Question: My son is constantly chewing or sucking on things. He is 12. His shirt, pens or pencils, his fingers, bottle caps – whatever he can get his hands on. I tell him to stop and he stops for 5 seconds and then his hands just go back to his mouth. You can see that he trying to fight the impulse but it just keeps coming every few seconds and then he forgets and does it. We got some spray on deodorant and sprayed it on his hands so he would taste it and remember so he would be more conscious of the problem and that helped a bit but it has not solved the problem. I am worried that people will make fun of him for sucking on his fingers in class. What can we try?

Dr. Lani Chin Says...:

Thanks for your post. I'll do my best to try to answer your question.

It sounds like your son may be trying to express himself through his chewing and sucking. Have there been any changes recently in your family? Your son may be trying to find a way to soothe himself or discharge some anxiety he is feeling. I would recommend you schedule an appointment with his general practitioner to see if there is anything physical going on that may result in this behavior. You can also ask his general practitioner for a referral to a Child Psychologist who might be able to help your son explore new ways to express himself.

For an immediate difference, try to give less attention to the behavior your don't want him to do. Sometimes attention can be a form of reinforcement whether it be positive or negative. Try to ignore the behavior as best you can unless he is harming himself and give more praise or attention to other behaviors. For example, if he expresses how he is feeling when he wants to chew or suck on something, reward him in some way. This way he will learn that if does something other than the behavior you want to decrease, he will have more positive interactions with you. Additionally, you can try to teach him when he is nervous or anxious to take a walk or do something else with his hands like play the piano or fold a paper airplane. Sometimes children have an excess of energy that they may not know what to do with.

Good luck to you and your son.

Question: I have an addictive personality. I am in cocaine recovery. I have had a problem with chewing my fingernails since I was a kid. Are these things related in the brain somehow? Seems weird that I can stop smoking crack but I can’t stop biting my nails.

Dr. Lani Chin Says...:

Thanks for your post.  I will do my best to help you understand how your nail biting and cocaine addiction may be related.

First of all, congratulations on staying sober.  Choosing to quit using any substance is not an easy decision. 

Using cocaine and biting your nails are two ways you've been using to cope with issues that have come up in your life.  At some point in your life, you realized that using cocaine or biting your nails made you feel better.  As a result, you continued to do either instead of using other coping skills (i.e. writing, exercising, etc.).  So try to think about your cocaine use and nail biting as two separate activities that make you feel different for different reasons.  When using cocaine, you probably feel carefree and numb.  The things that bothered you became insignificant because you had a a body high and the pain you were in probably went away.  When biting your nails, you are doing something that you find soothing and probably distracting.  Both activities take you away from feeling distress and both activities help you cope with things you don't want to feel or think about. 

Hope this answers your question and helps you understand what's going on.  I wish you the best of luck in your recovery and with the rest of your life. 

Question: My daughter has Trichotillomania (she is a hair puller). My daughter is 15 and she was able to hide it from me for a long time. I would see her pulling her hair while watching TV but I never knew it was a serious problem, I just thought it was a bad habit and I would scold her to stop. I have only known about it that it was a serious problem for a few weeks. I took her to our family doctor and he said if she couldn’t stop doing it on her own he might prescribe antidepressants to her. I do not want her to start off on drugs so young. I have a solution but my husband thinks it is wrong. I would like to ask you about it. What if we just shaved her head completely and kept it shaved for long enough for her to break her bad habit? I know this sounds extreme but I think she could pull it off looks wise and she could think of a reason to tell her friends and it would be better than starting her off on a lifetime of needing drugs.

Dr. Lani Chin Says...:

Thank you for your post.  Your daughter is lucky to have you on her side.

First and foremost, I would recommend individual and family therapy for your daughter.  Trichotillomania is an impulse control disorder.  As such, you daughter is likely having a difficult time with coping.  She has found comfort in pulling out her hair and probably finds the behavior quite soothing.  It would benefit her greatly to learn some new coping mechanisms and individual therapy can be the perfect setting for that.

I want to address your question.  You asked about shaving her head.  Is this something that she is on board with?  If you shave her head without her consent, you will likely exacerbate the problem.  Most of the time, hair pulling is about feeling in control of something.  If you shave her hair and she doesn't want you do that, you will make the problem worse and her symptoms will likely increase.  Additionally, since trichotillomania is an impulse control disorder, she will likely find another maladaptive way of coping with her emotions.

You also state feeling concerned that your daughter will be "on a lifetime of needing drugs."  This is a common misconception about medication.  An anti-depressant can be taken on a short term basis for your daughter to feel better and begin to address the problems that are contributing to her symptoms.  This is not a guarantee that she will need medication for the rest of her life.  Again though, if your daughter begins therapy, she will learn coping skills that will likely decrease the need for her to be on medication.

Hope I've answered your questions.  Good luck to you and your daughter.

Question: Do I have OCD if I have compulsions to do certain things but I don't really have any excessive anxiety. I don't know how to explain really, but for example, one thing I have to do all the time is whenever I am traveling by car I have to click my teeth whenever I pass a streetlight or electric pole. Or whenever I walk on a side walk I have to tap the side of my leg whenever I walk over a crack. It gets embarrassing and hard to explain to others so I'd like to stop but I can't and I don't understand why I do this? Is this some form of compulsive disorder?

Dr. Lani Chin Says...:

It sounds like you have some compulsions, however, I'm unsure if they can be classified as a disorder.  Do you feel like these behaviors have somehow impacted your day-to-day functioning?  It sounds like you're embarrassed when you're around others but are these feelings overwhelming enough to limit the time you spend with others because you don't want to explain what you're doing?  I would recommend individual therapy to talk more about these compulsions and what they mean to you.  Oftentimes, people may engage in compulsions to exert control over some part of their lives because they feel out of control/powerless in other parts.  If you are in the Los Angeles area, I would be happy to help you explore this further: www.drlanichin.com.  If you are not, I recommend you look for another professional to help you better understand your behaviors.  Good luck.

Question: Is habit reversal therapy the best approach to take for skin picking? Is there any need for me to work with a professional on this or should I just read up on the habit reversal and try it on my own?

Dr. Lani Chin Says...:

Habit reversal therapy can certainly be done on your own, but you may see only short term effects.  Doing more long term work with a psychotherapist will definitely yield more long term effects.  Specifically talking with a therapist about what is motivating your self injury so that you can address the root of the problem will be a lot more effective.  If you are in the Los Angeles area, I would be happy to help you: www.drlanichin.com.  If you are not I would strongly recommend you see a professional who can guide you through your recovery.  Good luck.

Question: My ex wife has custody of our children. She had OCD when she was younger but it was pretty under control when we were together but it seems to be quite severe again now. Our children are 4 and 6. How worried should I be that they will pick up on her obsessive and compulsive behaviors and start imitating them as their own behaviors? I have already seen worrying signs that they are very overly concerned with germs and getting dirty, which is not something a 4 year old should be very concerned about in my opinion.

Dr. Lani Chin Says...:

It sounds like you're worried about your children who may be picking up habits from your ex- wife.  While they may  be imitating what your ex-wife is doing in order to cope, you can also teach them other ways to deal with their emotions.  Just as they are learning from your ex-wife you can also talk to them about what's going on and how they can deal with their emotions.  It could also be helpful to find a family therapist to talk about the transitions your family is going through.  If that isn't an option, individual therapy for them could also be appropriate.  Good luck.

Question: Do extreme stressful events ever trigger obsessive compulsive disorder? My house was broken into a few months back and after that I got a lot more careful about checking to make sure all the doors and windows were secured and locked at all times. After a while it became like I couldn’t stop checking them even when I knew for sure that I had just checked them and everything was all right. Now I will check everything 3 times and get into bed and this voice will start nagging in my brain and I will have to get out of bed to check them again. Sometimes I do this 4 or 5 times before I can fall asleep. This crazy, I know, but I can’t control myself. What can I do?

Dr. Lani Chin Says...:

It sounds like you're attempting to retain control over something you can control.  When your house was broken into, you had no control over the situation.  Now, to compensate for that it sounds like you are attempting to control something you can.  Although you may feel like you are developing OCD, it sounds like you're reacting more from a fearful place and checking the locks helps to reduce your fears.  I would recommend you seek some individual therapy to talk about other ways you can cope with your fears.  You can definitely find a knowledgeable professional to help you with this.  If you are in the Southern California region, I would be happy to help you with this.  You can reach me through my website: www.drlanichin.com.  Good luck.

Question: When I was little my parents said I always used to have a problem pulling my hair out and eating it (gross). I can barely even remember doing it but now I am 21 and all of a sudden I can’t stop picking at my scalp and pulling my hair out. I am getting little bald patches. Help! What do I do to stop?

Dr. Lani Chin Says...:

It sounds like you're describing something called trichotillomania.  This is a way some people have learned to manage their anxiety.  What are you feeling when you think about pulling on your hair?  When you were younger, you probably realized this was something you could do to help yourself feel better.  Now that you're older this way of coping is no longer working for you.  I would suggest you begin working with a psychotherapist to better understand what's making you anxious and to learn other ways to help yourself feel better.  If you are in Southern California, feel free to contact me and I would be happy to help you: www.drlanichin.com.  Otherwise look up therapists in your area to begin talking about what you're going through.  Good luck.

Question: My husband has early onset parkinsons and is taking pramipexole. We were warned that one of the possible side effects of the treatment was a risk of impulse control disorders and we were told that we were to be on the lookout for certain types of behaviors. Well, my husband is now showing real differences in eating and sexual behaviors (his appetites are insatiable) and this is a difference from before. I told him that he should tell his doctor about it but he says that he feels good now and he doesn’t want to change his medication around. He says that if these side effects are the price he has to pay he is glad to do it. I am not sure. Should we be worried that he is having these ICD symptoms? Are things going to get worse or is he right to decide whether or not he finds the side effects acceptable?

Dr. Lani Chin Says...:

It sounds like you and your husband are going through a really difficult time.  I would recommend first and foremost that your husband make a visit to his medical doctor.

Although he is ok with these side effects, his doctor needs to know what's going on.  It sounds like what he is exhibiting is on the verge of "reckless" behavior but this can easily turn into "risky" behavior.  Having an insatiable appetite for food or sex becomes risky when your husband begins making decisions that impact his functioning.  An example of this might be calling you to have sex during his lunch break or wanting to have sex in the morning on a regular basis before work which could affect your attendance at work.  The consequences of either of these scenarios could be seen as minor, but if they continue there could be consequences to your husband's work life and functioning.  

When these behaviors become reckless is when his impulses lead to impulsive sex.  This could be having sex with prostitutes or getting drunk and having a one night stand.  This might sound like a stretch since you say these behaviors are not typical for your husband, but I want you to know the hallmarks of when impulse disorders become real problems.  Again, I recommend your husband see a medical doctor.  Just because he reports an increase in impulsive behavior doesn't mean that his doctor is going to do something to make the impulses go away right away, but his doctor does need to know.  I hope that the examples I provided help you to see when your husband's behavior could be described as dangerous and needing immediate attention.