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Pro-tip: A note on self-harm and self-help: self-harm happens in multiple diagnoses. It can be acute (cutting, head-banging, biting, etc.) or chronic (skin-picking, eating disorders, teeth grinding, etc.) Both types are neurologically driven and provide a way to meet a need.
Chronic self-harm is a way of attending to generalized discomfort of unknown origin. This is common with sensory processing disorder and alexithymia. It is a quite-literal manifestation of being uncomfortable in one’s own skin.
Stopping chronic forms of self-harm often lead to different forms of self-harm because the underlying needs driving compulsive behaviors are not met. You might be hungry or dehydrated, constipated, overly-full, stressed, bored, over or under-stimulated.
If you're autistic, your existence might be characterized by constant low-grade, complex trauma for social and neurological reasons. The best approach to dealing with chronic self-harm is trying to meet your needs through trial and error, if possible and within your means.
You could try a sensory diet, set timers to remember to use the restroom, eat, drink water, etc. Give yourself permission to unplug from sources of stress (like Twitter or toxic relationships) if you need. If you can, see an OT to get a sensory profile.
If you can, moderate exercise has helped many people with sensory processing disorder. Screen time can also be taxing for many because of the visual overstimulating and difficulty with processing text.
Acute self-harm happens as a result of what would be best clinically described as a neurological shitstorm. You feel a desperate discomfort that is completely uncontrollable. You can't think of a way to meet your needs because you're really not in the head space to problem-solve.
You might become easily dysregulated because your serotonin or dopamine is disrupted. This isn't a sign of weakness. You might have a medical need as real as needing an allergy inhaler.
If serotonin reuptake inhibitors like Prozac don't help, you could ask your doctor for an atypical anti-depressant like Wellbutrin which may help you to better regulate dopamine.
Acute self-harm triggers the brain to release endorphins that act like morphine. Sometimes, it can bring your runaway train to a stop long enough for you to orient yourself. The pain releases endorphins that act like morphine and slows the heart rate.
Also, causing oneself to bleed can achieve this effect. Acute self-harm is a tool of desperation from someone whose brain is out of electrochemical sync. There are safer ways to manage those moments, but they need preparation in advance.
Make a meltdown box with a very basic list of reminders. Have a playlist of songs that can stave off meltdowns. Meltdowns are traumatic themselves, and if you are biting your arm or punching your leg, that's not ideal but neither is a meltdown. It's safer than other forms.
If you're able, intense physical exercise and getting to the "runner's high" is a release of those numbing endorphins. You can hold an ice cube in a sensitive place like in your armpit. Punching a punching bag (with gloves) is a safe option.
A very good way to stop your neurological "shitstorm" is to fill a basin with ice water & dive your head downward into it like you're diving into a pool. You might need to do it more than once. This triggers the body to prepare to conserve resources as if to prep for hypothermia.
Your heart rate slows. Your breathing calms. Your stress hormones pause. These interventions leave no scars. Self harm isn't a reliable or healthy way to manage meltdowns, but it's better to bite your arm than concuss your head. You can keep a jar of really hot peppers, too.
That's a pain that won't leave you with scars or open you to infection. The best thing to do is to try and plan for meltdowns by having a box or list of reminders. Even better if you can prevent them, but sometimes they're inevitable.
You're not a freak for self-harming. You're a person who likely has profound trauma who isn't getting adequate support or doesn't have adequate tools to manage rogue neurostorms. It's a form of self care to have a meltdown plan.
If you're a parent of an autistic child, let them help you build a plan for meltdowns. Tell them that they're inevitable, but give them ownership of self advocacy. Help them find healthy ways to manage their overwhelming support. Ask them what would help.
Just feeling supported and loved can be helpful. They might want a punching bag, to be wrapped in a weighted blanket, to have noise-cancelling headphones, to be in a quiet, cool place, etc. Screaming or singing loudly can help, too.
But being given control, acceptance, and support will reduce meltdowns proactively and the shame and trauma that come with them. Know that meltdowns are similar to night terrors and confusion and ability to control oneself is diminished. Don't take behavior or speech personally.
This isn't a comprehensive list or a how-to, but just a thread to discuss some ways to maybe self-advocate or support your loved ones. #AskingAutistics what items or reminders would be helpful in your meltdown box or plan?
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