Ripping up clothes on her body, how can we deal with this? — Scope | Disability forum
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Ripping up clothes on her body, how can we deal with this?

atwitsend
atwitsend Community member Posts: 5 Listener
Hello to all,
I have a mentally challenged daughter, 37 years of age, she lives at home. She was born with pierre robyn sydrome.  She is non-verbal but we have ways of communicating with her.
About 5 years ago she developed a habit of ripping up her clothing, especially tops. Prior to this,  it was picking at any sore.  She could keep them going for a year.
I do remove labels, only buy what she seems to prefer but even that is not safe.
She uses her hands (and teeth, I suspect) to do the damage. Some of this clothing is repaired, but lately, it is irreparable. When I ask her why she says she does not know and it's not her doing this but some other person (who does exist but is not anywhere near her) 
She is under a psychiatrist who says this is an OCD  condition and her tablets are cloment, Ranflocs and serenace - this has not stopped the ripping.  She does not like threads.
(Please no suggestions of giving her a piece of material and getting her to unpick it) It needs to be on her body!
I am ready to pull my hair out as I have tried everything. Reasoning, punishing, shouting, pleading, locking the dressing room, taking away some of her possessions, spending more time doing activities, outings - not putting a top on her..... double hemming....I am out of tricks.  
Is there anyone out there who has a similar problem?
I feel like removing her from the meds as they are not treating the problem.

Comments

  • Pippa_Alumni
    Pippa_Alumni Scope alumni Posts: 5,793 Disability Gamechanger
    edited November 2018
    Hi @atwitsend, and a warm welcome to the community!

    Thanks for sharing this with us, it sounds like a frustrating situation for you all. I really hope some of our community members can offer some advice. 

    Whilst not specific to ripping up clothes, this page has some tips for addressing repetitive behaviours, which have all been suggested by community members in the past. Might be worth a look whilst you're waiting for any responses!
  • synergy2120
    synergy2120 Community member Posts: 19 Courageous
    I relate to the picking at sores and keeping them going for a year. It is referred to as dermatillomania and is a disorder linked to OCD. It sounds like the clothes thing is very similar. 
    I pick and attack my skin if i feel any bump or wrinkle causing sores and then i constantly pick at the scabs that form because it needs to feel smooth. There is no logic in it and it could be that your daughter is doing the same with her clothes. I dont have a solution but i do know trying to restrict her and telling her off wont help. It actually makes them feel worse and makes the issue worse. 
    Im on medication to help keep mine under control and am being referred for another go at CBT ... has she ever tried CBT?
  • Laura99
    Laura99 Community member Posts: 62 Courageous
    Can people who are non-verbal even engage with CBT?

  • Laura99
    Laura99 Community member Posts: 62 Courageous
    I was wondering if PRS was the only diagnosis - has your daughter been diagnosed with autism, for example? Or any other syndromes which often have OCD as a component?


  • SAM134
    SAM134 Community member Posts: 1 Listener
    edited November 2018
    Hi atwitsend 

    just keep calm and don’t show her you are worried help her by time she start  ripping her clothes give her anything she like food or dvd book....
    just be calm because your voice and your reactions all that is like therapy when you approche your daughter  she need lot of love and patience 
  • atwitsend
    atwitsend Community member Posts: 5 Listener
    Thanks to all who replied.  I had one day when I managed to avert the ripping but it was a CONSTANT watching/entertaining/keeping her with me, never letting her go upstairs to her room for any alone time until sleep time....very exhausting and not doable for everyday living. If I should just accept the mutilated garment without any form of emotion would that not signal that this behaviour is acceptable?

  • atwitsend
    atwitsend Community member Posts: 5 Listener
    I am not sure of how to get back to Laura99 and synergy2120 - so will respond from here. Don't know what CBT is.  From picking at sores she changed over to the ripping of clothing...so the picking at sores is a minor concern now.  I realise that it is just an exchange of habit - each one fulfilling some compulsion.  (my way of seeing it) The PRS was diagnosed at birth - These syndromes seem to overlap one another in certain areas. She is mentally challenged, normally not a trait of PRS.  I do have a grandson who is severely autistic. (also non-verbal) And he 
    struggles to keep his clothes on!
    Sam134 advice of calmness will be heeded. 
  • debbiedo49
    debbiedo49 Community member Posts: 2,904 Disability Gamechanger
    CBT is cognitive behaviour therapy. How does your daughter communicate? Does your daughter get other help? Is your daughter going through puberty of hormonal changes? All these things could be going on and more. I think you need help to get to the base of the problem if possible. Good luck
  • Laura99
    Laura99 Community member Posts: 62 Courageous
    Not puberty at age 37. Picking at sores goes with Prader Willi Syndrome which has some components of autism. Has your daughter got a menstrual cycle? (Cognitive Behaviour Therapy requires speech.)
  • Laura99
    Laura99 Community member Posts: 62 Courageous
    By the way, what medication is she on?
  • atwitsend
    atwitsend Community member Posts: 5 Listener
    Her medication is Ranflocs,  Cloment  25g and serenace 5mg -
    We communicate by means of basic sign language  (Makaton)- writing - lots of acting (facial expression) And she won't give up until you get it right.
    She had a hysterectomy age 12/13.  Don't think its Prada Willi - She is tall and lean until age 33. She has some traits of the syndrome - picking, repeating etc  as I have said before a lot of these conditions seem to share similar things.
    Thank you for your input.
  • [Deleted User]
    [Deleted User] Posts: 126 Listener
    Hey @atwitsend, I am going to bring my colleague @Jean_Scope in to this thread as I wonder whether she might have any suggestions for you from an Occupational Therapy POV.
  • Jean_OT
    Jean_OT Community member Posts: 513 Pioneering
    Hi @atwitsend

    Thanks for @Scope_rosie for inviting me to join this conversation. Although I must confess that your query is not really within my field of expertise.

    It sounds like you have already tried lots of different strategies and given this issue a great deal of thought so I fear that anything that I suggest will just sound like stating the obvious.

    In some ways I guess it is positive that this behaviour of ripping clothes has taken over from damaging skin, as it doesn't have the same health risks and implications. However, it also sounds expensive and frustrating for you having to keep replacing clothing. I am concerned that if you manage to stop her ripping clothing the obsessive nature of the behaviour will be displaced onto something more risky.

    I understand that the medical professionals that are working with your daughter are trying to use medication to reduce the behaviour but I  wondering if this might be masking it rather than really dealing with the root cause. What motivates your daughter to do this? What pleasure or benefits does she derive from doing it? Is she trying to communicate something to you by doing this? Is it her way of controlling her environment? Could these needs be addressed in other whys that are easier to live with?

    Obviously I don't know the answers to these questions and exploring them would probably take a long time observing, assessing and exploring the behaviour and the dynamics that surround it. I wonder if the Challenging Behaviour Foundation can signpost you towards suitable sources of professional help, certainly some of their publications might be of interest: https://www.challengingbehaviour.org.uk/information/all-our-resources.html

    As has already been stated by others I think positive reinforcement of desired behaviours and distracting your daughter when she is ripping clothing will be part of any program of behaviour modification. Clearly, giving her negative consequences for  ripping clothing hasn't helped. Negative reactions might even make the issue more difficult to work on, if she is enjoying getting a response from you, or if your reaction diminishes the bond between you.  

    If there are times when your daughter can't be supervised would it be feasible to have sets of clothing that she can wear when she is on her own that it wouldn't really matter if she ripped them? (I'm thinking cheap items from the charity shop). Keeping her best outfits for when you are able to manage the behaviour but not making an issue of this.

    Or course it is possible to buy specialist rip proof clothing  (examples:  https://www.professionalfit.com/collections/tear-proof-clothing-for-the-disabled-and-people-with-special-needs ) but I would be very cautious of going down that path.

    I hope you are able to access the support and answers that you need

    best Wishes

    Jean


    Jean Merrilees BSc MRCOT

    You can read more of my posts at: https://community.scope.org.uk/categories/ask-an-occupational-therapist

  • Laura99
    Laura99 Community member Posts: 62 Courageous
    I'm sorry I haven't been able to think of anything that might be helpful to you. I did wonder if one of the autism websites might be able to help since this behaviour sounds like something they might deal with.
  • debbiedo49
    debbiedo49 Community member Posts: 2,904 Disability Gamechanger
    edited November 2018
    You may know this see below
  • atwitsend
    atwitsend Community member Posts: 5 Listener
    Many thanks, Jean_scope.  She does the ripping in private, in her bedroom or when going to the bathroom.  She then shows me what she has done, and wants another garment.  Fact, is we are running out of garments that she will wear. So we have plenty to chose from but little that she will put on.  And the ones she favours are white, seamless and actually thermal wear.  You know that vest-like garment that one wears under clothing, which is okay as we live in SA. I think it is just something she enjoys.  When I ask who has done the deed - it is never her, but someone who she does know, who in the past may have done this to her clothing? In fact, she can produce tears if you accuse her. I have been on to all those sites that were recommended.  Thank you Laura99 and debbie49.  I have tried to leave her in her bra after she has ripped something but it does not work as she will seek out anything like her PJ top - and if she gets into the clothing section will try everything on and if it is not to her liking will make that unwearable too. The only thing that has relatively been successful is wearing a jacket over the vest and then her attention is not on the hemline, which I may add is scrutinized before donning and lo and behold if she spots a thread. I must get back to the mending what I can.  

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