Body-focused repetitive behaviors (BFRBs) are often misunderstood. Behaviors such as hair pulling, skin picking, nail biting, and other repetitive behaviors involving the body can cause physical and emotional distress, yet many people still believe that BFRBs are intentional, attention-seeking, or simply a matter of poor self-control.
These misconceptions can increase shame and prevent people from seeking help.
Let’s take a closer look at three common myths about BFRBs and the facts behind them.
Myth #1: BFRBs Are Self-Harm
Because skin picking and hair pulling can cause physical injury, it’s easy to assume that BFRBs are a form of self-harm. However, BFRBs and intentional self-harm are different.
Self-harm generally refers to intentionally injuring oneself as a way of coping with emotional distress or for another psychological purpose. BFRBs involve repetitive behaviors that may be triggered by an urge, sensory experience, emotion, thought, boredom, or a perceived imperfection.
For example, someone with trichotillomania (hair-pulling disorder) may feel an urge to pull a particular hair because of the sensation it creates. Someone with excoriation disorder (skin-picking disorder) may feel compelled to pick at a scab, bump, or perceived irregularity.
BFRBs can result in wounds, scarring, infections, or hair loss, but causing injury is not necessarily the intention.
Understanding this distinction is important because BFRB treatment is different from treatment for self-harm and should address the specific patterns and triggers associated with the behavior.
Myth #2: BFRBs Are Attention-Seeking
One of the most hurtful myths about body-focused repetitive behaviors is that people engage in them to get attention.
In reality, many people with BFRBs go to great lengths to hide their symptoms.
Someone with hair pulling may wear hats, change their hairstyle, use hair extensions, or avoid social situations where their hair loss could be noticed. A person who picks their skin may cover wounds or scars, avoid showing certain areas of their body, or feel embarrassed about visible marks.
BFRBs are often accompanied by shame, embarrassment, frustration, and anxiety. Being told that the behavior is “just for attention” can make these feelings worse and may discourage someone from asking for help.
BFRBs are not typically about getting attention. They are often behaviors that a person wishes they could control but finds extremely difficult to stop.
Myth #3: People With BFRBs Can “Just Stop”
Perhaps the most frustrating myth is that someone with a BFRB simply needs to exercise more self-control.
If people could simply decide to stop pulling or picking, many would have done so already.
BFRBs can become deeply ingrained behavioral patterns. Some behaviors occur automatically, meaning a person may pull their hair or pick their skin without fully realizing it. Other behaviors are more focused and occur in response to an urge or uncomfortable sensation.
BFRBs may also temporarily provide relief, satisfaction, stimulation, or a sense of emotional regulation. This temporary reward can reinforce the behavior and make it harder to resist over time.
That doesn’t mean change is impossible. It means that “just stop” is not an effective treatment strategy.
With appropriate BFRB therapy, individuals can learn to recognize triggers and urges, increase awareness of automatic behaviors, develop alternative responses, and reduce the frequency and impact of BFRBs.
Help For BFRBs Without Judgment
Body-focused repetitive behaviors are not a character flaw, an attempt to get attention, or simply a lack of willpower. BFRB therapy is offered at Anxiety & OCD Therapy of Maryland, with evidence based approaches that work. You don’t have to hide your symptoms or feel ashamed to ask for support. Reach out and you will receive a personal reply within one business day.
