Breaking the Silence: Why It’s So Hard to Talk About Skin Picking in Families

In many families, there are topics that are just not talked about or if they are mentioned, it’s only in hushed whispers. Just why a particular topic is off limits isn’t always clear. This silence isn’t necessarily intentional but often rooted in deeper generational patterns, cultural norms, and fears of being vulnerable. 

Skin picking is not uncommon yet it is a disorder that is often misunderstood, stigmatized and shrouded in secrecy. When skin picking and generational silence collide, it can leave you feeling ashamed, misunderstood, and alone in your experience. 

The good news is that generational patterns can be broken, and new ways of communicating can be established. Understanding why it’s so hard for families to talk about skin picking is the first step toward breaking that silence and creating space for honest, supportive conversations.

Why Families Stay Silent

We see generational patterns in families all the time. You’ve probably had the experience of noticing that you do something in the same way your mom or grandmother did. That’s a generational pattern. We learn so much about how things are done from our role models. Handling sensitive issues is no different.

Generational silence isn’t random. It’s a coping mechanism that has been learned and passed down from generation to generation and can manifest in different ways. For example:

• Some families believe that ignoring problems makes them go away. 
• Some families use silence as a way to shield children from difficult realities. 
• Others believe that personal struggles are just that and should remain private or dealt with on your own. 

While these beliefs are often rooted in love and good intention, they can create a sense of shame and fears of being vulnerable.

Silence can be isolating. Instead of feeling seen and supported, the person who picks at their skin may internalize the belief that their behavior is too strange or shameful to be acknowledged. For parents who also struggle with skin picking, talking about their experience or worrying that their child may also have the disorder can fuel feelings of guilt or shame or stir up painful memories.

The Emotional Impact of Silence

Silence is more than just “not talking about it”. The silence carries a powerful message: This is unacceptable behavior and something you have to hide. Over time, silence can feed feelings of shame and self-blame and increase isolation and avoidance. Avoidance and fears of judgment are often cited as a significant reason for not seeking help, avoiding social gatherings, or going to great lengths to conceal skin damage. Silence reinforces the idea that being honest is risky.

The truth is, while it might feel safe, secrecy is not protective. Healing thrives when there is safe space to have open and honest conversations.  

Tips for Breaking the Silence

Sometimes all it takes to break the silence is for someone to create space for a conversation. And, it doesn’t have to be confrontational or perfect. Sometimes, just knowing that there is opportunity for support and understanding can be the first step to healing.

Here are some ways to begin overcoming generational silence: 

1. Take It Slow - The silence won’t end all at once. Remember, there’s a lot of shame and fear that lies just beneath and it takes time to feel safe to talk about something that you’ve avoided for so long. 
2. Keep It Positive – Lead with positivity. Instead of using critical language (ex., “Why do you just stop?” or “Why are you always nagging me about picking?”), try a positive approach. “Sometimes I feel really anxious, and I pick at my skin” or ”I don’t understand. Could you tell me more about that”?  This strategy reduces defensiveness, models vulnerability, and signals that it’s safe to share. 
3. Educate with Care – Look for opportunities to share accurate information or resources. It’s also ok to ask questions too. 
4. Acknowledge Generational Patterns – Sometimes it takes one person to verbalize what everyone is thinking to break the silence. It’s not about blame or shame. It’s about noticing how your family does things. For example, you might say, “I’ve noticed that we don’t talk about uncomfortable things. I’m trying to change that for myself.” This signals courage and a willingness to take a step forward without judgment.
5. Lead By Example – Whether it’s you or a loved one who is struggling with skin picking, you can model compassionate behavior. Sometimes it can be as simple as starting a conversation: “How can I support you?” or “I’d like to help you understand my experience. What would you like to know?” These open-ended questions encourage conversation and signal that it’s safe to talk about it. 
6. Seek Help – Sometimes a safe, neutral setting can encourage the walls to come down. Support groups, therapy, or even online communities where BFRBs are discussed without judgment can be helpful for learning and sharing in ways that feel safe. 

Practice Patience

Generational silence becomes entrenched over many years and successive generations. The silence didn’t start with you, but you can be the catalyst for change and create new ways of connecting as a family now and for future generations. 

Confronting generational silence can be uncomfortable. A skilled therapist can help you navigate this path with your loved ones. At SkinPick, we have a team of expert therapists who understand the importance of family dynamics in the treatment process and can help you and your family find healthy ways of talking about hard things. And online therapy makes scheduling easier than ever. When you’re ready to break the silence, SkinPick is here to help. 

References

1. Zhang, J., & Grant, J. E. (2022). Significance of family history in understanding and subtyping trichotillomania. Comprehensive psychiatry, 119, 152349. https://pubmed.ncbi.nlm.nih.gov/36215772/

2. FAQ for relationships. (2023, July 1). Skin Picking Support. https://www.skinpickingsupport.com/resources/for-partners/