Updated: May 10
Everyone has bitten the occasional hang nail or gotten really into squeezing the perfect blackhead that needed to be expunged, it's the reason why shows like Dr. Pimple Popper exist because you experience that oddly satisfying experience. However, have you ever noticed that one moment your your binging the newest trending limited series on *insert your favorite TV streaming service here* and the next thing you notice is your fingers are starting to bleed because you have been biting them for the past hour or you are missing have of an eye brow when you started off only picking a few eye brow hairs to prevent growing a unibrow.
Well, I have. I don't exactly remember when or why it started, but I do have a vague memory of always twirling the hairs on the back of my head. The goal was never to pull the hair out and I was never concerned when it happened occasionally because I knew shedding hair was a part of life. As I grew older and started receiving the message of hair in regards to beauty, I began tweezing my eyebrows to get them to be the perfect shape. The earliest memory I have for when these behaviors started to became a problem was during high school when I was taking my college entrance exams. I always had anxiety around test taking and this was the most important test of them all. When I went to use the restroom after finishing my exam, I noticed half of my eyebrow was gone! Sometime between when I started taking the test and finished I had manage to unconsciously pull out half the hairs in my eye brow with my own hands, my index and thumb finger to be exact. Then one day challenged myself to stop twirling my hair whenever I caught myself and that process was much more difficult than I was expecting it to be.
Body Focused Repetitive Behaviors (BFRBs)
BFRBs are defined as intense urges to engage in behaviors that can cause physical damage to your body, but physical damage is not required in order for a behaviors to be considered in this category. Statistics demonstrate that BFRBs affect 1in 20 people in our population, however due to several commonly known barriers that affect underrepresented minorities from receiving mental health care this number in reality is probably much higher. In addition, that is also not including all the individuals that do not report their symptoms as a result of the shame they experience either because of the nature of their BFRB or the damage they have unintentionally done as a result.
Different Types of BFRBs
Hair Pulling Disorder/Trichotillomania: causes people to pull out from various places on their bodies including their scalp, eye lashes, and pubic areas that result in bald patches. In some cases swallowing the pulled hair also occurs.
Skin Picking Disorder/Excoriation: causes people to touch their face in a repetitive way that causes discoloration, scarring, or even damage to their skin tissue.
Nail Biting Disorder/Onychophagia: causes people to bite and chew on their nails to the point of bleeding and sometimes infection.
Other : Other behaviors can include activities such as lip and cheek biting, nose picking, and other self grooming behaviors.
Treatment for BFRBs
Treatment used to manage BFRBs is called Habit Reversal Training, which has 4 main steps:
Gain awareness by tracking the behavior.
Identify patterns of the behavior.
Create a competing response.
Find another activity to replace the behavior.
Habit Reversal Training is a form of Cognitive Behavioral Therapy that is evidence-based, which means there have been studies to prove that this method helps to decrease BFRB symptoms and live a more fulfilled life. Let me know if you want to learn more about treatment for BFRBs! If you resonated with any of the information above and are interested in receiving an evaluation to determine if you meet diagnostic criteria or if you currently struggle with BFRBs and are seeking treatment you can schedule a session with me by clicking here.