Candice Miller

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BODY FOCUSED REPETITIVE BEHAVIOR

BFRB

Body Focused Repetitive Behavior is an umbrella term for a group of related disorders that include hair pulling (Trichotillomania), skin picking (Excoriation), and nail biting (Onychophagia).  It is important to note that these behaviors are not tics or just “bad habits” they are actual disorders that cause people to repeatedly perform a behavior such as picking their skin or touching and pulling their hair to the point where it causes the individual actual physical damage.  If you suffer from a BFRB you know that it is not something that you can “just stop”.

Symptoms of BFRB

  • The behavior often occurs when you are engaged in a sedentary activity.  
  • The behavior is sometimes a highly focused act or one that you don’t even know you are doing until you notice the physical harm that has occurred. 
  • For some people there can be a sensation that compels you to pull or pick at a certain site, and for others there is no sensation prior to engaging in the act. 
  • You may find yourself searching out hairs, skin, or aspects of your nails that have certain characteristics, which cause you to pick or pull. 
  • Some people may examine the product of what they have picked or pulled including looking at it closely, rubbing it on the skin, face, or lips.  You may even put the product in your mouth and chew or swallow it.
     

Often those who experience BFRB feel shame, isolate themselves, and/or have low self-esteem.  It is important to focus on treating the BFRB as well as the overall emotional toll it has taken on the person. 

Treatment for BFRB

Cognitive Behavioral Therapy is the gold standard for treatment of Body Focused Repetitive Behaviors.  Habit Reversal Training (HRT) and the Comprehensive Behavioral model (ComB) are two approaches that fall under the CBT umbrella which have research and data supporting their efficacy.  Together we can go over these approaches and decide what will work best for you specifically.  There are cases and instances where pharmacotherapy can assist in the treatment of BFRBs and this is something that can also be discussed and explored.