Gaining control

[So sorry that this post is long!] I know how you feel. I know the regret. I, too, become consumed by it, but only after the damage is done. And that regret makes me miserable and makes me, as you said, "inevitably make it worse." Yet like you, the anguish of the experience doesn't help me avoid repeating it. I'll destroy my face or my shoulders and/or chest and I'll feel absolutely awful about it afterwards. I'll look at my splotched skin, sometimes with tears in my eyes, and think "I never want to do this again." But I do it again. And again. And again. It's a prison, a compulsive behavior. I hate the way I feel later but at the time.... it feels... good. You know? I definitely take my frustration out on the spots, like you. I feel like I'm "fixing" my skin when I do it. I'll be stressed out, so I get in front of the mirror and I relieve the stress. I go into a trance, it's like I can't feel the pain. While I'm doing it, I feel relief. But it's a hell of plan... because technically it backfires! Instead of feeling better when I'm done, I feel WORSE! Anyways -- I just wanted to let you know that I can relate to how you're feeling. You're asking for help... I'll do my best. First of all, I think if counseling is an option for you, it would be really helpful. They made determine that medication would be good for you. From what I understand, that doesn't work for everyone but the great thing about the counseling is that isn't the only avenue it leads to. There's behavioral therapy for problems like ours. There are actually professionals with experience in treating people who have dermatillomania. I myself cannot vouch for counseling with personal experience. I have never done it. I'm scared. So if you don't have the resources, or are afraid like me, then you can try to modify your behavior on your own. As I said in my "Telling your significant other?" thread, my dermatillomania and trichotillomania were really bad in middle school and high school but I'm 19 now and have been doing better.Having a boyfriend was what helped me, especially since he lived with me in my dorm room and was with me all the time when we weren't at college. But this semester, due to problems of his own, he is at home... leaving me alone in my dorm room. There's no one to notice that I'm spending too much time in front of the mirror. I don't have a roommate. I tend to chill in only my underwear (I'm just used to hanging around naked with a significant other hahaha), which leaves my shoulders/chest open to my eyes to spot places to pick. So sadly, as you could guess, I have been drifting back towards the bad behavior. Here's what I'm doing right now to try to get better again: because of this forum, I now have a piece of paper taped to the mirror in my dorm room. It has a message on it ("STOP you are gorgeous") to keep my head in the game. The size of the paper also doesn't leave much space for a reflection; just enough to see myself for clothing/hair purposes quickly and at a distance. Luckily for me the mirror is deeply inset on the vanity... like, it's built into the closet/drawers unit so you can't actually get close to it. This was helping me for awhile but then my mom got me a steeping stool because my bed is high off the floor. Unfortunately, I instead used the stool to be able to get close to the mirror, sometimes even using it to get ON TOP OF the drawer unit and sit at the mirror. I feel pathetic doing that. To prevent that from continuing, last week I pushed the stool away from the vanity and back towards the bed! When washing up in the bathroom, I look at my hands instead of at my reflection. I've cracked my window so my room is cold enough for me to have to wear clothes when I'm alone, which is a big help because seeing my bare skin is a definitely trigger. I don't know if any of these tips apply to your feelings or your situation. I wish I could help you! Obviously, these things that I am doing are just helping me manage the compulsion. I know they will not eliminate it, but right now they are really helping. I understand that it's like an addiction, so even if you do those things, you may still want to pick. So besides distracting yourself with those approaches, I also suggest finding something else to be obsessed with! I don't mean a TV show or anything like that. I mean... we have anxiety and we have this addictive behavior that we use to channel our energy at dealing with the anxiety. Channel it in a different way! I don't know if this will sound crazy but right now I'm trying to get addicted to... well, making my skin clear! For me the picking is like a vicious cycle, I do it and then I regret it and I'm dying for my skin to clear up. But just as my skin starts to get better, I see a spot and cave and then I have red splotches all over again! I want that pretty skin that I always get so close to achieving. So I'm making it my mission to be pretty again. I rejoice/mentally reward myself for each day that goes by where I don't pick more than one spot. I spend my time at the vanity observing how much better each mark/scab/scar is getting rather than obsessing over pinching/clearing out pores. I apply lotion containing good things like Vitamin E. Just like your "thoughts that the spots somehow arrive deliberately" I pretend that the lotion is REALLY helping my skin and that it's healing by the minute. Does that make sense? I don't know how else to explain it... basically, I'm allowing myself to be obsessive and delusional without harming myself. Finally, finding this forum is help itself. Posting here and learning that our problem is common is quite cathartic. I want everyone here to get better and I know everyone is trying, so I keep you guys in mind when the withdrawal symptoms get tough. I'm trying to be strong for myself, and for the people that believe in me. I wish you the best! We believe in you!