When you are an active participant in the body-focussed repetitive behaviors (BFRB) community, it seems incredible to think that there is lack of awareness of these conditions. Yet research shows that there are still many undiagnosed cases of compulsive skin picking and hair pulling disorders, among others. This is largely due to the shame and stigma surrounding the behaviors, but also due to the lack of awareness of the fact that these are clinically recognized psychological disorders and that it is NOT an indication of weakness or failure on the part of the individual sufferer. Sure there are many who engage in similar behaviors only habitually, but there comes a point where a habit evolves into something which impacts negatively on the person’s functioning and they find it hard to stop despite this. When this happens compulsive skin picking cannot be considered just a bad habit.
Artist and advocate for body-focussed repetitive behaviors (BFRBs), Liz Atkin is no stranger to the skinpick.com blog. We first introduced Liz last year when we outlined the highlights of her interview with BBC radio’s Felicity Finch, and then again in July this year when we shared a video of her speaking to an audience about her experiences with compulsive skin picking as part of the Critical Voices Campaign.
Through her efforts to raise awareness about dermatillomania and other BFRBs through visual art, Liz has become a spokesperson for dermatillomania sufferers everywhere. Her most recent contribution to the campaign to educate others about the condition and foster a better understanding of those suffering with compulsive skin picking, was to display her art at the David Geffen School of Medicine, followed by a talk with students explaining how she uses art to battle dematillomania.
People who compulsively pick their skin suffer varying degrees of severity of the behaviour. For some it may entail light scratching or popping of pimples, while others pick at their skin until it bleeds. Continuous picking over time inevitably leads to skin damage and causes the individual great shame and embarrassment. Many skin pickers suffer with this condition in silence for fear of being harshly judged. This is often not an incorrect assumption as the lack of awareness of this condition often leads to it being misunderstood. Friends and family of skin pickers struggle to understand the reason someone is not able to stop picking at their own skin and cause such visible damage. Some even think of skin picking as an attention-seeking behaviour, while many also perceive it as a form of self-harm.
BFRBs, or body-focussed repetitive behaviors is an umbrella term for impulsive pathological grooming behaviours including hair pulling and skin picking. Although its cause is unknown,
“research indicates that BFRBs are neuro-biological disorders and that genetics may play a role in their development.”
Since most people afflicted with a BFRB can hide the symptoms of their disorder from others, many people are unaware of even close family and friends who suffer from this condition. The severe psychological impact of BFRBs can lead to feelings of isolation, shame and loss of control.
The Trichotillomania Learning Centre (TLC), a non-profit organization dedicated to those suffering from BFRBs, launched BFRB week on October 1st to help raise awareness amongst the global population about this disorder which affects thousands of people worldwide.
On a recently released you-tube video, a member of the board of the Trichotillomania Learning Center (TLC), Dana Flores, shared some tools she uses to curb her skin picking, a disorder she has suffered from since the age of twelve or thirteen. Although she is not completely cured of her habit, the tools she employs have gone a long way in helping her to drastically cut down on the number of hours she spends picking every day.
He goes under the blog name Bleachnjam. He’s not a doctor or a therapist or indeed any type of professional that assists with Body Focused Repetitive Behaviours (BFRB’s), but those who suffer with the disorders are the experts when it comes to understanding how to respond to someone who picks. There are a huge number of people worldwide who are silently suffering from BFRB disorders and who desperately need to be understood. After over twenty years of suffering from dermatillomania, a condition which causes the sufferer to pick at the skin from anywhere on their body, he started an online journal to help raise awareness on skin picking. He found that Cognitive Behavioural Therapy (CBT), where sufferers are encouraged to focus on their thoughts, behaviours and feelings, was the most effective form of therapy to help him deal with his disorder. In a recent blog post, he addresses the family, friends and colleagues who don't know how to respond when seeing the person picking and gives advice on how to react when they see someone picking.
Excoriation disorder can be an overhwelming emotional burden on the individual struggling with the disorder. It is not only the shame and ebarrassment caused by the effects of continuous picking on the skin, but also the guilt around the act of picking itself. People with excoriation disorder often report feeling extreme negative emotions such as anger, sadness, fear even disgust following a session of picking. In addition one of the indicators of a diagnosis of excoriation disorder is that there is an impact on the person's daily functioning. This may be due to not engaging in meaningful occupations to avoid embarrassment of people seeing picked areas, or social isolation due the huge knock to the person's self confidence and feelings of self worth.
image: Vitalgate Health
There are many alternative therapies recommended for a variety of conditions. And while these 'new' treatments do not have enough empirical evidence supporting their use with disorders like compulsive skin picking, there are those who have tried various therapies and have reported positive outcomes. Biofeedback is one such treatment. Biofeedback involves using methods that assist the patient to learn to change and control physiological processes and responses of the body such as heart rate and muscle tension, to physical stimuli.
When I stop picking I will...
People struggling with BFRBS such as as skin picking disorder often experience intense guilt and shame around their behavior and the resulting damage it causes the skin. This can have a detrimental impact on their self esteem and impact negatively on their social functioning, often avoiding enjoyable social situations for fear of being harshly judged. A common phrase used by people with skin picking disorder is "When I stop picking...". However a regular blogger over at Diary of a Skin Picker recently published a post stating that you shouldn't wait:
Don’t put off today’s happiness, for some imagined happiness tomorrow.
Author: David Florendale
Publisher: CreateSpace Independent Publishing Platform (March, 2014)
Where to buy? Here
You may already be familiar with this book from as one authored by Skinpick.com's very own David Florendale. This insightful book provides indepth information about compulsive skin picking disorder. It takes you through identification of symptoms and variations of the disorder, possible causes and triggers, and highlights some of the effective treatment methods available. This is an important read for anyone wanting to learn more about skin picking as a clinical disorder.