Body-Focused Repetitive Behaviors

Body-Focused Repetitive Behaviors (BFRBs) is a term to describe a variety of compulsive behaviors including, skin-picking, hair-pulling, nail biting, cheek biting, or other similar behaviors. There is no clear explanation why some people develop BFRBs over others. Sometimes the behavior serves as a stress release, sometimes the behavior comes up out of boredom, or someone could have family members who engages in a BFRB as well. Some BFRBs can be considered Impulse Control Disorders and can cause significant damage to one’s body. This often chronic problem can be extremely difficult for someone to stop despite their efforts or desire to stop. This particular type of behavior cannot be explained by another medical condition and can cause distress to the individual.

Skin-picking also known as Excoriation Disorder or dermatillomania, is repetitive picking, scratching, rubbing, biting and touching of one’s skin in an attempt to improve perceived imperfections, often resulting in tissue damage, discoloration, and or scarring. 

Hair-pulling, or trichotillomania (trick-o-till-o-may-nee-uh), is the act of repetitively pulling one’s hair which can result in significant hair loss. Trichotillomania can be pulling hair from the scalp but it can also include pulling eyelashes, eyebrows, facial hair, the pubic area, or another area of the body. Without treatment, trichotillomania tends to be a chronic condition that may come and go throughout a lifetime.

Treatment for BFRBs

BFRBs can improve with treatment and finding a knowledgeable and trained therapist is key. Evidence-based treatments for BFRBs include a specific Cognitive-Behavioral Therapy (CBT) called Habit Reversal Training (HRT) and an enhanced HRT protocol – the Comprehensive Behavioral Model (ComB). Dialectical Behavior Therapy (DBT) and Acceptance and Commitment Therapy (ACT) have also demonstrated to be effective supplemental approaches. As a graduate of the TLC Foundation for Body-Focused Repetitive Behaviors Virtual Professional Training Institute for body-focused repetitive behaviors, I incorporate the ComB model along with DBT and mindfulness approaches in treatment of BFRBs.