Therapy & Counseling, Lake Oswego

Body Focused Repetitive Disorders (Trichotillomania & Skin Picking)

What does it look like?

People with Body Focused Repetitive Disorder have a set of disorders categorized by “self-grooming” behaviors that include pulling, picking, biting, or scraping one's hair, skin, or nails. Though BFRBs—which include trichotillomania (compulsive hair pulling), dermatillomania (compulsive skin picking, also called excoriation disorder), and onychophagia (compulsive nail biting)—have been theorized to be related to anxiety disorders, impulse control disorders, and obsessive compulsive disorder, most experts agree that they differ significantly from all three. Though certain BFRBs are currently categorized as “impulse disorders”, debate remains as to whether these grooming behaviors are undertaken impulsively or compulsively.

Who is affected?

The prevalence of Body Focused Repetitive Disorder (BFRB) is estimated to be at least 3 percent of the population, affecting both children and adults.

Where does it come from?

Research indicates that some people may have an inherited predisposition. There are other factors involved as well, including temperament, environment, age of onset, and family stress factors. BFRB's are among the most poorly understood, misdiagnosed, and under treated groups of disorders. The key factor underlying BFRBs is difficulty resisting the urge or impulse to perform a certain behavior that causes a degree of relief. The behavior continues because the BFRB results in a more pleasant state therefore, it is negatively reinforced.

When does it happen?

Body Focused Repetitive Disorder (BFRB) most often begin in late childhood or adolescence.

How do we treat it?

The most effective treatment is Cognitive Behavior Therapy with problem solving skills training. Some relaxation techniques are also used in treatment. CBT aims to help you overcome fears by correcting irrational thoughts and changing problematic behaviors. By acquiring a certain mindset, you can learn to approach anxious situations differently and learn to tolerate the anxiety and uncertainty.