Alicia Howard bounces her leg in a way that most people would call fidgeting. This repetitive movement is so innate that she often doesn’t notice she’s doing it. “People have always told me, ‘Stop shaking your leg! You’re stressing me out!’” Howard tells Health.
“That’s stimming,” Philip Fizur, PsyD, a clinical psychologist of behavioral medicine at Cooper University Health Care in New Jersey, tells Health. People who stim might appear as if they’re intentionally moving or making noises in nonsensical ways that don't serve an obvious purpose. But stimming does have a purpose; people stim to communicate, self-soothe, or even just because it’s enjoyable. Here's everything you need to know about this behavior, including why it's controversial right now.
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What is stimming?
Stimming is short for "self-stimulation," and it's referred to medically as a "stereotypic" behavior. Ian Davidson, lead psychiatrist for Adult Autism Spectrum Disorder Services at the Cheshire and Wirral Partnership in the United Kingdom, explains that almost all people engage in some self-stimulating behaviors. “Look around most waiting rooms or boring meetings," Dr. Davidson tells Health. "Many people are doodling, tapping fingers or pens, moving phones around.” These actions are usually described as fidgeting; the term stimming applies when the behavior is unconventional, intense, or repetitive.
Howard, a 39-year-old artist and mom, has anxiety, a panic disorder, ADHD, and an auditory-sensory disorder. She explains that leg bouncing and other "stims" are part of a coping strategy that offers relief and helps her function in overwhelming environments. Besides bouncing her leg, she relies on other self-stimulating behaviors, such as picking at her ears, flexing her hands, clapping, and occasionally beating her chest with a single fist like King Kong.
While stimming typically refers to repetitive movements, as Howard describes, it can also include staring at stimuli—such as lights—or making sounds like making noises or humming, says Dr. Davidson.
Stimming is commonly associated with autism, says Dr. Davidson. The DSM-5 even includes stimming as a diagnostic criteria for the disorder. When people with autism stim, they might do it in ways that are obvious and less socially accepted—like hand-flapping, rocking back and forth, or repeating sounds or phrases. Those with schizophrenia, obsessive compulsive disorder, or even post-traumatic stress disorder might engage in this behavior, too, adds Fizur.
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Why do people stim?
Stimming is a way to regulate stress and emotion. “All of these behaviors lead to sensory inputs but also release significant tension and energy, " says Dr. Davidson. "Stimming is ultimately a stress relieving mechanism like talking with friends, jogging, working out, or writing poetry. Emotional tension can come with happy and exciting feelings—not just negative ones—such as shouting and cheering at a house party or when a sports team wins.” Some people stim because it helps with sensory processing or aids in social communication.
What makes stimming so soothing or enjoyable?
It's not exactly clear why stimming feels good, but Fizur says that the behavior helps activate the many neurotransmitters—aka brain chemicals—that regulate our emotions. “Dopamine, serotonin, and glutamate are the big neurotransmitters associated with self-stimulatory behavior,” he explains.
Howard describes the relief she gets from stimming this way: “My body feels squirmy when I need to stim—like actual worms wiggling around just below the skin’s surface. Sometimes before that feeling comes, I get a sudden rush of dread or a feeling that the wind is knocked out of me.” Engaging the stim offers relief and pleasure, she says, and the pleasure she feels reinforces the behavior, creating a cycle.
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The controversy around stimming
People who stim used to be encouraged to unlearn the behavior, sometimes with the help of therapy and/or medication. These days, most clinicians have started to accept stimming and believe it doesn't need to be restricted if it isn't causing harm, says Fizur. “The side effects of medications that are used to control stimming [like SRIs and antipsychotics] can do more harm than good—so it’s best to address the issue with behavioral modifications if it even has to be addressed at all.”
Some people are taking this acceptance a step further and celebrating their stims, particularly on social media. On the other hand, the idea that stimming is a distraction and should be done in private or not at all still holds sway. It's a controversial issue, especially considering one study of autistic adults who told researchers they felt confused, angry, resentful, nervous, belittled, and ashamed when told to stop stimming.
The autistic people in the study also felt that neurotypical people often misunderstand stimming, which can lead to social challenges and an inability to function well, if stimming is their usual coping mechanism.
Howard says that her mom encouraged her to stand up for herself if people treated her coping strategies as if they weren’t valid or acceptable. But many people who stim learn to mask or camouflage this behavior. Although Dr. Davidson believes that modifying their actions might be the right choice in certain environments, it still doesn't address the root cause of the behavior.
“People who stim are communicating, and when you restrict stimming, you’ve removed an avenue for them to tell about their experiences," adds Fizur. "If they’re anxious, you’ve also eliminated a way they can cope with the stressor. What happens when people don’t have other options?”
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How to stim safely
If you're going to stim, make sure you aren't causing harm. “If it’s clear that the behavior is harmful, there will be bruises, scars, or raw areas on the body,” says Fizur. Get help if stimming leads to pain or injuries, so you can develop healthier coping strategies. Adds Howard: “I worked for years to rid myself of stims that bordered on self-harm—like digging my nails into my skin until I almost bled.”
When you stim in public, Fizur suggests carry a card that explains your behavior, communicates your needs, and reassures those around you that you’re safe. This card can include information that educates those who aren’t familiar with stimming. If you feel pressured to not stim in public, create an affirming space to practice stims at home and explain to your loved ones why these behaviors are important to your well-being.
Because stimming is a coping or communication skill, the behavior can help you learn more about what triggers your emotions or feelings of being overwhelmed. Finding community support can help you learn more about these triggers, while pro-stimming spaces on social media can help you feel less alone.
Ultimately, don’t let others shame you into changing harmless behaviors—but don’t feel ashamed if you’ve decided to mask your stimming in certain environments or want to modify or stop doing them. The choice should only be made by you.
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