When you are an active participant in the body-focussed repetitive behaviors (BFRB) community, it seems incredible to think that there is lack of awareness of these conditions. Yet research shows that there are still many undiagnosed cases of compulsive skin picking and hair pulling disorders, among others. This is largely due to the shame and stigma surrounding the behaviors, but also due to the lack of awareness of the fact that these are clinically recognized psychological disorders and that it is NOT an indication of weakness or failure on the part of the individual sufferer. Sure there are many who engage in similar behaviors only habitually, but there comes a point where a habit evolves into something which impacts negatively on the person’s functioning and they find it hard to stop despite this. When this happens compulsive skin picking cannot be considered just a bad habit. The Diagnostic and Statistical Manual (DSM5) of the American Psychiatric Association (APA) diagnoses this as Excoriation Disorder and describes key clinical features of the disorder.
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As with any psychological disorder, people with excoriation disorder, or dermatillomania as it has been previously known, need realize that they are not alone and need support to overcome the challenges of living with the disorder. This is sometimes easier said than done, as a symptom characteristic of BFRBs such as skin picking disorder is the often intense overwhelming negative emotions such as:
These emotions often result in the individual isolating themselves from others for fear of revealing their secret behavior. Sometimes skin pickers do have people in their lives they can trust and confide in, who would support them through their struggle, but feel too ashamed to talk about it. Many sufferers also report withdrawing from social encounters because they feel embarrassed by the way their skin looks due to the constant picking, which lead social isolation, often further perpetuating the cycle of picking. It is therefore critical that if you are a skin picker, or know someone who compulsively picks their skin, that the person relaizes that they need not suffer in silence and that there are support options out there that they can access.
There are increasingly more support groups modelled on the same principles of the Alcoholics Anonymous support groups. These are groups started by people with the disorder or have experience of working with the disorder and have identified a gap in support options for those seeking to share their experienced with people who can relate and understand their struggles without judgement. There is a great benefit in sharing your struggles and triumphs with a group of people who have shared similar experiences. Organizations like the Trichotillomania Learning Centre (TLC) and the Canadian Body-Focussed Repetitive Behaviors Support Network (CBSN), are great sources of information if you want to find support groups in your area. If you can’t find a support group in your area and would like to start your own, there is a 3-part webinar series hosted by TLC that takes you through the process of starting a peer support group.
Not everyone is able to speak in front of others in general, let alone about their experiences with skin picking, and that’s okay. Physically attending a support group is also not always accessible to most people due to constraints such as lack of time or transport. This is where online peer support groups are a useful avenue to gain support, information, advice and encouragement. These types of groups are very similar in nature and purpose to the physical support groups, with the exception that attendees support each other virtually. As a group you log in to a virtual environment where they can discuss strategies and share experiences. This makes group times more accessible after hours and enables individuals to participate in the comfort of their homes. These groups can be via video conferencing or via a text-based platform such as facebook closed group. There is a list of these types of groups on the TLC website.
Email support groups, like online peer support groups offer a virtual support environment. However these groups do not communicate in real time. These groups are generally moderated by an organization such as TLC or an individual who is an expert in the field and would like to help others by sharing their expertise. It operates as a closed group and you join by being added to the mailing list. Via this platform you can send questions and you will receive answers to the questions of others as well as information and advice.
For those who are not yet ready to share openly, forums and blogs are a great place to seek support anonymously. On websites like ours you will often find forums where users can post questions, share their experiences or simply read through the posts shared by others. It is often via these forums that people first realise that they are not alone and find comfort in the stories of others. There are also many brave souls who share their deepest inner most experiences with skin picking disorders on their personal blogs and youtube channels. The comment forms on their posts often become a form of impromptu peer support network. If you follow skin pick.com social media channels, we often post links to some of the powerful posts by other bloggers.
Last, but certainly not least is the support of family and friends. Most people find opening up to family and friends the hardest to do. And yet this is the source of support that is probably the most effective and has the biggest positive impact on an individual struggling with a BFRB. Why is it easier for us to open up to a stranger than to someone we love and care about? Most likely it is because we care more about the opinions of those we care about and our inability to share our shameful secrets stems from a fear of rejection and harsh judgement from them. However, of all the clients I have worked with, those who have good, strong relationships have found that when they do open up and share with their loved ones, they are surprised by the positive response they get. Sharing their treatment journeys with a trusted friend, partner or family member often results in a greater improvement in treatment results as well, so never underestimate the power of support and understanding from the ones you love. I often recommend to my clients a good way to break the ice about the subject of skin picking or any other BFRB for that matter is to share some for the informative articles found on sites like this one and allow that to open up dialogue between you to discuss how skin picking affects you personally.
You may choose to opt for just one or all these support avenues, the important thing is that you do get the support you need and deserve to help you on your journey to recovery and a pick-free life.