a proper assessment.

A  diagnosis  of OCD can only be confirmed or dis-confirmed by a qualified mental health professional. If you are concerned about your child, talk to your family doctor or pediatrician – this person can refer you to a psychiatrist or clinical psychologist for an assessment. OCD will not normally be diagnosed unless the symptoms are causing the child significant distress or unless they are affecting the child’s school life, social life or home life adversely. Even if the child is diagnosed with OCD, there is much to be hopeful about: there are excellent behavioral treatments for OCD. People who receive treatment have a good recovery rate.

What is OCD?
OCD involves obsessions and compulsions (also called “rituals”). Obsessions are “sticky” thoughts – thoughts that just won’t go away (at least not by themselves). A teenager might obsess about whether she remembered to lock the door. Instead of just leaving the house like others do, she thinks about that door, asking herself over and over again if she remembered to lock it. Obsessions can also be sensations – a type of feeling. For instance, a child might pull his sock up over and over again until it hits a spot on the leg that feels “just right.” His mother might say that he is obsessed with getting just the right spot and she would be correct – the youngster cannot tolerate the feeling of the sock being at the wrong spot. Compulsions are actions that a person does that either “undoes” an obsession or ends it in some way. Spending lots of time arranging the socks is a compulsion. The teenager who is obsessing about whether or not she remembered to lock the door, may go back to the house 2, 3, or more times “to make sure.” The ritual of checking is called a compulsion.

A common obsession has to do with the fear of becoming contaminated. This may involve a fear of germs. “I don’t want to touch the money because everyone else has touched the money and it probably is full of germs and germs are dangerous.” Equally common is the ritual of excessive washing in order to clean oneself of germs or contamination. “My daughter washes her hands until they bleed.” This is not normal washing that is meant to remove surface dirt; rather this is OCD washing that is meant to remove spiritual impurities that can harm a person. In fact, in order not to HAVE to wash oneself, OCD sufferers start to avoid being near problematic triggers. For instance, they might only handle money while wearing gloves (so their hands won’t touch the contaminated money and they will then not have to wash off the contamination). Or, they  may not open a door with their hand – they might use a foot or an elbow or ask someone else to open it. Avoidance actually contributes to the illness – the more a person avoids OCD triggers, the stronger the illness of OCD becomes. In fact, the major aspect of treating OCD involves teaching the sufferer to avoid avoidance! A child must be helped to confront and live with his or her worst fears.

Most obsessions center around issues of health, safety, goodness and cleanliness. As stated above, they can also center around certain “right” feelings (like the feeling of having a shoe lace tied up “just right”).

For instance, children and teens can obsess about the idea they have might have made a religious error. To “fix” it they might pray for hours on end (missing school in the process). Some people want to do things perfectly; a child may write something, erase it, write it again, erase it, write it again, over and over and over again – destroying the paper and taking hours to perform a task that other children are completing in minutes. Some people with OCD need to have everything in a certain order – for example, in order from biggest to smallest. Again, trying to get it that way can take painful hours; if the order is messed up by someone else, the person with OCD can become hysterical. These are just some of the common variations of OCD. There are many others and each person can have his or her own unique version of the disorder.

Treatment for a religious obsession might be insisting that the youngster DOES NOT pray for more than the normal few minutes that prayer takes a healthy person. In other words, the youngster must just live with the worry that perhaps she did something wrong. Instead of making that worry go away by praying excessively, she must just have the worry without doing anything to fix it or end it. This sort of treatment has the effect of stopping the worry altogether. Therefore, no more excessive praying is required. No obsession leads to no ritual which essentially is no OCD.

Obsessive-Compulsive Disorder (OCD)
People who suffer from OCD, even kids, usually know that their thoughts and actions are irrational, and they often feel distressed over their lack of control. The obsessions and compulsions, however, feel more powerful than a person’s will. The obsessive compulsive person is trapped in a vicious cycle; he or she needs to behave a certain way (perform a ritualistic behavior) to relive stress and anxiety, but the behavior itself creates more stress and anxiety. This can lead to intense attempts to avoid situations that will trigger the compulsion. For instance, if someone knows that touching a doorknob will create anxiety that can only be soothed by repeated washing of the hands, then he will try not to touch the doorknob. Instead, he might ask someone else to open the door, or he might open it with his elbow or he might wear gloves in order to open it. The time it takes to perform rituals can severely affect a person’s life and the difficulty of avoiding triggers can make a person function in a very odd way. OCD is thus very stressful. Attempts to manage OCD can sometimes lead to other mental health complications, such as clinical depression, other anxiety disorders, substance abuse and/or other impulse-control issues. OCD is sometimes found in people who have other clinical disorders like anorexia, Tourette’s Syndrome or ADD/ADHD.

What Causes  OCD?
Current thinking suggests that that OCD is a biologically- based condition, possibly the result of serotonin deficiency in the brain and other chemical conditions. It has been observed that OCD tends to run in families (that is, other family members have OCD or they may have other anxiety disorders) and therefore it is thought that a vulnerability for the condition is passed on through the genes.  OCD can also occur in a form called PANDAS  (pediatric autoimmune neuropsychiatric disorder) – when it suddenly appears following a streptococcal infection like strep throat. In this case it is believed that OCD is triggered by the same bacteria that causes scarlet fever and strep throat. Again, it might be that a person must have the vulnerable genes in order for the bacteria to have this effect.

What is the Treatment for OCD?
OCD is best treated with CBT – Cognitive Behavioral Therapy. Although some teens and adults can relieve their own symptoms with self-help by reading books on OCD (see for instance, “Overcoming Compulsive Washing” or “Overcoming Compulsive Checking” by Dr. Munford), most people will have the best results by consulting a qualified mental health professional who specializes in the diagnosis and treatment of OCD. Ask your doctor for a referral. Parents should read up on OCD and get professional counseling to know how to best help their child. Uninformed parents often accidently worsen OCD by helping the child AVOID triggers. As we saw above, EXPOSURE to the frightening element is curative – NOT avoidance! Parents need to know exactly how to help their child or teen in the home setting. The earlier OCD is treated, the easier it is to treat. On the other hand, the more one lets OCD fester, the more they will experience its symptoms. It is possible that intense stress causes certain physical conditions in the brain that then trigger the dynamics of OCD. Relieving stress may make it easier to treat the OCD. Therefore, psychotherapy may play a role in helping ease OCD by reducing overall stress and anxiety in the system (much like medication does) so that CBT can be effective.

Arranging Everything Just So

Some children are fussy about their things. They like everything in it’s place. Others care so little about this that their parents struggle with them for two decades to clear a path to their beds! And yet, despite the obvious benefits of being very neat and organized, this trait can sometimes be problematic. The basic question is, when is it too much?

If your child has to have everything “just so,” consider the following tips:

Monkey See, Monkey Do
If you or your spouse also like everything “just so,” it may simply be that your child is copying your style. Sometimes, the child’s copy is more intense than the parent’s original, but if it is in the same department, it may be nothing more than a learned behavior. As long as none of  you gets overly distressed when something is out of place, there is nothing to be concerned about. However, if any of you become extremely agitated when something is missing or not in exactly the right position or angle, then things are not quite as they should be. In that case consider the information below.

Nervous Habits
Arranging things “just so” can help calm inner feelings of tension and mild anxiety. Tension might be barely perceptible, not even conscious. However, straightening things up can bring a pleasant sense of order to an inner chaotic state, even when the person is not even aware of the inner chaos. In other cases, the person IS aware of feeling uptight or bothered and knows full well that cleaning, straightening, organizing or adjusting things helps calm him or her down.  Even when it accomplishes this, however, the inner tension has not been properly dealt with. There are much better ways of handling stress, such as using mindfulness meditation to see what exactly the stress is and to clear it out of the system, or some other strategy like EFT (emotional freedom technique) or Focusing (a technique for paying direct attention to the stress in the body to ‘meet and greet’ it and release it).

Consider an Anxiety Disorder
An intense need to have everything “just so” can also be part of the anxiety disorder called “obsessive-compulsive disorder” (OCD). The same psychological dynamics are at play in OCD as described above for normal stress and tension. However, in the case of OCD, the brain itself gets “hooked” or addicted to the behavior that releases the stress (in this case, arranging things just so). Once the brain is hooked, failing to be able to arrange things just so can cause an intense withdrawal reaction, including feelings of panic, rage, overwhelm, extreme irritation, and more. OCD is a physical disorder, a condition of the brain itself. Fortunately, the brain can be rewired to become “un-addicted” – but this may take some professional cognitive-behavioral therapy (and in some rare cases, the help of medication). Parents need to know how to help their compulsive child because ignorance not only fails to help, but it can actually worsen the child’s brain condition. In other words, when parents respond appropriately to their child’s need to arrange things just so, they can help re-wire the child’s brain, but when they respond inappropriately, they can actually help wire it in the WRONG direction! Therefore, if you suspect that your child may be suffering from OCD or OCD-like behavior, arrange for a consultation with a child psychologist or other mental health professional for a proper assessment and, if necessary, treatment plan.

Over and Over Again

When a child or teen repeats actions for no obvious reason, there is often a reason! In fact, there are many reasons why young people might repeat movements or actions. Let’s look at the more common ones.

  • Pervasive Developmental Disorders (PPD): Some mental health disorders like autism, Asperger’s Disorder and PPDNOS (pervasive developmental disorder not otherwise specified) may have repetitive behaviors as part of their symptom picture. For instance, there may be rocking or rhythmic movements, hand flapping or twirling. Such behaviors in and of themselves do not indicate the presence of a pervasive developmental disorder – many other symptoms must be present for a diagnosis to be made. Behavioral Therapy may help reduce these kinds of repetitive behaviors.
  • Simple Nervous Habits. Some children kick their legs back and forth when seated or rock back and forth, or twirl their hair or even crack their knuckles.  This sort of repetitive behavior may just be a discharge of “nervous energy.” Unless these behaviors interfere with functioning or cause distress, there is no need to treat them. However, some people find that giving their children Bach Flower Remedies (try “Agrimony”) may help reduce nervous habits. Consult a Bach Flower Practitioner for an individually designed remedy most appropriate for your child’s needs.
  • Tourettes Syndrome. Tic disorders are, by definition, repetitive behaviors. SImple Tic Disorders such as Transient Tic Disorder (common in 7 – 9 year old children) may consist of one repetitive behavior such as blinking or twitching a shoulder or clearing the throat. In simple Tic disorders, the particular behavior may change from time to time, or, there may be more than one movement or sound involved. These sorts of tics usually disappear on their own within a year or so, although in some children they can last years or right into adulthood. In Tourette’s Syndrome, the child has BOTH repetitive movement and repetitive vocalization occuring, and there can be more than one of each kind. Bach Flower Remedies have helped people with Tic Disorders. There are also medications that your doctor can presecribe. In addition, there are behavioral therapies that can help bring tics under control.
  • Obsessive Compulsive Disorder (OCD)When a child feels compelled to repeat certain behaviors and very anxious if he is prevented from doing so, he may be suffering from OCD. OCD is an anxiety disorder that consists of worries (obsessions) and rituals (repeated behaviors). Sometimes the child is aware of the worry (i.e. he is afraid that someone in his family will become sick) and sometimes he just feels anxious without knowing why. In either case, he discovers a series of repetitive actions that makes him feel temporarily calmer. For instance, he may count numbers in his head, or take a certain number of steps forward and backward, or wash his hands a certain number of times or write and rewrite and rewrite his schoolwork. There are many variations of repetitive behaviors that those who have OCD may perform. If the child’s behavior interferes with his functioning at home or school or if he is very distressed by having to do them, it is highly possible that OCD is the culprit. However, only a professional child psychologist or psychiatrist can make an accurate diagnosis and prescribe an appropriate treatment plan (usually consisting of cognitive behavioral therapy -CBT and sometimes, medication as well).
  • Physical Disorders and Medications. Occasionally repetitive behaviors can be symptomatic of a medical condition or a reaction to medication. Your pediatrician or GP can do an assessment for you.

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!

Head-Banging

Seeing one’s child banging his or her head against the wall or a wooden bed is alarming for parents, especially if the child is a baby or toddler. Parents are not only concerned about the possible pain and injury that may result from such an activity – they are also worried about the child’s psychological well-being. “Is something wrong with my baby?” is a reasonable question for parents to ask when their child deliberately harms himself.

In fact, in most cases, a child’s head-banging is caused by a normal desire for stimulation or soothing (as we will discuss below) — not by underlying mental health issues. Additionally, young kids rarely hurt themselves during head banging enough to cause considerable pain or head damage. Head-banging may also occur in certain developmental syndromes such as autism. In these cases, there will be other neurological and behavioral symptoms besides head banging. In an otherwise healthy child, head-banging is not a matter for intense concern.

What’s Behind Head-Banging?
Head banging can be a way for kids to get stimulation. The habit can relieve the discomfort of boredom or stress. Remember that during the toddler years, kids are in the process of understanding and appreciating different body sensations such as sights, sounds and  even feelings of pain and discomfort. The sensation that comes when we bang our heads against a hard surface is new and foreign to a child, and understandably, the child is curious about it. Thus he may repeat head-banging so that he can explore the sensation better.

It’s also possible for children to head-bang in order to soothe themselves when they are anxious, in discomfort or otherwise distressed. In these cases, head banging is no different from thumb sucking or nail biting. It’s ironic, but it’s possible that children find the pain of head banging a distraction for their current discomfort or unease. Some kids may also find the rhythm of soft head banging comforting, in the same way that a slow and steady drum beat can be soothing, rhythmic head banging can be reassuring to a child.

What can Parents Do?
Safety is always a primary concern. Even if head-banging is usually harmless, there’s nothing wrong with taking a few extra precautions. As much as possible, keep young children away from hard surfaces like walls or bed posts. If there’s a risk that they will run into a hard surface, protect your child by putting a soft pillow or foam padding as insulation. If you can make it impossible for your child to head-bang against something hard, then you can worry less about head-banging behavior.

It may also help to provide your child with stimulation and soothing when you feel that he or she needs it. Toys of different shapes and colors, as well as materials of varying comfortable textures and temperatures can provide stimulation to a child. Rocking, singing a lullaby or a soft massage are also positive ways to provide soothing.

When parents suspect that unease, discomfort or stress is causing the head-banging behavior, they can offer their child the Bach Flower Remedy Agrimony. Two drops in liquid four times a day can be used until the banging diminishes. Or, for a more complete treatment, call a Bach Flower Practitioner. You can find more information about the Bach Remedies online and throughout this site.

Older children who are banging their heads may need more than Bach Remedies (although these should be tried first). Stress reduction through professional psychological counseling may be very helpful. If very young children are stressed, family counseling may be preferable. Parents may be able to make environmental changes that put the child more at ease.

When Should Parents be Concerned?
While head-banging is generally normal and harmless, there are occasions of head-banging behavior when parents need to provide their children with stronger interventions and/or professional help.

One situation is when kids use head banging as a way to get negative attention, punish themselves or release anger and frustration. When head banging is a deliberate action to achieve an end, parents should arrange a consultation with a child psychologist. The psychologist may help the parents intervene in more appropriate ways or he or she may work with the child directly in order to reduce underlying tensions.

But a second situation is when parents suspect an underlying medical or psychological condition behind the head banging behavior. If head banging is seen alongside symptoms of social withdrawal, delayed speech and motor development, and inability to empathize, parents should consider consult their pediatrician. A referral to a mental health professional for assessment can confirm or rule out a diagnosis of autism or pervasive developmental disorder. Head banging that seems beyond a child’s control may be a symptom of Tourette’s Syndrome. Various seizure disorders may also account for head banging behavior. To be certain, it’s best to get a child diagnosed by the appropriate medical or mental health professional.

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.

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.