David J. Wartel, Ph.D.
Wartel Behavioral Services, P.C. 6346 Orchard Lake Rd., Suite 107, West Bloomfield, MI 48322
Ph.D. licensed psychologist
Cognitive behavior therapy for skin picking involves a technique called habit reversal. An
important part of habit reversal is developing awareness of situations, emotions, thoughts and
chains of behavior that lead to picking. For example, picking is often preceded by looking for
imperfections in one's skin, which leads to picking. Developing awareness of situations that
precede skin picking is important, as it is frequently easier to take action and prevent picking
before it happens, then after it starts to occur. With habit reversal, behaviors that are
incompatible and interfere with are used to decrease picking. For example, if someone picks
while driving, an incompatible behavior is keeping both hands on the wheel. It is physically
impossible to pick and drive with both hands on the wheel. By breaking the association
between the situation and picking, the urge to pick in that situation gradually diminishes.