I can still smell the scent of my best friend’s freshly painted nails. She was using a new polish in hopes of finding a way to stop biting her nails, which, at this point, were bleeding and damaged from years of biting and picking. She tried her best to break this “bad habit,” but it seemed she always went back to biting. We did not know then, but she was struggling with Body-Focused Repetitive Behaviors (BFRBs). Nail biting, skin picking, nose picking, and hair picking can all be categorized as BFRBs.
Most people mistake Body-Focused Repetitive Behaviors for “bad habits”, but according to the DSM-5, BFRBs are categorized under Obsessive Compulsive and other related disorders. Trichotillomania (hair pulling) is a disorder defined as “recurrent pulling out one’s hair, resulting in hair loss”. This can be done with any hair on the body, but most frequently, it is hair on the scalp, eyebrows or eyelashes. Sometimes, hair pulling can lead to bald spots. Skin excoriation disorder is “recurrent skin-picking resulting in skin lesions”. This can lead to scarring, skin damage or infection.
Suffering from BFRBs can be isolating and damaging to self-esteem. Sometimes leading to difficulty with leaving the home, going to work, or socializing with others.
So, the question is, what can be done?
For therapists, it involves gaining knowledge of the disorders, completing evaluations, and understanding treatment interventions.
For clients, the most important thing is to gain an understanding that BFRBs are a disorder, not just a bad habit. Reducing the stigma and having compassion toward yourself and others who are struggling with these disorders helps to decrease shame.
If you are a parent of someone with BFRBs, try not to blame or judge yourself. Continue to show your child love, support, and empathy instead of criticism. Education is important. Educate yourself and others in your family system on the different disorders of BFRBs. Explaining to family and friends your child’s appearance, behaviors, and the reason behind the repetition can help with understanding and lead to acceptance. Seeking therapy and utilizing resources available can help to decrease the symptoms of BFRBs.
Here are some helpful resources to check out for more information:
TLC Foundation for Body-Focused Repetitive Behaviors
Applications: CalmHarm, TrichStop, SkinPick
Utilization of fidgets: Therapyshoppe.com, Fivebelow.com
Taryn Colarusso, MSW, sees clients out of Centennial Counseling Center’s Yorkville office.
