But my question today is about a child with abnormally high pain tolerance who appears to seek/enjoy banging his head when he is angry or upset. I have seen this before in children from abusive or neglectful orphanages and in children born affected by or addicted to alcohol/drugs. I do not yet know the background of this young man as I just received the referral. Can you explain the physiology behind this behavior, and why would some children find this activity desirable or calming while individuals with normal systems would find it painful? If not, can you refer me to some articles or resources where I might find more information? And as always, what if any sensory strategies might be helpful to stop or minimize this behavior? I read one of your answers about skin picking online, and you stated something I have also found to be true: When the input the child is seeking is extremely intense, it is very hard to replace or substitute for it. Thanks for any light you can shed on this subject!
More often than not, kids are using a preferred form of input (intense proprioceptive and vestibular input) to override a nonpreferred variable (whatever is making him upset). The intensity of head banging causes a release of some of our feel-good neurochemicals like seratonin, dopamine, and endorphins. While for most of us, the neurochemical rush isn’t worth the pain, for some reason it’s worth it to these kids. Most likely, he is UNDER-responsive to proprioceptive input, which makes pain register more like touch for him. Sometimes these behaviors also become behavioral if they are reinforced somehow through attention, task avoidance, etc. As you mentioned, because we cannot match the intensity, it can be very hard to reduce or eliminate these behaviors. Your best bet will be to give him more of the input he is seeking (in a safer manner) while also developing a plan of rewards and consequences for the head banging. I do have a webinar titled Self-Injurious Behaviors if you’re interested in more information on the subject.
I hope this helps!