Tactile Defensiveness

Consider these scenarios, taken from my files:

1.  A beautiful little girl who routinely turns down play dates and party invitations, and prefers to spend her weekends sitting alone in her bedroom with her clothing off, playing video games.

2.  A man in his thirties who can't bring himself to be intimate with his wife.

3.  A little girl who routinely wipes off kisses, won't sit on her parents' laps, won't hug her grandparents, and hates and fears the family dog.

4.  A little boy who can never walk to school without becoming, in his mother's words, a "whining, miserable mess," complaining about the tag in his shirt, the seams in his socks, and bursting into tears at the feeling of his jeans rubbing his legs.

5.  A little boy who is at the center of every altercation at school and soccer practice, whether he is initially involved or not.

6.  A little boy whose shoes have to be endlessly tied and retied every morning because no one can tie them tightly enough to satisfy him.

7.  A little girl who absolutely refuses to wear undergarments or tights and insists on going commando and barelegged in every weather.

8.  A little boy who will not try any craft activity if it involves paint, paste, or glue.

9.  A little boy who is so emotionally rigid and controlling that he has everyone walking on eggshells.

10.  A little boy who is so distressed by anyone coming into his personal space or touching him without his permission that he becomes unglued and disorganized for the rest of the day and can't stop talking about how angry it makes him.

11.  A little boy who lashes out at the child sitting next to him without warning.

12.  A little boy who reflexively hits another child when she accidentally bumps into him in line.

13.  A little girl who sits quietly in class, keeps mostly to herself, constantly pulls the sleeves of her sweater over her hands, and insists on having the same exact thing for lunch every single day.  Each afternoon when school is over, she rushes to her mother and bursts into hysterical tears.

14.  A teenaged boy who gags at the sight of all fruit and vegetables, toothpaste, and liquid soap, and who subsists on white bread, chicken broth with noodles, and milk.

15.  An eight year old girl who, ever since she was a baby, finds having her hair washed, brushed, braided, or cut an absolute agony, and still cries when her mother cuts her nails.  Her mother reports an elaborate bath ritual that centers around making sure that no water gets anywhere near her child's face, lest there be a tantrum.

16.  A little boy who always walks on his tiptoes and holds his hands in tight fists.

17.  A baby who arches backwards and screams when someone comes to pick her up out of her crib, and is only made more distressed by stroking or hugs.

18.  A toddler who drives her mother mad by undoing her pajamas and taking off  her diaper at every opportunity.

19.  A four year old boy who absolutely refuses to go barefoot, tears off any hat or headgear no matter the weather, and who simply cannot behave in a calm or organized fashion, especially at school.

20.  A little boy who screams "NO!" and hits at anyone who comes into his personal space, including himself.

21.  A loving wife and mother who can't bear to hug, cuddle, or come in contact with her husband while they are lying in bed.

What do all of these people have in common?  They live with a clinical condition called tactile defensiveness.  Their skin is overly sensitive, and is wired directly to a part of the brain that interprets many kinds of touch as dangerous and/or painful.  Their skin doesn't filter out things that a normally functioning nervous system would not register, like the tag on a shirt or the elastic on an undergarment, and sensations that should be perceived as pleasant or neutral feel painful, threatening, and noxious.   Many fabrics, especially synthetics, drive them to distraction, hugs and kisses feel like an assault, light touch feels like spiders crawling on their arms, and anyone coming into their personal space could be a predator.

A child with tactile defensive skin has a challenging time coping in the classroom.  He can't bear to touch paint, paste, or glue, he doesn't like to sit in too close proximity to other children in case he gets bumped or touched, his clothes bother him, the smells are overwhelming, and he is required to interact with things and people all day long that feel dangerous, threatening, and noxious.  He has a hard time staying present in his body and an even harder time trying to shut off the danger signals so that he can turn his mind to what is being taught.


Next week I'll talk about the implications of tactile defensiveness and what occupational therapists can do to alleviate it.