Annette Pasternak, Ph.D. is the author of the book “Skin Picking: The Freedom to Finally Stop”. She has honored us with a guest post around her personal experience helping others overcome skin picking and the attitudes and qualities one needs in order to do so. If you would like to contact Annette, you can contact her through her website -www.stopskinpickingcoach.com.
Originally, I learned from being in treatment myself and also from personal discoveries that helped me become free of the continually destructive cycle of skin picking. In my last four years as the “Stop Skin Picking Coach,” I have learned more and have especially developed a clarity about which attitudes and personal qualities will set you up for success in this endeavor. Have them or develop them; here they are:
Excoriation disorder does not develop overnight. It starts as a habitual behavior and over time develops into a full blown disorder. Every habit has three components: a cue (or a trigger for an automatic behaviour to start), a routine (the behaviour itself) and a reward (which is how our brain learns to remember this pattern for the future).
Habit Reversal Training (HRT) is a form of Cognitive Behavioural Therapy (CBT) which says that in order to reverse a habit, the old cue and reward needs to be diagnosed, followed by changing the routine. Instead of fighting the urge to pick, HRT helps the individual understand what motivates the urge. HRT has four main components:
An individual is taught to be aware of their picking. Once an understanding of the picking behavior is gained, the individual is better equipped to gain self-control.
In recent years we have seen an increase in awareness about skin picking disorder among those who are challenged by it and those in the medical and psychiatric fields as well. This has largely been due to the efforts of advocacy groups such as the then named Trichotillomania Learning Centre (TLC), now named the TLC Foundation for Body-Focused Repetitive Behaviors (BFRBs). The Canadian BFRB Support Network, with one of the earliest and most vocal advocates, a skin picker herself, Angela Hartlin in their corner, have also been instrumental in advancing the knowledge and awareness of compulsive skin picking across the globe. This increase in awareness has led to increased interest among the research community, leading to further advances in our understanding of these conditions and improved treatment methods. The TLC Foundation for BFRBs also provide training to professionals with an interest in treating skin picking and hair pulling. The advent of the internet has meant that finding resources and information from the privacy and comfort of your own home is much easier and there are many other resources such as these available online.
Holly Stockport is a twenty-one year old from South Wales. She is a writer, blogger, YouTube star and sufferer of Dermatilomania. In her latest YouTube video, she lists the products that make her skin feel a little more comfortable while combating her skin picking. Holly’s main picking areas are her fingers, her face- mainly the chin area and her back.
Why do we pick our skin? Well the reasons vary for everyone. For some it is habitual i.e. not knowing when they are doing it while others consciously do it in response to stress or boredom. No matter what the reason is, it is important to find out what triggers the skin picking so that one can prevent or at least minimize the urge to do it. Being aware as to why you are doing it will help you address the root cause and treat it accordingly.
Many people report that picking is a response to feeling stressed as picking helps reduce that stress. The inability to stop engaging in this behavior despite wanting to is known as compulsive skin picking disorder or excoriation disorder. According to Anxiety UK, a national registered charity:
There are many conditions of the skin that can cause someone to excessively pick or scratch. This does not necessarily mean thy have exoriation or compulsive skin picking disorder. The Diagnostic and Statistical Manual (DSM) cleary defines the criteria required for diagnosis of excoriation disorder. These are:
There are many people on dermatillomania support forums who report to have ADHD, asking if the two disorders are related, and vice versa on ADHD forum. Attention deficit disorder with or without hyperactivity or ADHD, is a disorder typically diagnosed in childhood and is characterized by inattentiveness or hyperactive-impulsivity. Although diagnosis of ADD required the presence of symptoms before the age of 7, it is a disorder that extends into adult life. According to the Diagnostic and Statistical Manual (DSM) the criteria for the diagnosis of ADHD are: