Is Shame Regarding Hair Loss Or Skin Scars Impacting Your Life?
Are you constantly picking your skin or pulling your hair? Despite consistent efforts or a desire to stop, do you find it difficult to change these behaviors?
Maybe you engage in these behaviors consciously (“focused”) or you might not even be aware that they occur (“automatic”) and only later notice the effects. Or perhaps, like most individuals with body-focused repetitive behavior disorders, you experience a mix of focused and automatic pulling or picking.
Body-Focused Repetitive Behavior Disorders Can Have Stressful Consequences
You may often attempt to hide evidence of your picking and pulling behaviors. Trichotillomania can cause hair loss, thinning or bald spots, or a complete lack of eyebrows or eyelashes, while dermatillomania can lead to bleeding, bruising, or even infection. Though you may have a desire and have attempted to stop before, the visible manifestations of your behavior may cause a high level of shame or distress in social settings.
Fortunately, with help from a trichotillomania and dermatillomania therapist, you can identify factors that are leading to these behaviors and learn skills to combat the urges. At The OCD & Anxiety Center, we specialize in helping you learn how to change your thinking and replace body-focused repetitive behaviors with other non-harmful ones.
Urges Happen, But They Can Be Resisted
Both trichotillomania and dermatillomania are types of body-focused repetitive behavior (BFRB) disorders. Trichotillomania is a condition in which an individual repeatedly pulls out their own hair, body hair, eyelashes, or eyebrows for non-cosmetic reasons (not as part of grooming practices). Dermatillomania, also known as Excoriation Disorder, is a condition in which an individual repeatedly picks at their own skin for non-cosmetic reasons.
The shame, discomfort, and stigma that is experienced with trichotillomania and dermatillomania often cause individuals to suffer alone. Mental Health America indicates that between 1.4% and 5.4% of American adults experience dermatillomania, with more women than men being affected.* And the American Psychological Association reports that about 3.5% of the US population meets the clinical criteria for trichotillomania.** Both of these diagnoses are often comorbid, meaning that they occur alongside other anxiety disorders and OCD.
While it is not known exactly why one individual is more prone to trichotillomania or dermatillomania, we do know that there is a combination of biological and behavioral factors involved. If an individual has a family member with a BFRB disorder, there is a higher chance that they might develop a BFRB as well.
The behavioral component is extremely important to assess BFRBs and a large part of the treatment for hair-pulling and skin-picking. There are many factors that can affect where, when, and how much an individual engages in pulling or picking behaviors. Oftentimes, the physical environment needs to be considered, as these behaviors might only take place in certain rooms or when no one else is present.
An individual's mood can also be an influence because there tends to be an increase in behaviors when someone is bored, anxious, or frustrated. Moreover, sensory cues need to be considered—whether it is an attempt to relieve a sensation, an itch, or a feeling.
A specialized trichotillomania and dermatillomania therapist can help you explore and evaluate your thoughts (“I'll only pull a few hairs”) and your posture (pulling anytime your hands are near your hair). While you may feel hopeless after numerous attempts to stop your behavior on your own, with the right support, you can learn to manage these urges in a different way.
Treatment Can Change Your Relationship With Trichotillomania and Dermatillomania Urges
While these pulling and picking behaviors and the shame associated with them may have caused you to suffer in isolation, your therapist can help you change how you interact with these thoughts, urges, and behaviors.
Our treatment sessions for trichotillomania and dermatillomania are designed to help you notice unhelpful thought patterns that occur before, during, and after picking or pulling and address environmental and other triggers that are leading to the behavior. Through therapy, you will also learn to change the way you think about your hair-pulling and skin-picking to discourage future episodes. And together with your therapist, you will then work to replace BFRB behaviors with other less destructive ones.
Hair-Pulling Disorder And Skin-Picking Treatment Methods
At The OCD & Anxiety Center, we continue to provide the most evidence-based interventions possible. The gold standard treatments for trichotillomania and dermatillomania, as well as other BFRBs, are Cognitive Behavioral Therapy (CBT) and Habit Reversal Training (HRT), in addition to the Comprehensive Model for Behavioral Treatment (ComB). The goal behind all of these treatments is to help you to change your relationship with your thoughts and urges and learn to respond in a different way.
In Cognitive Behavioral Therapy (CBT), a trichotillomania and dermatillomania therapist helps you to identify unhelpful thought patterns and change the way you think about your behavior in order to discourage future episodes of picking and pulling. They can help you to see cognitive distortions that only continue or contribute to your behaviors.
In Habit Reversal Training (HRT), you will practice waiting out the urges and replacing those behaviors with other less destructive behaviors, such as the use of manipulatives, gloves, finger tips, etc. You will track your behaviors in between every session in order to gain more awareness of them, identifying what is happening before and afterward. Treatment will assist you in changing your environment to reduce the chance and frequency of hair-pulling and skin-picking behaviors, evaluating at each session what has worked and what new strategies you may need to try.
The Comprehensive Behavioral Model (ComB) will assist you and your therapist in identifying sensory, cognitive, affective, motoric, and environmental antecedents and consequences. This will assist you in seeing what triggers your picking and pulling behavior, as well as how those behaviors are reinforced, either positively or negatively.
Even if these patterns of behavior have been prevalent in your life for a long period of time, with treatment for trichotillomania and dermatillomania, you can learn to interact with your thoughts and your urges differently, regaining control over your behaviors.
Perhaps You Are Considering Skin-Picking And Hair-Pulling Treatment But Still Have Some Concerns…
I have been judged for these behaviors in the past, which has led to a lot of shame. How do I know that my therapist will not add to that?
We understand your concern and deeply empathize with you. And our desire is to provide you with a nonjudgmental space where you can talk about the difficult experiences that you have had due to your picking and pulling behaviors. Please be assured that BRFB is a common diagnosis we work with, and you are not alone. We will be alongside you during therapy and hope you can see that, with our support, you can overcome skin-picking and hair-pulling behaviors.
I tried treatment before. How is this different?
Cognitive Behavioral Therapy and Habit Reversal Training are the most evidence-based treatments for trichotillomania and dermatillomania. If you have been in treatment before, we will assess what has worked and what has not worked, assisting you with learning new strategies. Therapy is meant to be time-limited, and you should see progress relatively quickly through psychoeducation, increased awareness, and the development of skills to help break the current patterns.
I should be able to handle this myself. Why therapy?
Left untreated, picking and pulling behaviors can have lifelong impacts. Many people struggle to manage this on their own without the proper skills. At The OCD & Anxiety Center, we can teach you the skills you need to prevent this lasting negative impact and allow you to get back to experiencing life the way you want.
Relief From The Impact Of BFRBs Is Possible
If trichotillomania and dermatillomania have robbed you of confidence, treatment with The OCD & Anxiety Center can help you break free from shame and distress. To address further concerns or schedule an appointment, please call us at (630) 522-3124 or email us at email@example.com.
If you would like additional information, please consider reading our newsletter or blog as well.