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Self-stimulating behaviours (stimming) are repetitive movements, noises or patterns of behaviour that people frequently demonstrate.
Although stimming is commonly associated with people on the autistic spectrum, it is actually a common type of behaviour that is found in lots of people. Sometimes people may stim without realising they are doing it.
There are many different types of stimming behaviour; these include:
- Nail biting.
- Hair twirling.
- Cracking of knuckles/joints.
- Drumming your fingers on a desk.
- Shaking your leg.
- Jiggling your foot.
- Pencil tapping.
In people on the autistic spectrum, common examples of stimming are:
- Arm flapping.
- Head banging.
- Repetitive noises/words.
Stimming can involve all of the five senses, including touch, taste, smell, sound and vision, but the most common involve tactile stimming, which stimulates our touch sensation, or vestibular stimming which uses our movement or balance senses.
Why do we do it?
The majority of people will use stimming behaviours when they are feeling bored or anxious. This might be because their environment is over-stimulating or under-stimulating them, or because they are nervous, for example whilst waiting for a job interview or exam.
Sometimes people will stim simply because they enjoy it or because stimming has become a habit for them, such as whistling whilst driving.
The link between stimming and autism
There are around 700,000 autistic adults and children in the UK. For people with autism, stimming can be a way to deal with over-stimulation in an environment. Stimming can help to block out some of the negative factors they might be experiencing such as too much noise or too many people.
Stimming can also be used as a type of non-verbal communication for autistic people as they can struggle to explain their feelings or emotions clearly. It can also be a means for them to feel in control in an otherwise out of control environment or situation.
Often the difference between non-autistic and autistic stimming is the way the behaviour manifests itself and the person’s ability to control it naturally.
It is important to keep in mind that although stimming is usually present in those with an autism diagnosis, the presence of stimming does not necessarily indicate autism.
Is stimming a bad thing?
For many people, stimming is an effective coping mechanism when they are experiencing stress, anxiety or a lack of stimulation. Sometimes people may wish to modify their behaviour if they feel it is embarrassing them, causing them to feel isolated or seriously disrupting the people around them.
Most of the time, stimming is not a problem and can go unnoticed by those around you. Occasionally, stimming can become dangerous or be destructive and the behaviour needs to be stopped or modified because it can cause pain and injury or impact negatively on day-to-day life.
Sometimes stimming behaviour is not understood which can lead to those who witness it feeling amused, distressed or scared and reacting in a disproportionate way. The key here is education and understanding – safe stimming should not be a cause for alarm or a source of shame for anyone.
In extreme cases, it is possible to decrease the instances of stimming behaviours using medication, however, this is a contentious issue within the medical field and the way this treatment works is not fully understood.
More research needs to be done around this subject in order to prove the efficacy of using medication such as selective serotonin reuptake inhibitors (SSRIs) or certain antipsychotics in the treatment of the repetitive behaviours associated with autism, such as stimming. These medications also have unpleasant side effects including nausea, weight loss and suppressed appetite, which often outweigh the benefits of taking them.
Getting help for stimming
Medication is usually more effective if it is accompanied by behavioural or occupational therapies. Therapy alone can also help people with autism to develop their abilities and reduce their symptoms.
Applied behavioural analysis (ABA) is a technique that can be useful to identify and address specific behaviours. By examining the causes and consequences of certain activities, behavioural analysts can tailor interventions to each case they are dealing with. This approach can, at times, be helpful in cases of problematic stimming.
If you feel you would like to discuss stimming with a doctor, psychologist or therapist – first, make an appointment with your GP who should be able to signpost you to the correct help. Qualified medical practitioners will be able to advise on the best course of action, though people who are stimming safely often do not require any kind of intervention.
For decades, children who demonstrated signs of stimming in school were told to ‘stop fidgeting’, that they were distracting others or that they should not doodle whilst their teacher is talking as it means they are not concentrating. As people begin to understand more about the importance of child and adolescent mental health, our schools need to become more understanding and inclusive places, without this type of judgement or labelling within the classroom.
Children may stim at school or college as a way to self-soothe, so they are in fact less disruptive in the classroom, or as a way to cope with feelings of anxiety – this could be social anxiety or because they find their schoolwork challenging. Stimming in children or teens does not necessarily indicate poor behaviour, a lack of concentration or any kind of neurological problem.
Psychologists do not fully understand why stimming works for some people. They believe that it may be linked to certain chemicals in our brain, specifically dopamine, serotonin and glutamate. These chemicals, also known as neurotransmitters, are associated with self-stimulatory behaviours and they help to regulate emotion.
How to stim safely
Most of the time, stimming behaviours pose little danger and can be used as an easily accessible coping mechanism in difficult situations. Occasionally though, stimming can become hazardous.
Stimming behaviours that may cause problems can include:
- Excessive head banging.
- Hair pulling.
- Hitting yourself.
- Arm biting.
If stimming is causing injury (or the risk of injury), pain/discomfort, restricting access to learning or opportunity, then it is probably best to try to restrict or modify the behaviour.
If a person is stimming in an unsafe way you can help to encourage them to stop by:
- Creating a safe environment.
- Limiting stress/identifying triggers.
- Seeking professional help when needed (either a GP or psychologist).
- Rewarding good behaviours instead of ‘punishing’ bad ones.
- Creating a support network around them of family, friends, educators, employers and medical staff to share information and help them to feel safe and understood.
Although stimming is widely regarded as a repetitive behaviour, it can sometimes become more of an obsessive behaviour. Obsessive behaviours can impact on people’s quality of life and actually increase anxiety. If you suspect repetitive behaviour is becoming an obsession, rather than simply a coping mechanism, early intervention is key.
Firstly, consider why this type of behaviour is occurring and whether you can somehow modify the situation or environment to help the person who is stimming in an obsessive or unsafe way. Perhaps there is a sensory issue such as too much light or noise that can be easily dealt with.
It may be that the person is suffering from underlying anxiety and by talking to them and helping them to deal with their emotions in a different way they can find new strategies to replace unsafe stimming.
Some effective strategies to calm anxiety and replace obsessive or dangerous stimming behaviours can include:
- Taking 5-10 deep breaths.
- Squeezing a stress ball.
- Setting targets/limits.
- Identifying alternatives.
- Encouraging the idea of ‘self-control’.
There has also been a recent surge in popularity of so-called ‘fidget toys’ particularly amongst young children. These toys will often squash or stretch or come apart and fit back together easily. They can be an excellent distraction and a healthy way to deal with stress – using them often has a calming effect on children, especially those with sensory issues or ADHD and people of all ages with autism.
These fidget toys are often made from soft, pliable materials and interesting textures or are designed to pop back into place after being pressed. Stretching, scratching or biting these can provide a safe alternative to more harmful stimming behaviours.
Anxiety is experienced by many people in the modern world and it is not just those on the autistic spectrum who may begin to rely on stimming too heavily, especially those who may suffer from OCD.
The ‘elastic band trick’
The ‘elastic band trick’ is suggested by some psychologists for people who are experiencing intrusive thoughts/behaviours – the idea is to place an elastic band around your wrist and ping it every time you start to experience stress or bad thoughts. After a short amount of time, a person should begin to associate the uncomfortable feeling of the band snapping against their skin with certain triggers or behaviours, thus learning to avoid them.
Stimming is often subconscious and does not generally need to be addressed in this way, but if you begin to associate not acting out repetitive behaviours with feelings of fear, this simple technique can help you to regain a feeling of control over your life. This way, you might stim because you want to, but not because you have to.
If stimming behaviours become intrusive, obsessive or dangerous, then it is best to try to address the underlaying cause for this type of excessive stimming and look for an alternative coping mechanism. The vast majority of the time, stimming is a perfectly healthy distraction for people that can help them to feel calmer, happier and less anxious.