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Ask the Mental Health Expert Archives 2001-2004

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Self-Injurious Behavior Gear

Q. Do you know of any manufacturers or distributors of protective headgear for adults who head-bang, available to the general public? Would I need a doctor's prescription for such an item?

While I'm able to hold down a full-time engineering job, occasionally when I'm home alone, particular late at night, I have distressing agitation episodes where pressures can drive me to lose behavioral control, thrash and flail, and sometimes hit myself and bang my head. My therapist believes this is a post-traumatic related problem, and we're trying to work on it. Because of the agitation, I often crave a greater sense of safety and containment.

I also wish there was something that I could put on and take off by myself, but would partly contain my arm motions to limit self-hitting. If I could find someone who is skilled at heavy-duty sewing of canvas, one possible design has already occurred to me. But I'm interested to know what's out there in terms of head-banging and other self-injury protective products.

A. There is a website that lists dozens of medical equipment companies: http://dmoz.org. But I really think you would be missing the boat by pursuing the headgear idea, rather than establishing the cause of this unusual problem you are experiencing. Even though you are seeing a therapist, I would strongly recommend a thorough neurological and/or psychiatric evaluation, and perhaps an overnight sleep study called a polysomnogram. It would be important to rule out neurological or sleep--disorder related causes for your behavior.

Even if these don't pan out, there may very well be medications that can reduce the frequency or intensity of these bouts of head banging and agitation. It is true that some forms of self-injurious behavior (SIB) stem from unresolved traumatic experiences, or other deep-seated psychological problems. So... I am not saying that your therapist is wrong. But if your treatment thus far has not produced satisfactory improvement, I do recommend getting a medical second opinion before purchasing protective headgear.

December 2001

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