Just say no

November 12, 2009 at 9:39 pm 8 comments

          C has a version of something called Dermatillomania (also known as compulsive skin picking or CSP). It’s an impulse control disorder like the more well known trichotillomania (hair pulling), and is a cousin of OCD. What it means for C, which is slightly different from the traditional presentation of the disorder (of course it is; C always does things in his own way), is that he picks scabs over and over and over and over and over. After a particularly mosquito-y summer visit to Tennessee, we found ourselves wrapping his legs in medical tape so that he couldn’t get to the band-aids, pull them off, and pick. The kid goes through more band-aids than I can count, and we should own stock in bandage companies.

     C has yet to create a wound from nothing, but he has opened up old scars. There’s a leftover tiny cut on the top of his head from an oops with the hair clippers, and he’s now going on one and a half years (yes, years) of re-opening this wound. It has changed the pattern of his hair growth and I fear it will get to the point where he will be the only eight year old in the world with a bald spot. C spent half of last year wearing a hat all day, every day – we had to get special permission for him to wear it to school – to help. We’ve tried everything; we’ve yelled, we’ve begged, we’ve bribed, we’ve taken things away, we’ve given him fidgets for his hands, and of course none of it works for the long term. I suppose we thought he would grow out of it, and that we were doing all we could to help him do so. I remind myself that it’s not as if C can control it, but it still infuriates me like nothing else he’s ever done. I know that’s where I’m failing him the most as I’m sure he’s even more upset about this than I am, and probably far more confused about it than I am. This requires sensitivity on my part, not frustration.

     Save therapy, which to this point has seemed an unlikely path for this particular child, there’s only one other thing we haven’t tried. The one thing a doc who saw him two years ago for five minutes wanted us to try. A prescription for Zoloft, Xanax, and whatever other mood-altering drug you can name. “It will clear this right up,” he said as he tried to shove me out the door with script in hand. “It will probably solve those feeding issues he has too.” This was no expert; it was a hometown family doc who seemed to want to solve everything with a bottle of pills. If he hadn’t thrown in that last completely ignorant blip about C’s feeding issues, I might have fallen for it, so desperate was I.

     I don’t mean to go all Tom Cruise on this issue, but I’m pretty much against meds for my kid. I believe there are cases where drugs are absolutely necessary, but I don’t yet believe this is one of those situations. The research doesn’t show an enormous amount of success treating this issue with drugs. Couple that with the fact that I think C is precariously perched on the top of a fence – on which one side lies health and the other a downward spiral of medical issues – and body chemistry altering meds are not an experiment I find worth the risk.

     But where I wasn’t ready before, I’m ready now. I’m waving the white flag; I realize I’m in over my head and I surrender. So now begins the search for a psychologist or a psychiatrist who is able to do cognitive behavioral therapy (apparently the type of therapy that sometimes works with this disorder) on a kid who isn’t particularly enlightened about his own triggers nor the emotions that go with them. A search for someone whose first instinct isn’t to write a script, and a search for someone who has dealt with this before. A search for someone who won’t be fooled by C’s seeming grasp of language and its components. A search for a knight in shining armor, an angel who needs her wings, a healer who will be able to read this kid in a way no one ever has before. I hope this person is out there, waiting for us.

Entry filed under: autism. Tags: , , , , , , , , .

I mark the years in tennis balls C-isms Part XVIII

8 Comments Add your own

  • 1. Angie  |  November 13, 2009 at 6:41 am

    A white flag…we’ve been there before. Our therapist is amazing, very west meets east, and she has a ton of connections around the intermountain west. I could see if she knows anyone who fts your critieria. You know, “knight in shining armour” kind of stuff.

    Let me know…hugs. Happy Friday the 13th!

  • 2. Ghkcole  |  November 13, 2009 at 7:10 am

    My kid does the same, but to a lesser degree. I hope you find someone great to help. Is there any chance social stories would help?
    With our aba, I can imagine it might help to frequently reward or praise any time you aren’t seeing the behavior.
    I send u a big hug. Keep us posted.

  • 3. pixiemama  |  November 13, 2009 at 7:22 am

    Oh, how frustrating. Sophie picks things on her face and has some scars, and it drives me CRAZY – and it’s nothing to this degree. I’m envisioning the person you need. I see her (of course, I think it’s a her) connecting with C, helping him understand and overcome this compulsion. I see him realizing it’s not his fault, but it is something he can control …

    and i see myself giving you a big hug.


  • 4. pixiemama  |  November 13, 2009 at 7:23 am

    PS – Why, oh why! does WordPress give me that goofy, squiggly-legged icon? And why does it bother me so much?


  • 5. therocchronicles  |  November 13, 2009 at 7:49 am

    I’m hoping you find this person too – he or she is out there, it may take some searching but you’ll find her (or him).

    btw–you’re not failing him. You’ve never given up and that is what makes you a great mom.

  • 6. goodfountain  |  November 13, 2009 at 7:17 pm

    Finding a therapist could be good for lots of reasons – you never know what positives may come out of it. Good luck finding someone!

  • 7. The power of the people « What We Need  |  April 20, 2010 at 1:50 pm

    […] C is having a bit of a crisis in terms of his CSP (see here). It’s gone to a whole new level that required some additional intervention at school as well […]

  • 8. Elizabeth Channel  |  April 29, 2010 at 8:22 pm

    Oh I feel for you because this is such a hard one! E did this during kindergarten but it was more of a finger biting deal where he actually bit the tips off his fingers…we ended up putting gauze and tape on every fingertip so he could go to school. In the end our therapist felt that his school wasn’t a good fit for him and anxiety was causing the issue. We pulled him out and in a few weeks, the issue stopped. He still picked at scabs throughout that year but slowly this has subsided and now it’s not an issue. I guess I say this just to let you know that it can be something that a child grows out of…

    I do hope you can find an understanding therapist. And I agree about not jumping the gun on these types of meds with a child this young…


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