Excoriation Disorder Help

Tasneem Abrahams
Oct 23rd, 2015

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Excoriation disorder can be an overhwelming emotional burden on the individual struggling with the disorder. It is not only the shame and ebarrassment caused by the effects of continuous picking on the skin, but also the guilt around the act of picking itself. People with excoriation disorder often report feeling extreme negative emotions such as anger, sadness, fear even disgust following a session of picking. In addition one of the indicators of a diagnosis of excoriation disorder is that there is an impact on the person's daily functioning. This may be due to not engaging in meaningful occupations to avoid embarrassment of people seeing picked areas, or social isolation due the huge knock to the person's self confidence and feelings of self worth. 

Supporting excoriation disorder patients

Excoriation disorder patients require support and clinical assistance to manage the disorder. For some, this may be in the form of clinical counseling to deal with emotional problems that result from the behavior, for others the focus is more on the behavior itself. The road to recovery for excoriation disorder patients is long and ongoing, but access to the right support and therapy can make a huge positive impact on an individual's life.There are various avenues that they can pursue to get assistance.

Individual therapy

In many cases, the compulsive behavior is dealt with by the individual learning to respond to factors that lead to this behavior in better ways. Cognitive behavioural therapy (CBT) has been found to be the most effective form of psychological therapy for body-focussed repetitive behaviours (BFRBs) such as compulsive skin picking disorder.  Within CBT there are also varying modalities such as Habit Reversal Training, Acceptance and Commitment based therapyMindfulness and Dialectical Behaiour therapy (DBT). However it is important to note that not all CBT therapists have experience or knowledge in application of these therapies with BFRBs.  The Trichotillomania Learning Centre (TLC)  is a great resource for finding therapists who have undergone training or has experience with skin picking.

Alternate Therapies

Some of the lesser known individual therapies are also starting to gain popularity in treatment of skin picking disorder. Therapies such as hypnosis, biofeedback and even reiki have been accessed by individuals desperate to find relief from this often debilitating condition.

Support groups

Support from others who are experiencing the same difficulties as you plays a trememdous role in the treatment process. When you suffer from a condition that causes so much shame and embarrasment, it can often lead to social isolation and loneliness. The lack of awareness that skin picking is an acutal clinical disorder means that skin pick sufferers fear talking about their condition or seeking help for fear of being harshly judged or misunderstood. Being validated and having someone empathise with your struggles is hugely therapeutic and being able to share openly in a safe space can be cathartic for the individual. Organizations such as the TLC plays a major role in providing the group support to those with BFRBs in the form of conferences, workshops, seminars and retreats. They are also a valuable resource to find community support groups in you area.

Online therapy 

 In the technological generation, it is no surprise that therapy has also evolved so that it is more accessible via online platforms. Here at SkinPick.com, we offer online counseling, as well as an online therapy program which combines the self-help element with therapeutic support. There are a variety of online therapy options from fully self-help, to skype counselling session, and unlike any other organization, we also offer a text-based program. Many of our clients join the text-based program because they say they find it incredibly difficult to talk about their picking when sitting face to face with a therapist. For them, typing to an unseen trained therapist enables them to be more open and honest without fear of judgement or embarrasment. The added advantages is that the text-based communication is available for the individual to refer back to if they need to. A word of caution though to be aware of possible treatment scams. Unfortunately there are some opportunistic people out there who prey on the vulnerabilities and anonymity of the web. Be on the look out for programs that promise a miracle cure or guarentee a cure as this is an unrealistic claim.

Family members and close friends 

The primary support that is very important is support from family and friends. Unfortunately, very few people understand the condition. Thus, there is always some form of conflict as family members try to understand the condition. One of the ways the patients could get assistance is by raising awareness of their condition to the family members. It may help to refer people you care about or would like to have support and understanding from to websites like this one that provides information about the condition.

Support and help for excoriation disorder is out there, but the first step is to speak out and seek it. Arm yourself with informations, understand the condition and its impact on your life and take proactive steps to address it. But most importantly, know that you are not alone!

Tasneem Abrahams

Tasneem is an Occupational Therapist, and a graduate of the TLC foundation for BFRBs professional training institute. Her experience in mental health includes working at Lentegeur Psychiatric hospital forensic unit (South Africa), Kingston Community Adult Learning Disability team (UK), Clinical Specialist for the Oasis Project Spelthorne Community Mental Health team (UK). Tasneem is a member of both the editorial team and the clinical staff on Skinpick, providing online therapy for people who suffer from excoriation (skin picking) disorder.

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