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I've been around the block of many therapies. My psychiatrist was very expensive so I started using this 3 pronged approach at home. My approach uses (1) reward calendar (2) hypnosis (3) pampering :) I printed monthly calendars from calendarlabs.com which I display on my fridge and bought good old-fashioned kindergarten-style reward stickers. Each day I go pick-free, I get a sticker for the day! It's juvenile and hilarious, which drives me to stick with it. You can even use iphone apps for this. On days I slip, it's okay. (2) I can STILL get a sticker if I listen to my "Stop Skin Picking" hypnosis audio track, which I have found very helpful. This way, picking is not a "fail," but not doing anything about it is. (3) I use 1% hydrocortisone "anti-itch" cream to soothe the redness and scarring to lower the shame and desire to pick. I have two tubes, one on my nightstand and one in my purse. I've made it a nightly routine to moisturize and use hydrocortisone as needed. Once I accumulate 30 days worth of stickers, I "win" a manicure for myself. I'm still not 100%, but this has been the most helpful system for me and lets me focus on the positives. At some point in your journey, I think it's healthy to turn this into a fun game if you can!