Once examined closely, the relation between CSP and OCD becomes clearer. People suffering from CSP (compulsive skin picking) know, even as they are doing it, that they are doing something that is certain to be painful and self-defeating. One very tragic and equally confusing aspect of compulsive skin picking is that the subject finds comfort, pleasure, or emotional release in the very act of causing him- or herself pain. While knowing that the behavior is one that really needs to be stopped or avoided, the subject continues the behavior nevertheless. The subject often understands that his or her obsessive picking is something to hide, that it’s not what other people normally do.
The shame generated by the behavior only exacerbates the underlying emotional turmoil that leads to the behavior in the first place. The vicious cycle of self-destructive behavior that follows is a hallmark of the OCD skin picking syndrome that is often a symptom of more insidious psychological trauma. The psychological trauma may be a sign itself of physical violence or emotional abuse occurring in the subject’s past or present life.
Obsessive-compulsive behaviors may be a way of shielding oneself against the pain being inflicted by an outside party. The reason for the compulsive picking may be to control pain coming from outside. In this light, the subject places him- or herself in control of the pain. It may be the only avenue of control the subject feels is available. By personally causing the pain itself, the subject takes away or diminishes the extent of the pain that can be inflicted by an outside party. The threat from an outside source may be real but can also be exaggerated or imagined by a mind troubled with some undiagnosed illness that causes chemical imbalances in the brain.
The neurotransmitter serotonin is often cited as a factor in OCDs as well as in depression, insomnia, anxiety, and a host of other very disturbing but very real medical conditions. One of the mysteries of OCD behaviors is that some people resort to them in times of accelerated stress or emotional agitation. For these people, the obsessive picking seems to serve as an actively deployed mechanism used to focus on the issue causing the current situation or to avoid confronting it instead. Still other people report being unaware of their compulsive picking. Picking is done with an almost mindless disconnection from the physical activity. In many cases, it takes a companion to call attention to the fact that the picker is engaging in the behavior while the picker is actually quite relaxed and focused on other seemingly pleasant activities, such as reading or watching TV.
As the medical community becomes more aware of the intricate relation between CSP and OCD, the wealth of knowledge on the subject increases accordingly. At this point in time, however, many physicians don’t ask, so many patients don’t tell, about their skin picking issues. As a result, a sad number of serious medical and psychological conditions are being overlooked.
For more information about skin picking, its relation to OCD and other similar disorders, get the Complete Guide to Picking Disorders today.