Adult autistic daughter hitting self, help!

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My daughter is 26 and was diagnosed with autism as a teenager. She has never let her condition hold her back and is very capable of surviving in the "neurotypical" world--she has a college degree, drives a car, has a full-time job, and generally takes care of herself like an adult. Most of the time, you'd almost never know she was autistic at all except for a few social quirks; she doesn't quite look you in the eye, her voice is a little flat, things like that. The problem is that whenever something bad happens that she thinks is her fault (doesn't even necessarily have to be true), she becomes hysterical and punches herself in the head repeatedly. She won't do it in front of strangers, and she'll stop if I tell her to, so I think she does have some minimal control over it. However as soon as she gets out of sight it's right back to beating herself over the head until the pain forces her to stop or I catch her doing it. It seems almost like a tic, in that she can resist it temporarily but eventually it has to come out. I don't think she's doing it to get my attention or to self-stimulate, as I've seen suggested on some autism websites (she does "stim," but mostly by harmlessly flapping her hands, not violently).

I'm worried that she's going to seriously hurt herself if she keeps doing this. The problem is that, as mentioned, she has a life and I can't follow her around all the time to stop her from doing it. I also don't think that hospitalization is a viable option since a.) she doesn't want to go and I legally can't make her, and b.) as mentioned, she is perfectly functional in every other area. Putting her in the hospital because she self-harms maybe once a month and is fine the rest of the time seems like a fantastic waste of time and resources.

I've asked her why she does it and she says she doesn't know. I keep racking my brain trying to figure out where she learned this behavior and coming up blank. My husband (possibly autistic himself) also used to hit himself before he was put on anti-anxiety medication, but I don't think she ever saw him do it. Physical discipline was not used in our home, except for one isolated incident where I smacked her very lightly on the butt with a bedroom slipper, and I doubt that would have caused this. We don't even raise our voices at home most of the time. Do some autistic people just do this without learning it from somewhere? I'd hate to think I somehow made her think it was okay to do this, or that another adult was smacking her around behind my back when she was a child.

My bigger problem however is how do I help her find better ways of dealing with anger at herself when I'm not around to manage her behavior? My brother-in-law has brain damage from a head injury and I'm afraid something like that will happen to her. Repeated blows to the head sure don't sound good for you in any event. At the same time I don't want her hitting herself anywhere else either. Any suggestions for helping her find a coping mechanism that doesn't involve hitting?

I'd interpret it as extreme stimming. Self-stimulation is comforting, but stronger stress needs stronger stimulation. If you think she's hitting herself hard enough to cause injury, maybe you can encourage or help her to find a less harmful alternative. (Even though the drive to stim is instinctive, I've found I don't always think of all the options naturally.) Squeezing an ice cube in your fist or screaming into a pillow are both popular tactics. When I searched for the ice cube thing, I found this list of things to do instead of hurting yourself, and while most of those options probably aren't "strong" enough, there could be something good in there.

It always surprises me that people think self-harm needs to be learned. Even though it's unhealthy, it seems like an instinctive response many creatures use to cope stress. On the relatively mild side (excluding cutting yourself, etc), it's even pretty common. Animals do it, cartoon characters do it, people express their emotions by talking about doing it... If you do a Google image search for "frustration," most of the pictures will deal with someone either hitting themselves or pulling on their hair, with a large minority of banging their head on something, scratching themselves, or biting or punching a hard object. There are also other forms of stimming pictured, but they are either obtrusive to others (yelling, with gusto) or seem to apply to lower levels of frustration (rubbing parts of the face).

Maybe a sensory issue. Under stress from something she may crave pressure and if so, a weighted blanket might help, if that isn't available a corner that she can expreience pressing on and feel pushback from could also help. If all else fails even squeezing her own body tightly might do some good.

Thank you to both of you for replying. I may have exaggerated exactly how hard she hits herself. She isn't a very big woman and doesn't work out much, so I don't think she could hit herself hard enough to cause a concussion or anything like that. It's mostly the repeated blows to the head that worry me. Even if one punch doesn't hurt her that much, twenty in a row might.

Cyllya1, good point about self-harm. I guess my brain just figured that if someone is hurting themselves they must have learned it from somewhere, but that doesn't make sense when I think about it. After all, my husband was never taught to hit himself either. I do find it slightly weird that both of them have this same issue, but he is her father, so maybe there's a genetic component to it or something. I remember reading, anecdotally, that autistic people with autistic fathers tend to have a lot of the same autistic traits that their fathers do, but now I can't remember who said that.

I'll suggest that she might like a weighted blanket, and also send her the list of alternatives to self-harm and see if she finds any that seem good to her. She does enjoy ice (she used to lick ice cubes as a little girl, which I now realize was probably a form of stimming), so that might help.

My daughter also does this and she also blames herself for things that aren't always her fault like you describe. I have always felt she hits herself to 1) express extreme frustration when she has been taught not to hit other people or other things (what else but herself is left?) and 2) to create a pain that pulls her attention from the emotional pain she feels from the frustration. It is very difficult to watch someone do this and I think it is our instinct as a parent to get them to stop. I walk away when she does it although I do express to her that I feel she shouldn't do it. I think the best solution is to teach alternative ways for her to fulfill the needs it fulfills. However, I also feel it's a very personal thing for my daughter. She feels such extreme frustration so much of the time and she does not employ an age appropriate coping mechanism. But I hope she can learn to deal with difficult feelings in time.