Body focused repetitive behaviours, or BFRBs, affect around four million people – around one in 20 – in the UK and Ireland, according to BFRB UK & Ireland.
Often regarded as ‘bad habits’, BFRBs cover a range of issues, from skin and nose-picking to thumb sucking, hair pulling and cheek biting.
Despite being fairly common, scientists aren’t exactly sure what causes them, but hypnotherapy can be one of the most effective ways to break the cycle.
What are body focused repetitive behaviours (BFRBs)?
Although body focused repetitive behaviours (BFRBs) do come under the category of obsessive compulsive disorder, and can have the same unpleasant impacts on someone’s daily life, they are not quite the same.
Nor are they widely considered to be acts of self harm. Although some BFRBs can lead to tissue damage, the compulsions driving them are different.
Some common BFRBs are:
Skin picking disorder
Also known as excoriation disorder or dermatillomania, skin picking disorder is the repetitive urge to pick or scratch at the skin.
People with dermatillomania make a habit of picking at their face, back, shoulders and arms with their fingers, fingernails and teeth. They can even use tools such as tweezers, pins and scissors to facilitate their skin picking.
Many skin picking sufferers also focus their picking on their lips and gums, their scalp, stomach or chest, as well as their finger and toe nails and cuticles.
Skin eating
Dermatophagia or skin eating disorder is the repetitive chewing or biting of skin around the fingers. Repeated skin eating can lead to scarring and a thickening of the skin in the affected areas. People with skin picking disorder often have dermatophagia, too.
Hair pulling
Also known as trichotillomania, hair pulling disorder is the compulsion to pull out hair from anywhere on the body, including the scalp, eyebrows and eyelashes, as well as arms, legs, or pubic area.
Hair eating
Hair eating disorder or trichophagia is often associated with trichotillomania. And involves the chewing and swallowing of hair. In extreme cases, it can lead to bald patches and intestinal blockages.
Nail biting
Arguably one of the most common body focused repetitive behaviours is nail biting disorder or onychophagia. Sufferers bite their nails to the point of damage to the nail bed and cuticles.
Nail picking
Many people with onychophagia also have onychotillomania, or nail picking disorder, in which they repeatedly pick or tear at their nails, damaging the cuticles and nail bed.
Nose picking
Rhinotillexomania or nose picking disorder is another common body focused repetitive behaviour, particularly when compulsive picking damages the lining of the nose.
The causes of body focused repetitive behaviours
There are lots of theories about why people can develop body-focused repetitive behaviours but, to date, scientists and doctors have not been able to definitively pinpoint clear triggers. Instead, it appears several common triggers are involved:
Genetics
Many body focused repetitive behaviours are shared by several family members. Some experts have suggested it could indicate a genetic predisposition for BFRBs.
Others have theorised that BFRBs could be learned or observed traits: if someone witnessed their parents biting their nails, they adopt the same or similar behaviours.
Grooming behaviours
Another theory behind BFRBs is that they are part of common grooming behaviours in nature but are triggered by anxiety. Researchers know that animals eat their own fur or over groom when stressed.
Personality traits
Research has also suggested that people who consider themselves to be perfectionists but have low frustration thresholds could be susceptible to developing the unwanted behaviour associated with BFRBs.
Environmental factors
Doctors believe that while stressful situations can make body-focused repetitive behaviours worse and more difficult to stop, it is not clear whether they are triggered by a single event.
Low self esteem
The physical effects of body focused repetitive behaviours, such as visible tissue damage or bald patches, can lead to a drop in self confidence.
This can amplify the negative emotional impact about perceived imperfections in what is otherwise perfect skin, potentially leading to someone withdrawing from everyday life, and social isolation.
There are methods that can help you manage your BFRBs, including using fidget toys and stress balls to ease anxiety levels, or cognitive behavioural therapy.
To escape the vicious cycle of BFRBs entirely, develop more beneficial responses and regain control, a combination of Solution Focused hypnotherapy and habit reversal therapy is best.
How hypnotherapy and habit reversal training can help body focused repetitive behaviours
Solution Focused hypnotherapy can be very effective for BFRBs, because it addresses their root causes, rather than just the symptoms, quickly improving the overall quality of your daily life.
As with many aspects of BFRBs, some people are aware of their compulsive picking or other habits, spending hours in highly focused sessions, often after stressful events. Others are not, and it could be something they do inadvertently, while watching TV.
I can help you be more aware of what you do with your hands, and give you the tools you need to deal with your thumb sucking, nail biting, hair pulling or skin picking compulsions.
I will also help you break free from this vicious cycle by addressing the cause of the BFRBs, buried in your subconscious mind.
By working through past events that generated uncomfortable feelings, childhood trauma or emotional distress, you will be able to cast off these bad habits and see yourself in a whole new light.
How hypnotherapy works
My Solution Focused approach can help stop body-focused repetitive behaviours (BFRBs) in just a few sessions.
Treatment begins with a free, roughly 25-minute Zoom consultation during which I find out all about you, potential causes for your BFRBs, and what you want to achieve via hypnotherapy.
During each hypnotherapy session, I place you in a deeply relaxed state, before giving your subconscious mind all the tools it needs to overcome any compulsive desires to pick or bite, helping you manage stress and your emotional responses.
Habit reversal therapy
Once the reasons behind the anxiety have been identified, I use habit reversal therapy to make you aware of the negative effect, unpleasant impacts or even physical harm of skin picking or other BFRBs.
This professional help breaks down into five parts:
- Awareness training: brings attention to the behaviour so the person can gain better self-control.
- Competing response training: we will work to replace the unwanted behaviour.
- Motivation and compliance: we will define the problems caused by the behaviour to help you stay focused at challenging times.
- Relaxation training: I will teach you deep breathing and mindfulness techniques to keep causal factors or environmental triggers at bay.
- Generalisation training: you will practice your skills so they become automatic.
Ending body-focused repetitive behaviours can be the same as trying to quit smoking, or any other habit that’s not good for your health.
Clients that I’ve helped were able to break their damaging routines, and handled challenging social situations afterward, without resorting to their old habits.
I can help you too.
Contact me
Hypnotherapy can help you move on from hair pulling, nail biting, skin picking or any other body-focused repetitive behaviours, and reduce your stress and anxiety levels, allowing you to live life to the fullest.
I hold online sessions on Tuesdays, and you can find me at Salus Wellness Clinics on Wednesdays and Thursdays, and at Coach House Health Care on Fridays.
If you would like to find out more about how hypnosis can help you overcome your skin picking habit, book your FREE initial consultation.
