Body-Focused Repetitive Behavior (BFRB) Treatments (drafted by HealTheHealer)

BFRBs include compulsive hair pulling (Trichotillomania), skin picking (Dermatillomania), and nail biting, among other repetitive behaviors (e.g., lip biting). These conditions cause significant distress and impairment in a person’s life and are linked to experiences including anxiety, depression, and shame among others.

Image Credits: Posted on Mental Health America. All credits to the creator. I don't own this image.

Treatment recommendations for BFRBs include Cognitive Behavioral Therapy(CBT) and medication/ pharmacotherapy. CBT has been shown to help individuals with BFRBs identify triggers that cause picking or pulling. A specific form of behavioral therapy known as Habit Reversal Training may also be highly effective for recognizing behavior patterns and managing the negative emotions associated with BFRBs.

Several self-help strategies have helped people with BFRBs manage the behaviors on their own. These include:

• using an object to occupy the hands during times when pulling occurs

• wearing gloves or mittens to make picking harder

• joining a support group to connect with others with BFRBs.

Cognitive Behavioral Therapy (CBT) encompasses:

1. Self-Monitoring (to increase awareness and understanding of factors that contribute to the unwanted behavior)

2. Habit Reversal Training (core interventions)

1. Awareness Training

2. Stimulus Control (e.g., barriers and use of fidgets as “speed bumps” to prevent unwanted behavior)

3. Competing Response Training (learning to replace the unwanted behavior with an incompatible response, such as making tight fists with hands)

3. Relaxation Training

4. Cognitive Techniques (challenging unhelpful thinking patterns that contribute to the BFRB)

5. Enhanced with Acceptance and Commitment Therapy (ACT)/Dialectical Behavioral Therapy (DBT) techniques (to promote self-regulation, tolerance of distress/urges of BFRB, and management of slips)

6. Relapse Prevention/Lapse Management to promote maintenance of gains and adaptive management of slips

Pharmacotherapy:

• A few medications have been found to reduce symptoms in some individuals.

• Often seem to work by lessening feelings or sensations that trigger the BFRB, rather than directly targeting the BFRB itself.

• Also believed to help address comorbid conditions that can interfere with treatment.

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Tagging some people who have been interested in BFRBs in the past (hope that's okay) : @theriverissinging, @vlostwithyouv, @charmingHuman5049, @crofton09, @cafedaydreams , @resourcefulPond1641, @GracefulWarrior