10 yr old boy hits himself

[littlehouse]

Our 10 yo son has begun hitting himself when he's frustrated/angry/overwhlemed. He does this both when he's in a tense situation, and when thinking about certain thoughts that he obsesses over. In particular, he will latch on to a comment by another person he perceives as wrong - something as simple as "you thought I still had potatoes left on my plate," or "dad thought i was getting sad during the movie, but I wasn't," or "you thought a character from a movie was played by so and so, it wasn't." He will sometimes exhibit this behavior when we apologize to him for something, because he says it's "too sincere." The behavior goes like this: he either is in a situation with us or thinks about something, starts making a humming noise (he's done this humming noise while daydreaming/imagining since he was little) then will hit his nose and sometimes forehead with the heel of his hand (there is a light red mark on the bridge of his nose from hitting which fades but is then re-injured), or he will pound his chest, legs, or the backs of his legs with his hands. These rarely result in bruises, even though it seems like they should. Sometimes we're able to calm him down quickly by telling him to talk about what's bothering him, other times (this is relatively infrequent) we've had to physically restrain him. He has had bigger "incidents" a few times, when I was sending him to his room to calm down as a tactic for dealing with this - he really disliked being sent up there and a few times had screaming tantrums which included hitting himself. Once I stopped doing that, he has not had anymore screaming fits. He does not do this in social settings with his friends, or at his grandparents house (he said he started to do it once but "didn't want grandma to be scared" so he stopped). In every other way he is happy, extremely bright and very funny. We have tried punishments and rewards (we stopped that once we realized that it seems he can't "help it" sometimes), ignoring it, giving him a stress ball (he'll squeeze it but will sometimes squish it against his face), and I am ashamed to admit that our response has varied from calm understanding to hysterical screaming. This behavior started in May, a month after the birth of our second child. Our son dotes on her and is a great big brother. We are homeschoolers and have found ourselves inadvertently more and more isolated over the past year, a situation I'm correcting now. He is on the high side for weight and height but not over his ideal bmi. He has a swingset that he will swing and daydream and giggle on -he occasionally starts hitting himself outside,so I make him come in. He has told us that he sometimes feels tense before he does it, that his body "needs to be touched,"and that he can't feel it when he hits himself. Again, he is a really delightful person, but has dislikes being told no and has started to be defiant, which i think is normal 10yo behavior,but combined w/the hitting,etc,makes for tension. Thanks.

[Kevin Kennedy, Ph.D.]

It would be wise to have your son evaluated by a pediatric menatl health professional. He may be displaying signs of an obsessive-type Obsessive Compulsive Disorder or another emotional disorder. The behavior is not within the normal spectrum but can certainly be treated successfully. Try to maintain your equanimity; it won't help to be losing your composure. Also, from what you are saying, the behavior should not be punished. It's not as if he's doing something wrong. Try to be supportive and let him know that when he displays these behaviors you understand that he's worried. Ask him about the worry and what he can do to make it better.