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. Excoriation Disorder is a serious and poorly understood problem. People who suffer from SPD repetitively touch, rub, scratch, pick at, or dig into their skin, often in an attempt to remove small irregularities or perceived imperfections. Skin picking and other BFRBs can occur when a person experiences feelings such as anxiety, fear, excitement or boredom, and this repetitive behavior can negatively impact a person's social, work, and family relationships.
Compulsive skin picking can be defined simply. It is the uncontrollable picking, touching, rubbing, or scratching of the skin. It is often done in an attempt to remove small, often perceived, imperfections and irregularities. Among the many symptoms of skin picking disorder are discoloration and scarring. In the most serious of cases, severe tissue damage and visible disfigurement are common. Along with the physical symptoms of the disorder come a host of mental and emotional symptoms. Feelings of shame, embarrassment, alienation, and depression often plague those with compulsive skin picking. A feeling of helplessness from not being able to stop or discuss your problem can further contribute to an overall feeling of despair.
This will come as no surprise to skin pickers, but research indicates that there is a connection between mind and skin. Our skin is the largest organ of the body is designed to protect us from the outside world, regulate what is happening on the inside such as body temperature, and provides us with a complex communication network both inside and outside our bodies. Through the skin we are able to integrate environmental cues and transmit intrinsic conditions to the outside world. Research has shown that stimuli received in the skin can influence the immune, endocrine, and nervous systems at both the local and central levels. It is through recognition of these research findings that a new discipline called psychodermatology has emerged. Dermatologists are recognizing that protecting the skin from aging and disease is a two-fold process that involves addressing both internal and external factors. Some of the frequently treated conditions are include trichotillomania and excoriation disorder.
Accomplished short-story writer, Sarah Elizabeth Schantz from Boulder, Colorado, has published her debut novel called Fig. It is a story about the love and sacrifice of a young girl named Fig, who has to deal with a mother who has schizophrenia, as well as her own struggle with mental illness, including Compulsive Skin Picking Disorder. I had the priviledge of having an interview with the author.
Prior to Fig, your debut novel, you were already an accomplished short story writer. Many of your stories like “First Snow” and “News Item” centers around the complexities of the relationship between parent and child. What is it that draws you to these themes?
Last month we were contacted by one of our readers, Crystal Rutherford, a Compulsive Skin Picker of 18 years. Crystal was seeking permission to use skinpick.com on an awareness t-shirt she wanted to create for herself. Crystal also wanted to reach out to you, our readers, to share her story and let you know that you are not alone.
Hi, My name is Crystal Rutherford. I am a CSP sufferer, just like you. I have been suffering with this disorder since the age of 12, and being that I am 30...well that leaves me with 18 years of experience. My picking began with my mother. She used to do it to me all the time, and I guess I picked up where she left off.
I have TERRIBLE scarring, and open wounds that needed and still need medical treatment, as the doctors are worried I might contract Sepsis. I will normally pick anywhere from 3-6 hours a day, with tweezers, nail clippers, whatever I can get my hands on. I have tried wearing gloves around the house, or fidget tools, but the gloves come off, and the tools go down, until I am finished. At the time of picking, I feel like it soothes me, relieves any and all anxiety I have. Those who suffer with CSP or Dermatillomania will completely understand what I mean. Its a euphoric experience, and even though its a painful process, that’s not what is focused on, during a “session” or “episode” as I refer to them.
Scars of Shame is the first documentary featuring dermatillomania. The documentary depicts BFRB awareness advocate Angela Hartlin years back, as a brave and passionate person. Regardless of what she is going through she still wants to educate people by choosing to share her journey of living in shame for so many years. Even just watching a clip from the documentary, it becomes clear how people treat 'different', differently, and how even though she was living with dermatillomania she was depressed manly because the reactions from others led her to feel less worthy.
Angela explains that she does not do this out of choice. Its a mental disorder that she struggles to control. Even though she is fully aware of what she is doing and that her behaviour is harming her body she is unable to control it and her “Impulses take over”. Over the years it became more and more challenging, with the skin icking escalating. Angela felt alone. We all need a liitle help sometimes. She was suffering from anxiety and depression and could not control her impulses. She explained as “nothing else mattered" she just needed to pick her skin.
Dermatillomania, commonly known as Skin Picking Disorder (SPD), is classified as a Body-Focused Repetitive Behaviour (BFRB). It is a serious disorder where a person is plagued with the urge to pick at skin on the legs, arms, chests or anywhere on the body including the face. This condition can go unnoticed for years as pickers often choose spots that can be hidden under clothing. Symptoms of dermatillomania include repetitive rubbing, touching, pulling, scratching, picking or even digging of the skin. For some it starts with the urge to remove irregularities or perceived imperfections in the skin. For others it is an obsessive compulsion driven by boredom, stress, excitement or anxiety. Patients have described the effect of pulling as not painful in itself, but as satisfying or even pleasurable.
Body – focused repetitive behaviours (BFRBs) such as chronic hair pulling, skin picking and nail biting were in essence always thought to be ‘nervous habits.’ Current research on the subject, however, confirms that those suffering from such behaviours only “engage in these behaviours when under stress or when they feel bored or frustrated.” Researchers from the University of Montreal, Canada, conducted a study on 48 individuals, half of whom were suffering from body-focused repetitive behaviours. Each participant was exposed to four different experimental situations designed to elicit one of 4 emotions: stress, relaxation, frustration or boredom. During the frustration and boredom experiments, those suffering from skin picking and other related disorders, felt a stronger desire to engage in such behaviours. Seemingly, these behaviours satisfy some sort of an urge where individuals feel they have no control over a situation, and grant a type of reward to sufferers. On the other hand, participants experiencing a situation designed to induce relaxation such as listening to waves breaking in the ocean were unlikely to indulge in such behaviours. The urge to pick their skin or bite their nails was practically non-existent when participants were calm and relaxed.
People that suffer from dermatillomina or Skin Picking Disorder (SPD) exhibit symptoms that include repetitive touching, rubbing, scratching, picking at and digging into their skin. Some people do this to remove irregularities or perceived imperfections while others do it obsessively for other reasons. The behaviours associated with dermatillomania often result in the discolouration of skin and eventual scarring. Severe tissue damage can even occur in the most serious of cases. Dermatillomania is often referred to as a Body Focused Repetitive Behaviour (BFRB). These are disorders in which the person’s behaviour has the potential to harm or damage their body and physical appearance. In this way, skin picking disorder is very similar to hair pulling disorder (Trichotillomania). BFRBs occur for a variety of reasons. They often correlate with feelings of anxiety, excitement, and boredom. Some people even find that repeatedly picking their skin is pleasurable.
In this clip we see an excoriation disorder sufferer, Angela Hartlin, who has come to terms with the effect that her condition is having on her body. While she has sought assistance form a doctor, she has unfortunately been met with an assumption that she could just simply stop picking by being told to do so. It is sad to see that her doctor was not able to correctly treat her or able to refer her to a therapist that could more effectively treat and assist her and the condition that she has.