It is helpful to read the information on Sensory processing before reading this.

What does this mean?

Sensory stimulation is like food for the brain. Our brain seeks out sensory stimulation just as our body seeks food when we are hungry. If it cannot get what it needs in terms of sensory stimulation from the environment and others, our own body is used for sensory self-stimulation, for example repetitive body movements or repetitive movement of objects. It can incorporate use of any or all of the senses at varying levels of intensity, in response to a variety of emotions or sensory differences.

Examples include:

  • Movement stimming: spinning, rocking, swaying, pacing, jumping, fidgeting.
  • Tactile stimming: nail biting, hair twirling, tapping, skin rubbing / scratching / picking, hand movements like opening and closing the fist, biting cheeks, thumb sucking.
  • Smell or taste stimming: smelling objects or people, licking or tasting objects.
  • Visual stimming: or eye rolling or tracking, staring at objects, peering from the corner of the eyes, lining up objects, repetitive blinking, moving hands in front of the eyes, hand flapping.
  • Sound stimming: vocalisations like humming, grunting, throat clearing, high squealing, tapping, covering / uncovering ears, snapping the fingers. 

How does it affect people?

The reason stimming occurs is not fully understood. Self-stimulatory behaviours, or stimming, is sometimes used to self-regulate, to support calming and provide comfort in times of anxiety, psychological difficulty, low self-esteem, or over-arousal as it gives an alternative focus on one specific thing, away from a stressor. This can be very soothing.

Stimming may also be used to increase arousal of the sensory nervous system when drowsy, bored, under-alert, or when the person is not receiving enough stimulation in a particular sensory system. It may also be used for predictability and control.

Stimming provides a pleasure response due to release of endorphins, which produces dopamine, the pleasure response. 

Over-sensitivity (defensiveness) to a particular sensory system may lead to stimming behaviours. For example, if a person is very sensitive to touch, they may engage in self-hugging or skin picking, as it puts them in control of what is happening as opposed to receiving this from others. Over-sensitivity to sound may lead to vocalisations of varying pitch and tone in order to manage the sounds around them. Under-sensitivity can also cause stimming behaviours, to increase the sensation so that it is felt to a meaningful degree.

Stimming is often a healthy way to manage sensory information and can offer a person calming input. It is normal to see differences in the way that people cope with sensory information and emotions. 

Stimming may sometimes have adverse physical, emotional or social effects on some individuals. For some, stimming can involve harm, pain, injury to body parts or danger, which can be stimulating for them but also distressing for both them and for care givers. 

It is important to seek help when the behaviours cause a high level of interference or impairment, such as when they are unsafe, harmful or injury is sustained, or when the stimming behaviours are stopping the person doing what they want or need to do in their day. 

What strategies might be helpful to reduce harmful stimming?

To reduce the intensity and frequency of the behaviour, or to help it stop altogether, gradually support the person to replace the behaviour with safer, more appropriate alternatives that still provide the person with pleasure, calm, grounding, soothing or stimulation they need, choosing strategies within the same sensory category first. Abrupt removal of stimming strategies is not recommended as this can increase distress.

Step 1

Help the person to have full awareness of all aspects of the behaviour, including the awareness of time passing and how they perceive it. Openly talking about the behaviour and what you have observed about the behaviour can also be useful.

Step 2

Help the person to recognise when they do the behaviour, and what the triggers may be. Ask questions on how they feel when they do the behaviour and validate that there is nothing wrong with feeling soothed by it. Talk about any risks of the behaviour fact that there are other ways to soothe, stimulate or feel good. Will power is usually not enough of a driving force to enact change.

Step 3

target the timeframe with strategies during which behaviour typically occurs. 

Examples:

  • Nail biting during TV watching - having a bowl of squeeze balls or fidgets next to the sofa, eat a small bowl of sunflower seeds, apply a cream to the hands so the sensation changes, wear gloves. 
  • Thumb sucking at shops - use oral fidget, suck on ice, or time limit it to bedtime.
  • Biting fingers or cheeks on the bus - take chewy snacks, gum or chew tools .
  • Skin picking at school- have the body enact things that make it more difficult to do the behaviour, such as intentionally making a fist and putting it on the desk. 
  • Hair pulling or spot popping in front of mirror- be arm's length from a mirror.
  • Touching of genitals repeatedly- open conversation about body discovery and what is socially appropriate privately vs. publicly. 

Ensure replacement strategies are risk assessed first.

These small strategies may seem trivial but offer a competing response so can be very helpful. Substituting strategies has a similar reward element, gained from the sensory aspects of the replacement behaviour, such as touching, tasting or seeing (the seeds in the bowl, for example).

Step 4

Review what is working and what is not - the person should keep a record in the easiest way for them, such as speaking into their phone, as to what is working and what isn't, where they are doing it, and what they like about the behaviour. This will help the professional to understand what they are feeling so they can help them move away from it and work together to find useful strategies.

Step 5

Look at negative thought patterns. Help the person to challenge negative self-talk about not having self-control or willpower or feelings of personal disgust, as these can exacerbate stimming. Help them to develop a more compassionate and accurate perception of themselves.

Step 6

Emotion regulation skills such as using mindfulness approaches can be a very helpful alternative way to manage uncomfortable emotions such as anxiety or low mood.

Ensure the person is receiving the correct treatment / medication for any other conditions they have. Speak to a health professional if you need more support to understand stimming or if you feel you require therapeutic intervention. 

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