So bandage up that finger quick, because he's the one who's really in danger.
Recently, Sam wandered off without me for the first time. I was in the bathroom upstairs, and when I got out, I saw him playing with his Matchbox cars, doing his normal routine. I thought nothing of it until I heard my neighbors knocking on the door. Upon answering, I learned that Sam had gone outside, jumped excitedly on a parked car, and tried to get into the neighbor's house, all in the span of the five minutes that I was on the toilet. Thankfully, my neighbors know Sam and helped lead him back into the house without incident. We've since added a top lock to the door, but Sam running off is now something we have to be constantly vigilant about.
Certain obsessive behaviors can also lead to self-harm. One huge challenge we have is that if Sam has a runny nose, he will rub his face raw. More than once, he's come home from therapy with a deep rash on his face, because he's done nothing but rub it like a dude with a head full of angel dust for the last seven hours.
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Repetitive scratching, picking, and rubbing may not sound too dangerous, but can end in broken bones, blindness, and death.
The first few times this happened, we didn't know what to do, other than restrain him so that he couldn't remove the healing ointment we applied to his face. This failed miserably, because he wound up rubbing his face on a wall, floor, or any object he could find. We had to stay home from work and physically block him from rubbing his face as often as we could throughout the day, which is a fantastic excuse to try to explain to your boss. Since then, my wife has come up with a brilliant solution: She takes a sheet of paper and writes down every number from 100 to 0. Sam isn't allowed to wipe the ointment off his face until it ends. Countdowns are a lifesaver for us; Sam can focus on the progression, where otherwise he thinks that unpleasant things will never end.