BFRB is a term related to disorders that refers to repetitive self-grooming behavior. These behaviors cause people to repeatedly touch their hair or body in ways that can result in emotional distress, isolation and/or medical problems. The most common BFRBs are trichotillomania and body excoriation disorder. Additional BFRBs include nail biting and behaviors involving frequent chewing inside the cheeks or biting the lips.
Trichotillomania (Hair pulling)
Trichotillomania is a disorder that causes sufferers to repeatedly pull their hair. Individuals with trichotillomania pull out hair from any part of the body where hair grows. The most common areas are from the scalp, eyelashes and eyebrows. Individuals who pull their hair can feel isolated and shameful. Medical complications that can occur are skin infections or intestinal problems as a result of ingesting hair. Failure to stop pulling hair leaves people feeling out of control. Urges to pull often occur when the person feels bored or distressed.
Body Excoriation Disorder (Skin Picking)
Individuals with skin picking disorder repeatedly scratch, or pick their skin to remove irregularities or imperfections. The most common areas that individuals pick are the face, arms, and hands. In addition to picking, some individuals squeeze, rub, bite or lance the affected area. Repeated skin picking can result in lesions and cause tissue damage. Individuals feel out of control after having repeated attempts to stop picking.
Habit Reversal Training (HRT) is at the heart of the treatment for BFRBs. HRT is a structured behaviorally based therapy that focuses on awareness training, followed by identifying alternative responses to pulling hair or picking skin. We will work to Identify lifestyle behaviors that may increase the behavior, as well as behaviors associated with being successful in eliminating pulling and picking behavior. Acceptance and commitment therapy (ACT) and mindfulness based strategies are also integrated into the treatment to help individuals allow the urges to pass.
Helpful Treatment Augmentations
Family therapy is often useful so that your family members have a plan to support you in ways that will help you reach your goals. We will address problematic behaviors that affect your relationships and interfere with your progress. Together, we will find alternative strategies that can help you.
Compassion focused therapy is useful for clients who feel guilty, are self-critical and lack self-compassion.
Medication can be a helpful addition to your therapy. If you are not currently taking medication for your anxiety, and we determine that it may be useful, a referral to a physician will be provided.