My daughter, Natalie, who has ADHD and anxiety, compulsively picks her skin to cope with social anxiety. But we've tried the following alternatives to get her to stop picking.
by Kay Marner
My daughter, Natalie, who has attention deficit hyperactivity disorder (ADD/ADHD), seemed to buzz with anxiety one morning last week. She woke up at 5:30. She was too nervous to eat. And she picked and squeezed her skin and made herself bleed in at least four or five spots. I couldn’t keep the Band-Aids coming fast enough! Why was she so anxious that particular day? Her fourth-grade class was going to be taking a field trip.
Having a change in her routine that major would have been enough to cause a noticeable change in Nat’s behavior, but anticipation of this particular trip was also fraught with social anxiety.
Unlike our family's previous encounters with skin picking, this day Natalie was able to talk about the thoughts and feelings that were dominating her brain and behavior that morning. She explained that the teachers had divided the kids up into groups who would travel together on the day of the field trip, with each group assigned to a teacher or principal. Natalie and Lydia, an on-again, off-again friend of hers, were assigned to the same group. Natalie anticipated that Lydia would ignore her, whisper about her to the other girls, and generally make her life miserable. I thought she was probably right.
I gave her positive statements to repeat to replace her negative thoughts, and, bless her heart, she sincerely tried to utilize this coping skill, even taking my suggestions and building on them.
When I offered, "I always feel safe with Mrs. McCasland. Mom trusts Mrs. McCasland to take good care of me today."
She repeated my words and added, "Mrs. McCasland truly cares about me. She will give me hugs when I need them."
When I offered, “I can’t control how Lydia acts today, but I can control myself. If she is with other friends, I’ll remind myself that she still likes me too; she just likes to spend time with other friends once in a while, and I’ll walk with my other friends, like Savannah, Will, or Mrs. McCasland.”
Natalie replied, “Yeah, or anybody.”
When I dropped Natalie off at school, I texted Mrs. McCasland to give her a heads up that Nat wasn’t just nervous about the field trip itself but that the social dynamics were her biggest concern. Then I sat down and turned on my computer and decided to reread my recent blog post about Natalie’s problem with skin picking and how anxiety is one of the triggers behind this behavior.
How right I am about that, I thought. And though in this case being right doesn't bring me pleasure, confirming that my instincts were spot-on at least gives me tools -- it helps me know how to help Natalie. It’s a small consolation, but I’ll take it!
Natalie ended up having a great day. She was able to watch an IMAX movie about tornadoes all the way through, a huge accomplishment given her tendency toward sensory overstimulation. And the kids didn’t pair up very much; they moved through the displays as a group, so Natalie’s tender feelings weren’t hurt.
Extra stress or no extra stress, Nat’s picking habit pervades most of our days. A few mornings later, we were seconds from leaving for school when I turned to see Natalie squeezing blood from a spot on her arm. I dashed into the bathroom for a Band-Aid.
“Mom,” said Natalie, “I think I have the chicken pox. No! I have the pickin’ pox!”
And off we went to begin another day.
Does your child with ADD/ADHD have a chronic case of the pickin’ pox? In my earlier post, I shared a tip from our psychologist about using ice to provide strong sensory input as a diversion from picking. I recently heard two other suggestions: Put non-toxic glue on the child’s skin, let it dry, and then allow the child to pick the dried glue off -- a safe way to provide the sensation of picking skin. A thick coat of henna, used for henna tattoos, left to dry overnight, is purported to work too. Please share your tricks and tips for dealing with skin and scab picking.