Body-focused repetitive behavior (BFRB) is an umbrella name for impulse control behaviors involving compulsively damaging one's physical appearance or causing physical injury. The main BFRB disorders are:
Trichotillomania, hair pulling
Trichophagia, hair nibbling
Trichotemnomania, hair cutting
Dermatillomania, skin picking
Dermatophagia, skin nibbling
Onychotillomania, nail picking
Onychophagia, nail biting
Morsicatio Buccarum, cheek biting
Morsicatio Labiorum, inner lip biting
Morsicatio Linguarum, tongue biting
TLC's Annual Conference on Body-Focused Repetitive Behaviors is the only event of its kind in the world. The world's top BFRB experts, community leaders and changemakers will guide nearly 500 of us -- individuals, families, and treatment providers -- through a weekend of education, inspiration, support, and most importantly, healing.
The TLC Conference will be held April 21-23, 2017. Sessions begin Friday afternoon, then break for dinner, and the opening welcome session begins Friday evening. The closing session ends at noon on Sunday.
Skin Picking is very common in the general population but has received limited research attention therefore the onset of the disorder still remains a mystery. It is viewed as a long term skin condition which is often associated with high levels of psychological distress. People who suffer from it repetitively touch, rub, scratch, pick at or dig into their skin. Repetitive skin picking appears to be a way for some people to increase their activity levels when they are bored, or to control their emotions when they are feeling anxious, tense, or upset. The fact that some individuals can actually regulate their emotions by picking their skin maybe why they develop this problem in the first place.
Therapy can help you handle emotions from problems or stressors, even if they aren't dramatically life-altering or traumatic. Therapy is well-known for its problem-solving techniques and reputation as a tool for overcoming anxiety, depression and addiction. This article summarizes the therapy process as it was formed and structured by Dr. Vinod throughout her work. It contains her personal impressions about online counseling for Dermatillomania, as well as client’s perspective.
In the process of decision making, two parts of us having opposite views surface in our conscious mind and get into a dialogue. One part of the pair could be a top dog (a dominant one) and another underdog (not quite sure of itself). If one part takes a back seat, then decision is made as per the wish of the dominant one. There occurs a temporary resolution. If both these parts fight with equal strength for dominance, then, no decision is made and the issue is kept pending…thus the issue is swallowed and is kept unresolved. Each decision making involves essentially some reward and some loss. So, we decide on the basis of us being comfortable with the losses in that package. If, one can see a gain in a temporary loss, one wins.
It is not uncommon for people to subconsciously rub, touch, or scratch at their skin, just as it is a common practice for many people to pick at skin imperfections such as acne or blackheads. However, for some, this practice becomes so consuming that it is classified as a skin picking disorder known as excoriation disorder or dermatillomania. Picking your skin becomes problematic when the picking is repetitive and it becomes difficult for the person to voluntarily stop engaging in the behaviour, and impacts negatively on daily functioning. This poorly understood problem often goes undiagnosed and therefore untreated.
Approximately 75% of people with this disorder are women. It occurs in less than two percent of the population. Skin-picking often begins during adolescence in response to acne or another skin condition. Most people will admit to popping a pimple or picking a scab once in awhile. So do we all have skin picking disorder? Well, no. People with this disorder have tried to stop or reduce their picking behavior, but without success. Moreover, like all mental disorders, skin-picking disorder limits a person's functioning. It may be time-consuming and interferes with a person's social, occupational, or educational activities.
Diagnosis of skin picking as a disorder is based on the criteria outlined in the Diagnostic and Statistical Manual 5 (DSM 5) as follows:
While body-focused repetitive behaviors (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. While we cannot change our genetic make-up, we certainly can influence our neurobiological processes and our hormone levels through diet. Could what we eat and drink therefore aggravate the urge to pick, or even place us at higher risk for developing a skin picking disorder in the first place?
The food we eat inevitably affects our overall health. However we often only attribute the effects of diet to our physical health and neglect to acknowledge the impact it can have on our psychological health as well. There has been an overwhelming influx of research over recent years that suggests poor quality diet increases one’s risk for common psychological disorders such as depression and even compulsive skin picking disorder, now named excoriation disorder.
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 severity of the condition.
Meditation is a practice where an individual trains the mind or induces a mode of consciousness, either to realize some benefit or for the mind to simply acknowledge its content without becoming identified with that content, or as an end in itself. Meditation exercises are closely linked to mindfulness and are recommended to help cope with stress related to skin picking. These exercises keep the mind and body healthy. They enable patients to keep busy and replace skin picking with something more positive. Exercise can reduce anxiety and depression. It minimizes skeletal muscle tension and increases metabolism of excess adrenaline and thyroxin in the blood. It even acts as an anti-depressant.
The severity of skin picking differs for everyone. For some it can be so severe that is causes severe scarring and sometimes even infection. This causes great distress for the individual and a question or concern that often comes up is - can skin picking lead to more serious skin conditions like cancer?
There are a lot of myths about compulsive skin picking, it is therefore important to discuss both the myths and facts about the disorder.
Excoriation is a disorder characterized by recurrent skin picking, resulting in skin lesions. Some people with the disorder say that picking at their skin makes them feel good, but everyone affected by the disorder do it intentionally, or consciously; some may not even remember doing it. Onset is most often around puberty.
The face is the most common target of skin picking, but other targets may be limbs, back, gums, lips, shoulders, scalp, stomach, chest, fingernails and toenails. A child may pick at one part of the body repeatedly, or “rotate” to allow the previously picked part to heal. Compulsive skin picking is one of a group of behaviors known as body focused repetitive behaviors (BFBRBs)
Compulsive skin picking is NOT an Obsessive-Compulsive Disorder (OCD), but is classified under the umbrella category OCD and Related disorders.
Trichotillomania, also known as Compulsive Hair Pulling Disorder, is characterized by the repetitive pulling out of one’s own hair leading to hair loss and functional impairment. The most common sites pulled include the scalp, eyebrows, and eyelashes; although any bodily site with hair can be affected. 2-3 pulling from multiple sites is common and pulling episodes can last from a few minutes to several hours. Also under the body focused repetitive behaviors (BFRB) is skin picking disorder, formerly referred to as Dermatillomania, but more recently renamed Excoriation disorder. It is characterized by the repetitive and compulsive picking of skin, leading to tissue damage. Although most individuals at some time pick at their skin, either to smooth out irregularities or to improve blemishes or acne, clinicians must differentiate between normal picking and more clinical forms. We know that both the disorders are under BFRB’s but is there evidence of comorbidity?
video by Annette from http://www.stopskinpickingcoach.com/
There are some unique challenges that come with travelling simply because you have to try and adapt to the new environment and also try and keep your daily routine that you’ve been doing on track. Preparation is there for key, make sure that you are both physically and mentally prepared so that you are sure that you can handle a different environment.
At home, you have all your bottles and brushes and jars and cloths and whatever else you need within easy reach. You can take care of your skin like you should, with some products for morning, others at night, and still others for midday refreshers. Everything works like it should, because you know how your skin acts at home. You know the climate and how your skin reacts to it, and when it needs a little more moisture or a serious oil-sopping mask. Your skin thrives with your TLC.
Here are a few tips for skin pickers who are planning to travel soon. Remember: These aren’t meant to be medical recommendations, but they’re tactics that have worked for others and might work for you, too.