Seven, children who bite their nails
About 30% of children aged 7-10 and 45% of adolescents have the habit of biting their nails. If this behavior is too severe, it can cause damage to the skin and nails of the fingers, secondary to various fungal bacterial infections. In some cases, the nail bed is damaged and the nail is deformed for life. Although most do not need to be corrected too deliberately, after that period of time will naturally stop biting. However, in a few children, the habit may persist for a long time or even persist into adulthood. I have personally seen a successful man in his late fifties who would occasionally bite his nails while sitting at a podium.
It is not uncommon to see children who come to the clinic with flaking fingertips, nail spurs and broken skin on both hands. A slightly more experienced doctor will notice the jagged nail edges, which are signs of gnawing. Fingertips with broken skin are very sensitive to pain and it is common to see both old and new scars. If the question is asked, do you usually bite your hands? The answer is usually yes.
According to the textbook definition, nail biting is a habitual behavior of chewing nails in a state of stress, pressure, hunger or boredom. Sometimes it is also a symptom of a psychological or emotional outburst. It is supposed to be a compulsive or even unconscious habit, and the sufferer is sometimes unable or has difficulty realizing what he or she is doing. Freud believed that this is caused by the person not being fully satisfied during the micturition period.
The dermatologist, after completing the diagnosis and the explanation of the above-mentioned pathogenesis, did little, as the correction of the behavioral habit was clearly beyond our scope of work. However, I happened to be preparing for my counselor exam during that time, and knowing little about the theory of behavioral therapy but eager to try it, I had to ask more questions whenever I encountered such patients, trying to find some specific causes and treatments.
Among the young patients I met, most of the children with nail biting fetish were lively and active, and they did not seem to be under any tension or stress, and most of the parents did not think they were putting pressure on their children. They also got along normally with their peers and did not particularly misbehave. So for a while I was very confused about the cause of the disease. Only one little boy, 5 years old, who might have ADHD, closed the lid of the printer, unplugged the connection, and turned his chair around 5 times within a minute of entering my office. His grandmother and grandmother kept trying to stop him, but the boy was quick-eyed and found the hand sanitizer on the side of the sink again, squeezed a lot of it in the sink, turned on the faucet again, and stirred it up with his hands. The child’s grandmother carried him to a chair and sat down, he still kept wriggling his body and biting his hands.
In less than half a minute, the child turned off my computer again with a lightning speed. In the end, Grandma had to hold him while she watched him, while Grandma had to help watch his hands and feet. Finally, I asked the two seniors not to stop him to see just how much the boy could toss and turn, only to have him play with my stethoscope and stamps before climbing up on the small cabinet by the window and we had to stop him. Later, I referred him to Professor Mei in the psychology department of the Children’s Hospital, as she is an expert in treating ADHD in children.
After a follow-up phone call a month later, the grandmother told me that the child had been diagnosed with ADHD and was taking medication for it, and was just starting to show some improvement. This little patient is, after all, an isolated case. Other than that, most children with nail biting fetish have no other cognitive, emotional or behavioral abnormalities. So, what exactly is causing this behavior and how can it be effectively corrected?
That is, until the day my own child developed such a condition. My six-year-old son, McDull, was in elementary school and was often praised by his teachers because he liked to raise his hand to answer questions and express himself clearly. But after a month in elementary school, I noticed that his fingernails hadn’t been cut for a long time, and they used to be cut every week. A closer look shows that each fingertip of that little hand is scarred, and the nail edges are uneven.
”Did you bite this yourself?” I couldn’t help but ask.
My son nodded silently.
I said, “hands are bitten, pain does not hurt ah?”
”Yes, but I know when I bite,” said my son, looking at me with an aggrieved face.
”When do you usually bite? In class or out of class?” I held my son on my lap and continued to ask, pretending to be calm.
”In class.”
”Why did you bite your hand? You see it hurts to bite through, and it’s easy to get bacteria, and your little hand will rot, mommy has seen a lot of kids like this.”
”I don’t know why, I didn’t mean to. But class is really boring, you have to sit all the time, unlike kindergarten where you can run around by yourself.” The son seemed really aggrieved.
”Oh, did you understand everything the teacher said?” When I asked this question, I thought to myself that the summer before school, my grandfather had bought the first grade textbook and taught it in general, and my son did know it all. Was it because he thought he knew how to do it that he didn’t want to listen to the lecture anymore?
”It’s really boring to hear the teacher talk several times.”
”Boring” is a surprising word coming from a six-year-old, “Oh, it’s a bit. Then if you understand, let’s bring a book to read, okay?”
”The teacher forbids it! The teacher said you have to sit and listen in class, not allowed to do other things.”
”And did the teacher find you biting your hand?”
”No.”
”Look how poor your little hand is bitten, so you may not even grow nails in the future, what if your fingers are rotten? You can’t play with blocks anymore.”
”I don’t want to, but I can’t help it ……”
”Mom help you to change this habit, okay?”
The son nodded vigorously, so we began a six-month-long effort with a lot of twists and turns.
The next day before school, I repeatedly instructed my son, bored in class when you can recite the text, or write in notebooks, drawing, if unconsciously bite the hand, found it quickly stop. I then went to the school and told the classroom teacher about my son’s situation, hoping that the teacher would give appropriate attention and encouragement to help my son through the adjustment period from kindergarten to elementary school. The teacher said that it was normal for children in elementary school to have short attention spans, and that by giving them more opportunities and encouragement and using other things to attract their attention, the bad habits would slowly be forgotten. Since then, every two or three days we will communicate via QQ or SMS. There were also a few times when we picked up the child or communicated in person during parent-teacher conferences.
It turns out that praise or encouragement from the teacher is far more effective than from the parents. I am glad that my child has a good teacher, a young classroom teacher who is very resourceful.
For the first week or two, I reminded my child every day before school and checked his hand after school. There seemed to be some improvement and the skin that had been bitten began to scab over and heal. My son often told me that today Mr. Su praised me, today Mr. Su took me to another class for an observation lesson, today I helped the teacher hand out homework books, and today I got 10 points for my three-minute speech before class …… He is starting to get used to being an elementary school student. I am happy, but the good times are not long, not a month after the child’s hand and bite bruises.
What is the reason for this? The child is normal at home, I have observed carefully, he never bites his hand when watching cartoons or playing with toys. The teacher said he was also normal at school, answering questions positively, participating in group activities, and getting along well with his classmates. I was also confused, so I found my psychology teacher and took my son to do a sandbox game. My son set up a tray full of soldiers, dinosaurs and various animals in formation with great interest. The teacher said the child was smart and had no obvious psychological problems. I seemed a little relieved, but still hadn’t found a solution.
When I got home, I talked to my son about using a Band-Aid to help him wrap his fingertips before school every day so he couldn’t bite them, and biting into the Band-Aid would remind him to stop the behavior. Of course, this was all based on the premise that my son wanted to change and was very willing to cooperate. So, every morning I wrapped each little finger and unwrapped it after school. 3 weeks later, the skin was completely healed and new nails were growing. My son and I were so happy that we thought we had won the battle and had a little celebration.
The month after that was normal and I think my son has changed his habit of biting his hands. One day I came back from a business trip, very late, and my son was already asleep. I gently walked into his room to help him put his hand under the covers, but suddenly found that the skin of my son’s left thumb was bitten in several places, with blood scabs. My heart thumped, my heart ached! The next day was a weekend and I arranged a family outing where we watched black swans swim in the lake, watched ants move, built various castles in the sand, and in the evening we had a barbecue together.
Everyone had a great time and I paid attention to the fact that my child did not have any abnormalities and did not bite his hand all day. The problem was still at school, and I was more sure of my child’s speculation that he was maladjusted to elementary school life. In kindergarten, my son had been getting a lot of attention from his fellow teachers because he was cute and could play piano and sing. He was the kindergarten host from the age of three and a half, and every now and then a little girl would come up to him and hug him and say, “McDull, I want to marry you!” Once he went to kindergarten after recovering from an illness, the whole class spontaneously shouted “McDull! McDull!” It was obvious that he was very popular. But when he went to elementary school, he went to a new environment with unfamiliar teachers and classmates, a completely different way of learning, and a significantly weaker level of attention, he didn’t adapt.
In fact, one cannot always be a red flower, one has to be willing to be a green leaf. But how do you get a six year old to understand this? In an only-child family, parents always say one thing and do another, teaching their children to be humble, but always putting them at the center of everything, with the family revolving around one child. Each child is accustomed to being the center of attention, so they are uncomfortable and uncomfortable when they enter the peer group.
I thought it would be better to let the children play more with the children and feel it for themselves in the play. Over the next few weekends, I organized several activities for the children. We invited 8 children, informed them of the approximate time and invited them to prepare a program. We also prepared a lot of small gifts and goodies. The concert was a great success and the children had a great time and were still reluctant to leave until after dinner. My son learned to enjoy quietly when others were performing and to give a sincere applause afterwards. Time after time, I was pleased to find my son’s progress, he gradually understood some rules, respect others and compromise appropriately ……
My son is getting more and more accustomed to elementary school life, he started to come back and tell some fun things, talk about the games in PE class, show the crafts in art class, and also talk about the female classmates at the same table. His little hands are much better, but his nails still don’t need to be cut because they are all chewed off by him. I really didn’t know what to do, except for the nail biting, everything was normal for my child. I reviewed a lot of literature and finally decided to try behavior therapy. In short, it is to give punishment when the bad behavior occurs and reward when the behavior subsides, with the aim of eventually eliminating the behavior. But the reward, that is, the stimulus, must be something that the child very eager and very fond of. It just so happens that at that time, my son was obsessed with the Dragon Warrior and dreamed of having a set of the six gods of war that could be combined.
So, I discussed with my son, if he insisted on not biting his hand for a week, he was rewarded with a God of War, if the second week biting his hand will have to return his trophy. As long as you insist on six weeks not to bite, save all six gods of war can be combined. The son flashed his big eyes and agreed with great anticipation. Of course, we eventually won, but the process was not smooth sailing. I still clearly remember my son’s ecstatic expression when he got his first trophy and his frustrated look when he was forced to return the prize because of a foul. The day the six gods of war merged, no, it was the following days, my son loved them all and introduced their weapons and supreme powers like a family treasure. I was happy for my child to change his bad habits and even happier for his experience of success through his own efforts. Today, my son is 7 and a half years old, has never bitten his hand again, and is a perfectly happy elementary school student.
I still encounter children like this in the clinic from time to time, and I suggest specific practices to the parents, and more and more cases are proving that behavior therapy is very effective in the treatment of children with skin behavior disorders. It is not necessary to go to a professional psychological clinic, but with enough patience and appropriate approaches from parents, you and your child can definitely succeed.