Do you pull your hair or pick your skin to a degree that causes problems for you?
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 are recognized conditions. 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 with trich often pull so frequently they experience bald patches and thinning, 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; however, the end result is often bleeding or scarring. Some people require medical treatment from creating large, open sores or developing infections.
More general talk therapy is rarely helpful in stopping pulling or picking. Medications can help somewhat but tend to be inadequate on their own. Only certain kinds of psychotherapy have been shown to work reliably. Effective treatment involves structured behavioral interventions such as habit reversal training to help individuals learn to recognize and stop these behaviors.
About Dr. Brian Thompson
One of the most established organizations for therapists who work with people who struggle with these issues is the The TLC Foundation for Body-Focused Repetitive Behaviors, a grassroots organization started by people who have personally experienced problems with pulling and picking. I have completed up-to-date training in understanding and working with these problems through the TLC virtual professional training institute.
In treatment, I draw from a 10-session protocol, though treatment may be somewhat shorter or longer depending upon client need. Treatment incorporates well-known interventions for hair pulling with newer interventions drawn from Acceptance and Commitment Therapy (ACT), an innovative cognitive behavioral model with a strong research foundation.
You can overcome this problem. But it helps to have help.
Overcoming pulling is possible AND it’s also hard work. If you want someone who can support you in overcoming this problem, please give me a call or contact me below, and we can see if we’re a good match. I’m here to meet you where you’re at and help troubleshoot ways of making treatment a success. There are no surprises, and treatment is straightforward and typically time-limited.
Sliding Scale services from Dr. Kaylin Jones
For those in financial need and for a limited time, I offer sliding scale evidence-based treatment for problematic hair pulling or skin picking. I draw from a 10-session protocol that has been studied in several research trials. I currently work with adults only. Please contact me to learn more about my approach to treating trichotillomania or excoriation, to set up an appointment, or to inquire about sliding scale fees.