Body-Focused Repetitive Behaviors

Body Focused Repetitive Behaviors (BFRB) is a term for a number of problems that involve pulling, biting, picking, or scraping at one’s own hair, skin, or nails. People with BFRB’s are often extremely frustrated in their attempts to stop, and many do not realize that what they’re struggling with is a recognized condition.

The most common BFRB is hair pulling or trichotillomania, with skin picking or excoriation being a close second. Other BFRB’s include cheek biting, biting at nails or skin around nail, or biting at the lip. BFRB’s tend to be very destructive, leading to cosmetic damage such as bleeding or scarring—sometimes infection.

Trichotillomania (trich for short) or hair pulling, involves repeatedly pulling hairs at one or more sites. Commons sites include the scalp, eyelashes, or eyebrows. People will trich often pull so frequently they experience bald patches and thinking, and it is often a source of great shame and embarrassment.

Excoriation or skin picking involves picking at one or more sites on the body. The face is common and one of the greatest sources of embarrassment, but many people pick at multiple places on the body. Often in the moment, the person believes he or she is engaged in grooming, but the end results is often bleeding or scarring. Some people require medical treatment from creating large, open sores or developing infections.

BFRB’s don’t tend to respond to traditional talk therapy and require a structured and individualized behavioral approach. Contact us at the Portland Psychotherapy Anxiety Clinic to discuss treatment options.