I heard a question about this topic during Dr. Miletic's webinar and so I wanted to share my own personal experience in case that asker is reading, or maybe it will provide some insights to someone else as well. I'm not trying to explain his point or anything. It just really resonated with me, so I wanted to provide my take on it.
I started getting acne when I was around 12 or 13. My mom would stand me in the bathroom up against the wall and squeeze the whiteheads and blackheads on my forehead. This was really embarrassing and uncomfortable for me. It was bad enough to have acne and to figure out what to do with it at that age. This extracting the material from the pimples and zits appeared to be the solution. I really hated when my mom did this to me and it was stressful for me, so in order to avoid that, what would be the natural solution? I started doing it myself. I think that in my mind, if I could get to those pimples first and squeeze them out myself, then I wouldn't have to tolerate her doing it to me. I started spending long periods of time in front of the bathroom mirror, examining my skin and trying to get rid of any blemish. I think that my mom put a lot of pressure on me. Literally by applying direct pressure to the pimples to squeeze them, but also figuratively by giving me the impression that my skin was no ok, it was not acceptable to have a pimple or zit and something had to be done about it.
In the webinar, Dr. Miltetic provided the example of his dog, when she was young being frightened by some construction on the street and then to this day not wanting to turn in that direction and walk that way on the street, to avoid having to pass that area even though there is nothing there for her to be afraid of now. I liken myself and my own experience to this example because I felt like I sort of 'learned' this behavior (of squeezing my pimples) by trying to avoid something that I found unpleasant (my mom squeezing my pimples and the unpleasantness of the pressure she put on me to have good looking skin). It has been many years since then, but my picking continued beyond the acne of adolescence. I also have found that any time I feel pressure from my mom, that is something that is a trigger for me. She doesn't bug me about my skin or looks anymore, but it could be other things (other life choices I'm making, family issues, whatever). I wouldn't say that this sums up the whole of my picking experience, nor is it the singular cause, but I definitely think it was an initial contributing factor and a continually triggering factor.
However, the good new is, through my healing process I have learned a lot about triggers and setting boundaries and self-compassion, which has helped me immensely. Any thoughts or questions, feel free to post. Hopefully this is helpful to someone out there :)