Skin picking disorder can be a pervasive intrusion on a person's life. The constant struggle trying to resist the behavior can be exhausting, but it can also have devastating effects on the skin pickers emotional health. There is no uniform picture of what skin picking entails. Different people pick different parts of the body, in different ways and at different times. Some pick only with their fingers and nails, others use objects, such as tweezers or hairpins to prod and squeeze scabs, pimples, or even unblemished, healthy skin. There is also no set cause for the onset of skin picking, but there has been links found to other mental health conditions such as anxiety disorder and mood disorders such as depression and bipolar. However a correlation does not neccessarily equate to a cause and it may be that theses conditions only co-exist because they aggravate each other.
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Experts purport that skin picking may provide some sort of distraction from other overwhelming emotions and thoughts such as intense anxiety. Some people who pick their skin feel like all their problems disappear when they focus intensely on their appearance, scrutinising their face or arms or other areas of the skin. Such present-moment awareness, as unhealthy as it is, prevents the person from worrying about the future or dwelling on negative thoughts and anxieties. Many people who pick describe the experience as going into an almost relaxing, trance-like state, in which they are oblivious to everything but their bodies.
Conversely the after effects of severe skin picking is that the person experiences shame, guilt and even anger toward themselves. A person with dermatillomania will experience intense emotions as part of their compulsion. It's typical to experience an intense urge to pick the skin, with increasing tension until they do. After picking, there is a sense of relief, but this is quickly followed by negative emotions. It's common to try to deny the compulsion or cover up the skin with make-up for fear of being judged negatively by others. Scars that ineitably result from constant picking may lead to the person feeling unattractive and develop low self-esteem and in severe cases even self-hate.
Whether picking started because of negative emotions, or negative emotions are a result of the effects of skin picking, with time this cycle becomes harder and harder to break. The individual therefore spirals deeper into depressive episodes, anger, self-resentment, and unhappiness. It’s not uncommon for many to end up isolating themselves and avoiding socialising, as well as living in fear of being discovered as a ‘skin picker.’
But habits can be broken, and cycles can be redirected. Cognitive behavioral therapy (CBT), thought to be the most effective form of treatment for skin picking disorder, is based on the thought-feeling-behavior cycle. The core belief is that by altering one or more of these factors on is able to change the cycle of events. for example by replacing undesirable behaviors such as picking with more acceptable ones such as playing with a fidget toy, it may break the cycle of emotions that often follws a picking episode. By making positive changes in thoughts and interpretation of feelings as well, a greater directional change in the cycle is possible. The key is to recognize that change is possible and that there is hope.