It is estimated that about 3% of the population has a body focussed repetitive behavior (BFRB). Body Focused Repetitive Behaviour “is an umbrella term for any chronic behavior that causes a person to consistently cause physical damage to oneself unintentionally through a compulsive act in order to relieve anxiety.” The key difference between BFRB and other compulsive behaviours that cause harm to the body is that BFRBs are characterised by direct body-to-body contact. It is collectively grouped among Obsessive Compulsive and Related Disorders in the Diagnostic and Statistical Manual 5 (DSM5). These behaviours can manifest in a variety of ways, with the overarching similarity between the different disorders being the regulatory effect experienced by the person engaging in this behaviour, on overwhelming emotions or cognitive thought patterns such as stress or anxiety. There a number of different BFRBs, namely:
It is one of the hardest things to be a parent with a child with an illness. As parents we want to protect our children from harm and shield them from all the pain in the world. So when your child is sufferring, it can cause so much emotional anguish as you feel like you have failed them and like you have lost control over your ability to protect them. We tend to see our roles as parents reflected in the image of a mum kissing her child's hurt knee after having put a plaster on, or the dad hugging his daughter after she had fallen off her bike. But the reality is that there are some hurts that cannot be fixed with a simple bandage or a hug. Sometimes the battles our children face are are far deeper and far more challenging to overcome. In particular when these battles are related to mental health.
We have featured videos by Dr. Tammy Fletcher from her Youtube channel Talk Therapy Channel. Dr. Fletcher has a PhD in Cognitive Studies, two Masters degrees, has published two award-winning books. A licenced marriage and family therapist Dr. Fletcher is also passionate about raising awareness and providing treatment to people sufferring from body-focused repetitive behaviors (BFRBs) and has therefore produced numerous videos on BFRBs such as compulsive skin picking and trichotillomania over the years. Her videos are always very informative. In this video Dr Fletcher shares what the therapeutic technique of Tapping is and demonstrates a sample session for people with dermatillomania. In this post we want to explore this topic more deeply, giving you a more detailed break down of what Tapping is and the sciencific theory is behind the technique.
While it can be easy to confuse the two based solely on physical appearance, there are several key differences when considering the conditions of nodular prurigo and dermatillomania. Both can be very painful, even debilitating conditions, but it's important to note the similarities as well as differences between the two, as a misdiagnosis could waste precious time and money, as well as prolong unnecessary pain. As a result, in this post we're going to look at a description of both conditions, as well as applicable symptoms and possible treatments and outline some of the basic similarities and differences between the two conditions. First let's start off with nodular prurigo and check out what some of the clinical features of that condition are.
A recent study suggests that the use of n-acetylcysteine has had a remarkable effect in treating excoriation or compulsive skin picking disorder. At the study’s end point, of the 53 participants who completed the study, 47% receiving N-acetylcysteine were much or very much improved compared 19% receiving a placebo The n-acetylcysteine showed no side effects and seemed to be well tolerated and effective.
Skin picking may start with something mild and harmless but if not treated early it can escalate into a serious clinical condition. When it starts affecting a person’s physical health and/or emotional well-being, it means professional help is needed. There are many therapies and medications that can be used depending on the patient’s condition.
One of the methods we employ in out online therapy program is Mindfulness-based therapy. Many times people try to control discomfort coming from unwanted feelings, thoughts and urges. As a result they start picking their skin to eliminate the discomfort. Mindfulness-Based CBT (Cognitive Based Therapy) helps the patient understand how he can non-judgmentally accept psychological experiences that are uncomfortable. The patient realizes that he can experience uncomfortable thoughts without harming his skin. There are many exercises that have been linked to mindfulness such as yoga and meditation.
Until recently, there hasn't been a treatment for body focused repetitive behaviors (BFRBs), such as compulsive skin picking disorder. Dermatillomania, aka excoriation disorder, is the picking of one's skin repeatedly, which leads to damage. The face is the primary area where the skin picking occurs, but skin picking can happen at any part of the body. People with this disorder may pick at normal skin variations, such as moles and freckles, where there are pre-existing blemishes, sores, or scabs. These people with this disorder would use their teeth, fingernails, pins, tweezers, or other devices. And as a result, bruising, bleeding, infections, or permanent damage would occur.
Human behavior is complicated. Why people do certain things is often unclear. People engage in certain behaviors that may be detrimental to themselves in some way. One such known problem is that of skin picking. Picking at skin is a isn't neccesarily an abnormal behavior. Many people will idly pick at their skin now and then. However, this issue can cause problems for people when it becomes a compulsion they cannot resist even if it is harming their skin. A person may have a compulsion to pick at their skin in a way that can cause all kinds of pain, impede healing and leave serious and disfiguring scars. People can pick at their skin even when it means picking at an existing scar that has already healed over. This kind of disorder known as a body focused repetitive disorder or, more specifically, an excoriation disorder that has a specific meaning. In our present society, research and knowledge about body focused repetitive behaviors such as excoriation disorder has only recently advanced. Much work has been done so far to help determine the source of the problem and assist those suffering from it to avoid such injurious behavior that may cause serious harm.
Tanya Silva, suffered for years from Dermatillomania after she was diagnosed with an eating disorder. However once she overcame her Binge Eating, she was left with the skin picking. She has overcome her compulsive behaviours by healing her mind and shifting her thoughts, “your thoughts trigger your emotions and your emotions are what drive your behaviours”. If she can overcome two addictive behaviours, she believes that you can too. Her YouTube channel is for those who want to look, feel and be the best version of themselves.
One of the most effective CBT developments for the treatment of Excoriation Disorder is Mindfulness Based Cognitive Behavioral Therapy. The primary goal is to learn to non-judgmentally accept uncomfortable psychological experiences. From a mindfulness perspective, much of our psychological distress is the result of trying to control and eliminate the discomfort of unwanted thoughts, feelings, sensations, and urges. In other words, our discomfort is not the problem - our attempt to control and eliminate our discomfort is the problem. For those with Excoriation Disorder, the ultimate goal of mindfulness is to develop the ability to more willingly experience their uncomfortable thoughts, feelings, sensations, and urges, without picking their skin. Mindfulness is not necessarily only accessed through therapy though. There are many resources that encourages and helps people to practice mindfulness in their daily lives as it can be beneficial even for those who do not suffer from a mental illness. We round up some of the resources we could find on the web.