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Dr. Tammy Fletcher is a Marriage and Family Therapist who is an expert in the treatment of body-focused repetitive behaviours (BFRBs) such as compulsive skin picking disorder or dermatillomania. She has a YouTube channel called Talk Therapy where she shares general information about various conditions and some of the strategies that can be used to manage these disorders. In this video she talks about the strategies that can be used for BFRBs such as dermatillomania.
The most effective therapy for BFRBs has been found to be cognitive behavioral therapy (CBT), and one of the methods used in CBT is to address the urge to pick the skin through the use of competing responses. Competing responses are actions, behaviours or movements you make in response to the urge to pick the skin that competes with the act of picking. For example, using your hands to play with a fidget toy means that your hands are occupied and therefore cannot pick. These competing responses often involve the use of external objects or tools which the person leaves in high picking trigger areas such as the television or in the bathroom. However, as Dr. Fletcher points out, not everyone’s trigger areas, where they most frequently experience the urge to pick, is in one specific spot or in a private space where they can leave these items lying around. For this she recommends creating what she refers to as a ‘BFRB first aid kit’. This is a small, portable kit that contains some of the tools you might need as a compulsive skin picker. She also offers some great ideas for strategies that can be used to make picking difficult and to help you clean up and care for spots where picking has occurred.