Teen cheek biting

[YourNeedyBee]

My 12 DD is having trouble with recurrently biting the inside of her cheek. She bites and bites until there's a big painful wound, which swells up and makes her bite it more. It gets worse when she is anxious. When she was younger she had a nervous cough which just went away after a few years, so I've just been ignoring, but recently it's making her really distressed. Dentist said just try really hard not to bite it, but it's a compulsion and she can't.
She won't engage with any relaxation stuff that I've suggested. She puts cotton wool in when she's at home but then it makes it worse when she goes to school. Anyone had this before? Did it get better on its own or should I be getting her some CBT or similar?? She is a worrier overall and has become quite stroppy and demotivated recently. When it's really bad she is begging me to stop her biting but I'm at a loss for how to help.

Difficult if she won’t engage in any activities that might help her relax.

Have you spoken to the school SENCO regarding her anxiety or the GP?

She has said if I speak to the school she will never go in again! I am trying to get her to agree to go to GP. At school she is quite high achieving and doesn't show any of this, I was just hoping someone had some experience of something that was helpful. She would probably engage in something recommended by someone else - just not mum!

If she has high anxiety and repetitive, unwanted behaviour and is high achieving, has there ever been any concern about her being ND @YourNeedyBee? I know it’s often trotted out in MN but those are pretty common signs, especially in virals around that age

Not virals. No idea where that came from. I meant girls around this age.

She's always been very socially adept so ASD was never on my radar, that said she does have a thing about needing to touch the furniture and doors in a certain way, which is worse when she is wound up, and she has to have the TV and radio on a specific level (20, NOT 21!!) so maybe there is some OCD type trait. Neither of these is overwhelming or distressing so I've just let it be.

My concern is just how to help because her mouth is so painful and that is distressing. 😥

I think the social thing might be a bit of a red herring, you can have people who have ASD who are extroverts and have friends. My DD is diagnosed as having AuDHD and has a lovely social life.

If she’s biting and has to touch things it might be OCD. Don’t take that from me though as I’m not a HCP but I would talk to the GP again, preferably a female GP, and include everything that you’ve mentioned here.

She might need some SSRIs. DBT might help too and there are some suggestions of books that help with anxiety here.

It’s also worth noting that OCD is also very frequently co-morbid in people who have ASD.