The Illusion of Control: Why We Pick When Life Feels Overwhelming

Sometimes, life can feel like a runaway train. Work responsibilities pile up, relationships struggle, and the constant flow of information 24/7 can leave you reeling and feeling out of control. In the midst of the chaos, we look for something that we can control, something that calms the noise and brings a sense of relief, even if only for a few moments. 

For some, that “something” is skin picking. It may start as a seemingly benign response to stress. But over time, skin picking, clinically known as excoriation disorder, can evolve into a coping mechanism that offers a strange and deceptive kind of comfort – the illusion of control when everything feels overwhelming. 

The Need for Control in Chaos

As humans, we crave control. It’s a survival instinct that is hard-wired into us. We feel safer, more competent, and more secure when we can influence our environment or circumstances. But when things feel chaotic, like dealing with time demands or managing relationships or trying to meet expectations, our sense of control can vanish, leaving us feeling stressed out and looking desperately for ways to regain some sense of control. 

For some people, and just why isn’t entirely clear, skin picking becomes that go-to response. Skin picking can feel like a way to regain some control. In a moment of anxiety, you spot a blemish or bothersome patch, and you act. For that time, you’re in charge: “Here’s something I can fix.” The problem is that control is an illusion. While picking brings relief, that feeling is fleeting, and sets in motion a cycle of picking that can lead to shame, damaged skin, and deeper emotional distress.

Why Skin Picking Feels So Compelling

Even though it might feel that way, skin picking isn’t random. 

Skin picking is deeply rooted in the brain, particularly the brain’s reward system. When you pick, your brain releases neurochemicals, like dopamine, a neurotransmitter involved in pleasure and reward. Picking provides immediate satisfaction/relief (as brain chemicals are released), and the brain stores it as a solution. Over time, it becomes a default response to overwhelm.

Skin picking is a deeply sensory and tactile experience. The texture of the skin, the sensation of picking, and the tactile feedback you get from manipulating the skin can be intensely satisfying, creating a cycle of compulsion and relief, even when it causes pain. 

Skin picking often spikes when life feels unmanageable and can provide a temporary escape from the distress. During a picking episode, time can seem to “stand still”. In fact, it’s not uncommon to experience what are often referred to as “trance” episodes where you’re not aware of your picking until after the episode has happened. These trances are thought to be a mechanism of dissociation from painful emotions or overwhelming thoughts.

Skin picking thrives on the need for perfection. A blemish, rough patch, or bump feels “wrong” and must be corrected. Studies suggest that skin picking is linked to anxiety, perfectionism, and low self-esteem. This need for perfection can serve as a way to control something tangible. A pimple or rough patch feels like a problem you can solve but creates a paradox: you pick to feel better but end up feeling worse, which drives more picking. It’s not about vanity. It’s about battling emotions too big to name.

So how can you break the cycle?

Practical Coping Strategies

Managing skin picking isn’t about willpower. Breaking free from skin picking starts with understanding the need to control and finding healthier coping strategies. 

Identify Your Triggers – Being aware of what triggers your picking is a key step in managing it. Keeping a journal is a great way to track your picking episodes. It’s a way to identify patterns which can help you anticipate and be prepared when urges arise. 

Use Distractions – One way to distract from picking is to keep your hands busy. Fidget toys, stress balls, or textured rocks or fabric can mimic the sensory satisfaction of picking without the harm.  

Practice Mindfulness – Awareness is key to managing your picking. Mindfulness strategies help you to become more aware of what’s happening in the moment.  Techniques like deep breathing or body scans can help you stay grounded and present and better able to avoid trance-like picking.

Challenge Perfectionism - Challenge the idea of perfection and the belief that your skin (or any aspect of your life) must be flawless. Remind yourself that perfection is an unattainable pursuit and that imperfection is not failure. Learning to tolerate it is a powerful act of self-compassion. 

Practice Self-Compassion - Shame fuels the cycle of picking. Instead of berating yourself, acknowledge the urge to pick as a sign that you’re overwhelmed. Learning to Being kind to yourself and acknowledging that you’re struggling can ease the emotional distress that drives picking. 

Seek Support – Whether it’s family or friends, an online community or a support group, having the support of others is an important part of healing. You don’t have to deal with this alone. 

Seek Professional Help - Skin picking is a symptom, not the problem, and is thought to stem from deeper emotional distress. Therapy, particularly Cognitive Behavioral Therapy (CBT) and Habit Reversal Training (HRT), can help you manage underlying anxiety or perfectionism. If therapy’s not accessible, try stress-reduction techniques like exercise or journaling.

Moving Forward

Skin picking is not about vanity or weakness. It’s about coping when things feel out of control and a search for relief. By understanding the illusion of control it offers, you can start to replace it with healthier strategies. 

If you are wondering how to get started, therapy can help. A therapist skilled in treating skin picking can help you explore your experience and help you decide next steps. At Skinpick.com, we have a team of experienced therapists who understand the complexities of skin picking and can guide you towards healing.  And online therapy makes getting help comfortable and convenient. When you’re ready, there is help and hope waiting for you

Research

1. Nederkoorn, C., Vancleef, L., Wilkenhöner, A., Claes, L., & Havermans, R. C. (2016).  elf-inflicted pain out of boredom. Psychiatry research, 237, 127–132. https://pubmed.ncbi.nlm.nih.gov/26847946/

2. https://www.youtube.com/watch?app=desktop&v=yL2OaCVp1KE

3. Grant JE, Chamberlain SR. Trichotillomania and Skin-Picking Disorder: An Update. Focus (Am Psychiatr Publ). 2021 Oct;19(4):405-412. Epub 2021 Nov 5. https://pmc.ncbi.nlm.nih.gov/articles/PMC9063575/#:~:text=This%20theory%20suggests%20that%20the,tension%20generated%20by%20these%20emotions.