Last month we shared a video about a technology product called Slightly Robot, a device that tracks your hands and vibrates each time you do certain movements. We think this is a great device for developing awareness, an important aspect of Habit Reversal Training (HRT) in Cognitive Behavioral Therapy (CBT). The founders and creators of Slightly robot, Matthew and Joseph Toles graciously took the time to answer some of our questions about Slightly Robot.
While body-focused repetitive behaviours (BFRBs) such as excoriation disorder are gaining increased awareness, our knowledge about the disorder is still in its infancy. For example, even though research has found evidence of some plausible causes for compulsive skin picking, there is still no known single definitive cause. Some evidence points to hormonal imbalances, some indicates the cause is neurobiological, while genetic correlation also holds merit. We may not be able to change our genetic make-up, but we certainly can influence our neurobiological processes and our hormone levels through diet. Could what we eat therefore aggravate the urge to pick, or even place us at higher risk for developing a skin picking disorder in the first place?
Methods of cognitive behavioral therapy such as Habit Reversal Training have shown to be effective in the treatment of body-focused repetitive behaviors (BFRBs) such as excoriation disorder and trichotillomania (compulsive hair pulling). Habit Reversal Training is a multicomponent behavioural treatment package originally developed to address a wide variety of repetitive behaviour disorders and has four main components: Awareness Training, development of a competing response, building motivation and generalisation of skills.
There are many different theories about the cause of excoriation disorder, and it may be possible that more than holds true as the theories are often supported by research. One such theory is that it is caused by sensory processing disorder (SPD), whereby the person is sensory seeking. In this instance the person may benefit from self-regulating or sensory tools as a more desirable alternative to skin picking. One such tool found to be effective as a competing response are fidget toys. These are self-regulating tools that can calm or enable individuals to focus. There are a variety of different fidget tools easily accessible online.
This video is from Bethany, a British woman who vlogs as "Freedom, Birdie!" about vegan living and her lifelong struggle with dermatillomania. Also known as "skin picking" or "excoriation disorder" it's a body-focused repetitive behavior classified in the Diagnostic and Statistical Manual (DSM) as related to Obsessive Compulsive Disorder. Patients are unable to resist picking at skin imperfections in an attempt to correct them and often end up causing themselves scarring and damage. Like all body-focused repetitive behaviors it is an impulse disorder - the person is unable to prevent themselves from doing it and may not even be consciously aware of the behavior.
In this video, Bethany talks about having a relapse after being able to keep herself from picking for 180 days - and how she has no clue why she relapsed at this point.
"I've been seduced by the feeling I get, the pay off I get when I pick at my skin."
Every person develops their own technique for handling the stress and tension that comes with daily life, but for up to 5.4% of the population, the most their response can cause permanent skin damage or disfigurement. These are people suffering from a disorder known as dermatillomania, which is also known as excoriation or simply compulsive skin-picking disorder.
In the most simplistic of terms, this is a repetitive behavior that forces sufferers to focus on certain parts of their body due to an extreme urge to pick and pull at real or imagined marks. They may pick at moles, acne and freckles, or they may pick at perceived spots or marks that others cannot see. While most sufferers pick at their face or neck, the fingers and other parts of the body are often impacted as well.
On the 10th September we celebrated World Suicide Prevention Day. Founded in 2003 by the World Health Organization (WHO) and the International Association for Suicide Prevention, this day highlights the fact that every year more than 800,000 people commit suicide, and millions of others make a suicide attempt. It is vital to understand the causes behind suicide, and talk about it openly, because caring, open communication and social connectedness play a big role in helping to prevent suicide. Suicide of a friend or loved one can be devastating to those who are left behind as well. With that goal in mind, this article will address BFRBs (Body Focused Repetitive Behaviors) and suicide.
Though they are often largely ignored, mental health problems can be a major issue, both among children and adults. Mental health problems can be debilitating, which is why they should be given more attention than they currently receive. Educators in schools should make the mental health of their students a priority. One out of five children and youth have some sort of diagnosable mental health disorder or emotional/behavioral issue, and one out of every ten young people have a severe mental health issue that can be debilitating enough that it interferes with their functioning in school and at home, as well as out in the community. Even though mental illness is so ubiquitous among these young people, somewhere between 50 and 80 percent of them do not receive the help that they need, when it has been shown that support is key to managing a mental disorder.
Rachel L. Beitsch is an author and poet who hails from Israel. Her book Rain to Aifa has been well received, but she is also a regular performer at the Jeruselum Poetry Slam in Israel. A poetry slam is a competition at which poets read or recite original work. These performances are usually judged by selected members of the audience or by a panel of judges. In this performance Rachel's poem focuses on compulsive skin picking. It is a powerful performance that beautifully describes what it is like to have dermatillomania, while still managing to get the message across with a touch of sarcasm. You can follow updates on Rachel's works via her facebook page.
Dealing with a mental health issue like anxiety, depression or a body focused repetitive behaviors (BFRBs) such as compulsive skin picking is challenging and it is important not to go through it on your own. However, as opposed to physical conditions that are outwardly recognizable, mental health disorders are often hidden. We may appear to be smiling and doing okay, but there can be turmoil raging inside of us. Going through life with these issues alone can put undue burdens on ourselves. Our friends and loved ones can be our greatest allies in our time of need, but first, we need to be honest about ourselves and open up to them.
Here are 5 simple steps you can take to bring up your mental health issue with friends or family.
1. Set up a good time and place.