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rocking and head-banging
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rocking and head-banging


  hi!  i'm a 25 year old female trying to find information on head-banging.  i started banging the back of my head against walls almost as soon as i was old enough to sit up.  i do not have any of the problems such as autism, aspergers, tourettes, adhd, ptsd, or childhood illnesses (e.g. ear infections) or traumas that can be associated with this.  my parents asked their pediatrician about it when i first started, and he told them that it  was just a comforting motion and i would soon grow out of it.  i didn't, but because i was otherwise a very healthy, interactive, and happy child, my parents did not seek further advice.  
  now, i do not bang my head.  instead, i sit on a couch and repetitively and violently (although there has never been any pain or injury involved) slam my back into the back of the couch.  when i am busy, i can go for several days at the time without doing this or thinking about it, but i do get increasingly tense and irritable without realizing it.  conversely, i can do it for 10 or more hours a day when i have nothing pressing to do.  i also lie on my side and rock for at least an hour every night to get to sleep.  
  i have found the term "stereotypic movement disorder" through internet searches, but i cannot find more than a cursory explanation of what that is.  is that what this sounds like?  is there any information on what may cause the need to do this?  is there any treatment for it?  what kind of professional should i see  if i decide to seek out help to stop rocking?
  like i said, i haven't found very much about this topic. i would really appreciate any information you can give me.  
  thanks.
  -tara
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Dear Tara,
Stereoypic Movement Disorder is characterized by repetitive, seemingly driven, and non-functional motor behavior(ex: rocking, head banging, self-biting, picking and waving) which persists for at least four weeks.  The behaviors markedly interfere with normal activities or could result in injury if preventive measures are not taken.  The disorder is more prevalent in boys than girls.  Stereotypic behaviors are common among the mentally retarded(10-20% affected).  Self-injurious behaviors are also seen in genetic syndromes, like Lesch-Nyan syndrome.  Patients with Tourette's Disorder, characterized by vocal and motor tics, can also have self-injurious behaviors.  Stereotypic Movement Disorder can be differentiated from Tic Disorder and Obsessive Compulsive Disorder in that stereotypic movements are likely to be comforting, whereas tics are often associated with distress.  Compulsions are bothersome for the patient but also tend to alleviate anxiety.  A careful evaluation may determine if your behavior is consistent with Stereotypic Mocement Disorder or Obsessive Compulsive Disorder.
The causes of Stereotypic Movement Disorder are essentially unknown, although there are several theories.  Eighty percent of normal children show rhythmic activities that stop by four years old.  The progression to Stereotypic Movement Disorder is thought to involve disordered development(mental retardation or pervasive developmental disorder) or psychological conflict.  Stereotypic movements may be associated with certain neurochemical messengers in the brain.  
Regarding treatment, behavioral therapy techniques are successful in some cases.  Psychotherapy has been used in persons with prominent intrapsychic conflict or interpersonal difficulties.  For cases which result in physical injury, medication may be considered.  The psychsocial environment should be changed in certain cases.  
With the history that I have, it sounds like you have some symptoms of Stereotypic Movement Disorder, if not the disorder, and I recommend that you see a mental health professional who can diagnose and treat your condition.  If you wish to see a mental health professional at Henry Ford Hospital, call 1-313-874-6680 for an appointment.  I hope that this information has been helpful for you.  It is for educational purposes only and should not replace consultation with your doctor.  





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