This video is from Bethany, a British woman who vlogs as "Freedom, Birdie!" about vegan living and her lifelong struggle with dermatillomania. Also known as "skin picking" or "excoriation disorder" it's a body-focused repetitive behavior classified in the Diagnostic and Statistical Manual (DSM) as related to Obsessive Compulsive Disorder. Patients are unable to resist picking at skin imperfections in an attempt to correct them and often end up causing themselves scarring and damage. Like all body-focused repetitive behaviors it is an impulse disorder - the person is unable to prevent themselves from doing it and may not even be consciously aware of the behavior.
In this video, Bethany talks about having a relapse after being able to keep herself from picking for 180 days - and how she has no clue why she relapsed at this point.
"I've been seduced by the feeling I get, the pay off I get when I pick at my skin."
Every person develops their own technique for handling the stress and tension that comes with daily life, but for up to 5.4% of the population, the most their response can cause permanent skin damage or disfigurement. These are people suffering from a disorder known as dermatillomania, which is also known as excoriation or simply compulsive skin-picking disorder.
In the most simplistic of terms, this is a repetitive behavior that forces sufferers to focus on certain parts of their body due to an extreme urge to pick and pull at real or imagined marks. They may pick at moles, acne and freckles, or they may pick at perceived spots or marks that others cannot see. While most sufferers pick at their face or neck, the fingers and other parts of the body are often impacted as well.
On the 10th September we celebrated World Suicide Prevention Day. Founded in 2003 by the World Health Organization (WHO) and the International Association for Suicide Prevention, this day highlights the fact that every year more than 800,000 people commit suicide, and millions of others make a suicide attempt. It is vital to understand the causes behind suicide, and talk about it openly, because caring, open communication and social connectedness play a big role in helping to prevent suicide. Suicide of a friend or loved one can be devastating to those who are left behind as well. With that goal in mind, this article will address BFRBs (Body Focused Repetitive Behaviors) and suicide.
Though they are often largely ignored, mental health problems can be a major issue, both among children and adults. Mental health problems can be debilitating, which is why they should be given more attention than they currently receive. Educators in schools should make the mental health of their students a priority. One out of five children and youth have some sort of diagnosable mental health disorder or emotional/behavioral issue, and one out of every ten young people have a severe mental health issue that can be debilitating enough that it interferes with their functioning in school and at home, as well as out in the community. Even though mental illness is so ubiquitous among these young people, somewhere between 50 and 80 percent of them do not receive the help that they need, when it has been shown that support is key to managing a mental disorder.
Rachel L. Beitsch is an author and poet who hails from Israel. Her book Rain to Aifa has been well received, but she is also a regular performer at the Jeruselum Poetry Slam in Israel. A poetry slam is a competition at which poets read or recite original work. These performances are usually judged by selected members of the audience or by a panel of judges. In this performance Rachel's poem focuses on compulsive skin picking. It is a powerful performance that beautifully describes what it is like to have dermatillomania, while still managing to get the message across with a touch of sarcasm. You can follow updates on Rachel's works via her facebook page.
Dealing with a mental health issue like anxiety, depression or a body focused repetitive behaviors (BFRBs) such as compulsive skin picking is challenging and it is important not to go through it on your own. However, as opposed to physical conditions that are outwardly recognizable, mental health disorders are often hidden. We may appear to be smiling and doing okay, but there can be turmoil raging inside of us. Going through life with these issues alone can put undue burdens on ourselves. Our friends and loved ones can be our greatest allies in our time of need, but first, we need to be honest about ourselves and open up to them.
Here are 5 simple steps you can take to bring up your mental health issue with friends or family.
1. Set up a good time and place.
Dermatillomania is a clinical condition where the patient gets regular uncontrollable urges to pick his or her skin. The picking can sometimes be so severe that it causes injury and scarring and can even sometimes lead to infection. People with compulsive skin picking disorder are unable to control the compulsion to pick his or her skin. The parts of the body that are mostly affected are the lips and the face. However, the other parts of the body are often affected too, such as arms and legs, cuticles, scalp and even the gums. Picking is often followed by a sense of relief, but this often follows shortly after with feelings of shame and embarrassment.
For those struggling with compulsive skin picking, finding the right mental health professional to treat the issue can seem like a bewildering task. With so many different types of therapy available, you may find yourself confused as to which type of professional and which type of therapy you should be using to see genuine progress. Finding the right mental health professional will save you time and money, but it will also help you see real progress. Consider this information as you seek assistance.
A psychiatrist is a medical doctor who is trained to both diagnose and treat mental health issues. While a psychiatrist is not typically trained to provide counsel for patients, he or she can prescribe medication to you. There are also psychiatrists who specialize in treating children and adolescents. If your compulsive skin picking stems from a condition like anxiety or depression, a psychiatrist may determine that medication is the best course of action to curb the habit. Of course, many individuals still seek other forms of therapy while also seeing a psychiatrist.
Dermatillomania, or excoriation disorder is a complex disorder with no definitive cause for onset. If you investigate what triggered the of onset in a sample group of people who compulsively pick their skin, the conclusions will vary from modelling a family member to stress, neuro-imbalances to anxiety. One often overlooked possibility is the link with sensory processing. Sensory integration has been thought to be associated with body focused repetitive behaviors (BFRBs), whereby the act of picking the skin, pulling the hair or biting the nails provides a form of sensory input that either dampens an overstimulated brain or stimulates an understimulated one. The concept of sensory seeking behavior is not new. In 1972 occupational therapist Jean Ayres defined the term sensory integration as "the neurological process that organizes sensation from one's own body and from the environment and makes it possible to use the body effectively within the environment".
Here at skinpick.com we offer a therapist guided, online therapy program, based on CBT (Cognitive Behavioral Therapy). CBT has been consistently found to be the most effective form of therapy for the treatment of body-focused repetitive behaviors. It is the method of choice that is primarily used by expert therapists worldwide, who specialize in treating this disorder. There are many methods within this treatment framework that can be applied in isolation of each other or together as a holistic and comprehensive whole. Regardless of the primary method of CBT employed by your therapist, one fundamental principle of CBT is the developing of awareness by the patient of the behavior they are trying to change and the contexts in which they occur.