Clinical Psychologist
Cascade Clarity
Psychological Services©
Integrative Evidence-Based Psychotherapy
In-Person or Online in California
Body-Focused Repetitive Behavior
You pull hairs from your skin, whether your scalp, eyebrows, eyelashes, your skin, or pubic area. You pick at your skin, whether bumps, cuticles, scabs, or pimples. These behaviors give you something to do with your jittery hands. Over time, it started to give you a sense of satisfaction and relief from negative feelings. It's become automatic. You're losing patches of hair or have lesions on your skin. Other people have started noticing. You try everything to conceal the evidence on your body. Maybe you avoid social settings altogether. You may have tried to reduce or stop the picking or pulling without little success. The urge to pick or pull has become so strong, it's difficult to focus.
There are two types of body-focused repetitive behavior--Trichotillomania and Dermatillomania. Trichotillamania is characterized by recurrent hair-pulling that results in hair loss. Dermatillomania, also known as Excoriation disorder, is characterized by recurrent skin picking that results in lesions on the skin. Estimates suggest these disorders affect 2-5% of the U.S. population. Though relatively less common than some other disorders, they can be very distressing for those who suffer from it. There may be fear of judgment from others and difficulty focusing. Relationships, work, and other areas may begin to suffer.
Cognitive Behavioral Therapy and mindfulness tools are the most effective treatments for these body-focused repetitive behaviors. CBT skills are used to give you replacement behaviors, create barriers, and identify helpful thoughts, among others, that help you change the problematic behavior into healthy ones. Mindfulness and self-compassion help you become more aware of pulling or picking, ride the wave of urges, and develop a more kind, non-judgmental, and motivating voice.