When the person you love is a skin picker

Tasneem Abrahams
May 27th, 2015

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Having a loved one to support and encourage you when you are suffering from a disorder is always an advantage. However, most people are not aware of how little they understand about body-focussed repetitive behaviours. This can sometimes cause barriers in communication in the relationship between you and your loved one and can create obstacles to recovery.

Toward a better understanding

Often the condition is considered to be just a “bad habit”. The biggest mistake that loved ones make is assuming that they can stop the picking by policing the behaviour and preventing the picking. It’s important to understand here that the only person that can stop the behaviour is the person themselves. Making the person aware that they are picking is not always helpful unless it is done so collaboratively.

It not what you say, but how you say it

Even though done with good intention, policing the behavior can be perceived as shaming. It is therefore important ro be mindful of your tone and manner of support, being careful not to use a tone of sarcasm or resort to tactics that elicit feelings of guilt as this will only serve to discourage the person further.

Their recovery, not yours

Every person with dermatillomania wants to stop what they are doing, but cannot resist the urge to pick. This is not an indication of weakness or lack of character, this is an indication of a recognized clinical disorder as classified by the Diagnostic and Statistical Manual (DSM5). As with any other mental health condition, no matter how much support someone has, the ultimate responsibility for recovery lies with the sufferer. Therefore it is important not to take over the recovery process. Your loved one needs to be empowered to take control of his or her recovery process as this will lead to far more sustainable results. Signs that you have become over involved can be:

  • Your emotional state is related to how they are coping on any given day
  • Thoughts about their condition occupy your mind more than other things
  • The condition is a daily topic between the two of you
  • You spend a lot of time researching the condition
  • You can’t stop watching them when they are pulling or picking
  • If they are in treatment, you feel the need to be kept in the loop, and constantly remind them of they fall behind

Do's and Don'ts

  • Stop watching your partner. Walk away if you don’t like what you see
  • Don’t police their picking behaviour. Only they can stop themselves.
  • Do not shame, use sarcasm, get angry or try to change them
  • Don’t blame them for having the problem. The condition is biological.
  • Do not comment on their appearance. You can encourage them. Tell them that they will make it if they keep trying
  • Do not discuss it with others. It is your loved ones private matter
  • If they are being treated, and are making an improvement do not point out their failures. Do not risk damaging their motivation.
  • Do not expect treatment to go smoothly. There will be setbacks
  • It is not your responsibility to supervise their treatment and remind them to do their homework
  • Support their effort to help themselves. Encourage their persistence, even when things take a downturn
  • Concern yourself with your own life goals.

Most importantly, know that when you choose to be in a relationship with someone, you choose to love that person with all their imperfections, just as they choose to love you with all of yours.

Tasneem Abrahams

Tasneem is an Occupational Therapist, and a graduate of the TLC foundation for BFRBs professional training institute. Her experience in mental health includes working at Lentegeur Psychiatric hospital forensic unit (South Africa), Kingston Community Adult Learning Disability team (UK), Clinical Specialist for the Oasis Project Spelthorne Community Mental Health team (UK). Tasneem is a member of both the editorial team and the clinical staff on Skinpick, providing online therapy for people who suffer from excoriation (skin picking) disorder.

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