Hypnosis for Skin Picking Disorder

Tasneem Abrahams
Aug 24th, 2015

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The American Psychological Association (APA) describes hypnosis as a cooperative interaction in which the participant responds to the suggestions of a hypnotist. The technique has been clinically proven to provide medical and therapeutic benefits, most noticeably in the reduction of pain and anxiety. Many skin picking sufferers report going into a trance-like (hypnotic) state when picking at their skin. Hypnosis is sometimes used as a tool to understanding this behaviour and bringing it under control.

But how does it work?

Hypnosis speaks directly to your subconscious and makes you more aware of what you are doing when you pick or scratch your skin. Rather than automatically indulging the behavior, hypnosis makes you become very mindful of what you are doing. This means that you notice your hand reaching towards your mouth, or that you are clenching your jaw and grinding your teeth, or rubbing the skin to feel for imperfections, rather than just automatically doing it. Using hypnosis in conjunction with an existing treatment program has been shown to increase treatment success.

Hypnosis can:

  • Turn the picking hand into an automatic soothing device
  • Protection from the impact of triggering stressors
  • Make habits that have felt automatic controllable
  • Enhance relaxation techniques
  • Increase mindfulness
  • Identify and diffuse historical picking or pulling triggers
  • Help you feel things in the heart, not the hair or skin

Is it effective?

There is significant and comprehensive research detailing the effectiveness of clinical hypnosis being used as a tool to treat emotional, medical and behavioural problems. However there is little empirical evidence into its effectiveness as the primary therapeutic medium with body-focussed repetitive behaviors (BFRBs) such as skin picking disorder. Hypnosis requires the patient to focus and concentrate on feelings, impulses, and sensations so that you move into a trance state. This mimicing of the subconcious state can help a patient develop an awareness of the sensations, thoughts and emotions they may experience prior to and during picking. As such it can be a useful tool to develop awareness as a contribution to a more comprehensive cognitive behavioral approach such as habit reversal training (HRT).

Treatment with Hypnotherapy

Most believe that skin picking is a stress/habitual based disorder. This means that following a process of relaxation and distraction can be used as one tool to reduce stress that may be triggering the urge to pick. In short, the patient is induced into a deeply relaxed state. The patient is then taught how to self-hypnotise and is given the take-home exercise of going into this relaxed state and developing this as their “comfort place”. Given that the patient is able to access this comfort place on their own and as requested, the therapist can then issue the request to the patient that whenever they feel the urge to pick at their skin, they can then go into that deeply relaxed comfort place. Their hands will then become relaxed. At the following session, the patient can then be given the suggestion that should they feel the urge to pick; they can choose to stop this behaviour. This is then practised so as to create a pattern of behaviour until the initial behaviour of picking is then reversed. One can also try to link a response that is averse to picking. Skin picking as a condition has varying stages of severity and symptom transference may be needed in the beginning. Regression may also be used to understand where and when the behaviour began. Then review the event or occurrence to understand why it created the pulling behaviour and give it the relevant attention.

One part of a whole

In short, hypnosis can be used to treat picking quite effectively, however it is important to note that it should be used in conjunction with other therapies such as Cognitive Behavioural Therapy or medicines. A holistic approach is needed to effectively treat and this chronic condition.

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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