Body Focused Repetitive
Behaviors Therapy
online throughout Maryland
Are Skin Picking Or Hair Pulling Behaviors Creating Shame And Distress?
Do you experience body-focused behaviors or habits—including hair pulling, nail biting, or picking your skin—that you can’t seem to control?
Are these behaviors becoming disruptive, all-consuming, and physically damaging?
Have you developed a sense of shame or secrecy around these behaviors?
Body-focused repetitive behaviors, or more simply BFRBs, can be attempts to self-soothe and often develop early in life. Most people do not realize that BFRBs are a neuropsychological disorder involving multiple parts of the brain, including awareness, impulse control, movement inhibition, and emotional regulation.
There are some common BFRBs that include:
Trichotillomania (pulling hair from scalp, eyelashes, eyebrows, or other places)
Excoriation (picking skin)
Onychophagia (nail biting)
Chronic cheek or lip biting
If you live with these behaviors, then you may feel frequently distracted, overwhelmed, and exhausted by urges.
You may tell yourself “this is the last time,” only to find yourself picking or pulling hours later. Despite attempts to stop, especially as you begin to see physical changes occurring, you may feel unable to control the behavior. Maybe you lose countless hours to grooming—picking or pulling until it feels “right.”
Or maybe you fall back into the behavioral pattern every time you zone out or engage in some other activity, like reading or watching TV. It’s possible you’ve noticed that as stress and anxiety increase, so does the need to repeat the behavior. Sometimes the behavior may feel out of your awareness (called unfocused BFRB), while other times the behavior may feel more intentional, such as when it’s done in front of a mirror (called focused BFRB).
The Emotional, Mental, And Physical Effects Of BFRBs Create A Heavy Burden
I understand the emotional impact BFRBs can have on your life. Not only do you experience the mental and physical effects of the compulsion/behavioral pattern—you may also feel embarrassed and anxious about being around others. Secrecy is often an aspect of living with a BFRB, reducing feelings of connection and healthy self-esteem.
Therapy helps you manage the stress of life without engaging in body-focused repetitive behaviors. By incorporating evidence-based treatment approaches, you will learn new skills for reducing urges and managing distress.
Have a question? Send me a message
There Is No Shame In Seeking Help For A BFRB
BFRBs are considered an obsessive compulsive-related disorder in which the picking or pulling behavior is the compulsion. It is common for Obsessive-Compulsive Disorder (OCD) to coexist with BFRBs.
Shame and embarrassment often come with the visible changes to appearance that occur as a result of BFRBs. Maybe you’re suffering in silence with deep feelings of isolation and self-judgment. You may have put off seeking help for many years out of a fear that a therapist will dismiss your BFRB or misunderstand it as attention-seeking.
You deserve support and to know that you are not alone in these behaviors. In fact, trichotillomania is estimated to affect anywhere from 3 to 6 million people, while 1 in 20 individuals report their skin picking symptoms are severe enough to cause distress.
These issues are treatable—and together in therapy, we can conquer your body-focused repetitive behaviors.
Anxiety & OCD Therapy Of Maryland Specializes In Treatment For Body-Focused Repetitive Behaviors
As a therapist specializing in BFRBs, I know that treatment is not as simple as saying, “Just stop!” I want to approach your history from a place of curiosity and nonjudgment so I can understand when your symptoms originated, how they show up currently, and what beliefs about yourself have developed around your behaviors.
There is a lot of misunderstanding about BFRBs, so a big aspect of our work together will be laying the foundation for an accurate, self-compassionate understanding of these patterns.
My Treatment Approach
Therapy is highly individualized to your specific symptoms and needs, incorporating evidence-based treatments for BFRBs such as:
Habit Reversal Training, which builds tools for behavior tracking and awareness training so that other interventions can be introduced.
Comprehensive Behavioral Therapy (ComB) focuses on developing core skills and targeted categories (SCAMP—Sensory, Cognitive, Affect, Motor, Place) to reduce picking and pulling behaviors.
Acceptance & Commitment Therapy (ACT) teaches skills for mindfulness, acceptance, and self-compassion that will lead you toward a more fulfilling life according to your values
Together in treatment, we work to build, practice, and implement your skills in a way that allows you to manage BFRB-related urges both in and out of the therapy space.
These approaches work! While there is no cure for body-focused repetitive behaviors, they can be managed with therapy. No matter how many years you’ve been struggling—and how consuming these behaviors may have become—there is hope for lasting change. With the right support, you can have the life you deserve… free of the burdens caused by BFRBs.
Frequently Asked Questions About Therapy For BFRBs
I have other mental health conditions besides a BFRB—can your treatment approach still help?
It is extremely common for body-focused repetitive behaviors to co-occur with other mental health issues, particularly anxiety, panic disorder, depression, PTSD, and OCD. As a seasoned therapist, I have extensive experience treating all of these issues.
My practice specializes in OCD and compulsive behaviors. My approach strives to see the big picture of how your symptoms are showing up. Rather than isolating your concerns, I try to take into consideration all the factors that may be contributing to the behavioral pattern so that deep, lasting change is possible.
Will you view my BFRB or related injuries as self-harm? I don’t want to be misunderstood as needing emergency psychiatric intervention.
It’s true that BFRBs can lead to physical injury and harm, including skin infections, hair loss, pain, and scarring. However, I understand the difference between these behaviors and intentional injuries due to self-harm.
Psychiatric hospitalization would only be necessary if injuries crossed the line into intentionally life-threatening self-harm or suicidal thoughts with a plan. I will make sure to clarify my policies and expectations during the intake process.
My body-focused repetitive behavior has been present for as long as I can remember—can therapy still help?
No matter how long you’ve been struggling with picking or pulling behaviors, you are not a lost cause. So many of the clients I work with have put off therapy for years because their BFRB was misunderstood, misdiagnosed, or they were afraid of being judged.
These behaviors can be managed and treated. Having specialized in OCD and related disorders for years, I have seen how my structured, evidence-based treatment approach effectively treats BFRBs.
Take Back Your Sense Of Control
If you suffer from the effects of hair pulling, skin picking, nail biting, or another body-focused repetitive behavior (BFRB), treatment through Anxiety & OCD Therapy of Maryland can help. For more information, contact me, and you will receive a personal response within one business day.
Serving clients virtually in Maryland
