The Trichotillomania Learning Center’s (TLC’s) National Conference is the only conference of its kind in the world. An annual event that focuses on Body-Focused Repetitive Behaviors (BFRBs), the event is a must for anyone suffering from compulsive hair pulling disorder, compulsive skin picking disorder, and other related BFRBs.
To some extent, occasionally picking the skin is an action that is performed almost universally by humans. We all will occasionally pick a bit of dry skin off or pick at a new pimple. However, it is when these actions become serious, repetitive, and compulsive (especially on “perceived” imperfections) that skin picking becomes a disorder.
It is this difference between “picking the skin” and “compulsive skin picking” that Annette Pasternak covers early on in her new book “Skin Picking: The Freedom to Finally Stop”. She lays down the ground rules for what dermatillomania is, why people do it, and why it is so hard to stop doing.
Right off the bat, it is apparent that “Skin Picking: The Freedom to Finally Stop” is different than many other dermatillomania resources out there. In a high-emotion industry saturated with scams and false claims, Annette Pasternak’s writing rings of the truth.
A picture is worth a thousand words, right? This infographic concisely explains Dermatillomania.
Dermatillomania’s name explains the condition, which is compulsive picking of the skin despite causing physical damage. People who pick at their skin experience skin damage as well as psychological and emotional distress. What makes the condition a disorder is the amount of time someone spends doing it, usually impairing their ability to go to school, work, or socialize. Additionally, people with skin picking disorder devote much time and expense, covering up the damage.
While not very common, skin picking disorder affects 1-6% of the population and usually begins in early adolescence. Although it lasts a lifetime, picking behaviors are often episodic and correlate with stress, anxiety, or depression. However, every person is different, which is why thorough assessment by a qualified professional helps determine the best course of treatment. Therapeutic interventions include cognitive-behavioral therapies like habit reversal training and acceptance and commitment therapy. Successful recovery is possible and usually consists of a healthy lifestyle, therapy, and social support.
Recently I got an email from ocdla (the OCD center of Los Angeles), as I’m subscribed to their newsletter. I was surprised, but more than that happy, to read in that letter that Compulsive Skin Picking was added to the DSM-5 last May (more precisely May 18 2013). I was caught a bit off guard, since I haven’t been on top of the news lately…
We recently had a Skype interview with Jon Hershfield (MFT) – an experienced therapist who specializes in Cognitive Behavioral Therapy (CBT) for OCD and related disorders.
Needless to say we talked mainly about Dermatillomania. We covered topics such as classification of Dermatillomania (OCD, addiction, bad habits) and various treatment methods used to deal with compulsive skin picking (CBT, habit reversal, mindfulness).
In addition, we discussed the Internet as a potential tool for counseling. In this regard we talked about teletherapy (or what we call here at SkinPick– remote coulseling), and about Jon’s involvement in online forums for OCD.
Click this link for the full interview with Jon Hershfield .
Liz Atkin, a visual artist from the UK, contacted us a few days ago. She told us about her new exhibition, at the center of which is her experience with the skin picking disorder.
There's a short but rather interesting interview with Liz that took place a few days ago on the Woman's Hour radio show on BBC Radio 4. She talks about the way her art is influenced by compulsive picking, and on the other hand, how her art helps her to deal with the disorder. You can listen to the 8 min interview here
If you happen to be in the London area, you might be interested in visiting Liz's exhibition, which takes place at the Bethlem Gallery until the 15th of March. More details about the exhibition can be found on this Bethlem Blog Post.
Question: I've heard that hypnosis can be quite useful for controlling picking. I don't know much about it but would like to learn more. Can you suggest some information on the real science so I can go beyond the cliches like swinging watches and people clucking like chickens?
Answer: Even many otherwise well-trained mental health practitioners know very little about the research and practice of hypnosis. There is an excellent review article from SCIENTIFIC AMERICAN which I give to new patients. This is a great place to start. You can read it at: http://grossbart.com/sciam-1.pdf
I stumbled upon a new documentary in progress, called "Trichster", by director Jillian Corsie. It focuses mainly on Trich, and a bit on dermatillomania, judging by the trailer:
Towards the end of the production, the crew, together with 7 of the subjects of the film, are planning to attend the Trichotillomania Learning Center Conference in New York. You can help them attain this plan by donating here. Planned release date is spring 2014.
To those of you who are not familiar with "Scars of Shame" - this is a documentary on skin picking by Lisa Heyden. This film is about a 24 year old Angie (Angela Hartlin) who suffers from skin picking.
After a long hiatus due to funding difficulties, production is now back on track, with the film being in last editing stages. Angie tells me that the expected release date is March 2013, which is great news.
Believe it or not, Skin Picking is still not considered as an "official" disorder. The DSM (Diagnostic and Statistical Manual of Mental Disorders), is the “bible” of mental health professionals. It is published by the American Psychiatric Association, and is used to classify and diagnose mental disorders. Yet the Skin Picking disorder is not listed in the current version of the manual (DSM-4).
The good news are that a new version, DSM-5, which is going to be published in 2013, might include Skin Picking as a disorder. The draft of DSM-5 lists skin picking under “Obsessive-Compulsive and Related Disorders”. However, there’s still risk that it will be removed in the final version.
The draft of DSM-5 is opened for public comments until June 15th 2012. In order to make sure Skin Picking disorder makes it to the final version of the manual, you can do the following: