Challenging Myths about Hair-Pulling and Skin-Picking
Hair pulling, skin picking, nail biting, cheek biting–these common human behaviors are known collectively as Body-Focused Repetitive Behaviors, or BFRBs. BFRBs have been poorly understood for decades, allowing several myths to spring up that remain commonly espoused today. Read on to learn how more recent scientific inquiry into BFRBs has challenged a number of these myths.
MYTH: People with BFRBs pull hair or pick skin in an attempt to harm themselves, akin to burning or cutting oneself.
Not so. BFRBs are not intentional self-harm. Unlike those who self-harm, people with hair pulling and skin picking are not trying to hurt their bodies in order to offset unbearable psychological pain. Instead, BFRBs are now thought to be an exaggerated manifestation of the human grooming instinct. In addition, there is a genetic component to BFRBs. Looking through their family trees, people with BFRBs often identify relatives who also contend or contended with picking or pulling.
MYTH: Hair pulling and skin picking are compulsive behaviors stemming from Obsessive-Compulsive Disorder (OCD).
Wrong again. Research from the past few decades has removed BFRBs from under the OCD umbrella, and here’s why: people with OCD perform compulsive behaviors in an attempt to neutralize anxiety or rid themselves of intrusive thoughts. They rarely enjoy the compulsive behaviors, instead completing them because they believe they must. By contrast, people with BFRBs usually derive some satisfaction from the behaviors. Some say pulling or picking feels good, and others find it gratifying to rid oneself of skin blemishes or hairs that don’t match the others. Still others pick or pull without being consciously aware of it, sometimes even in their sleep.
MYTH: People with BFRBs pull their hair or pick at their skin because they are anxious.
Not necessarily. Anxiety is not always present in people with BFRBs, and traditional anxiety treatments (medicine and talk therapy) generally do not help people with BFRBs to reduce their pulling or picking. That said, people diagnosed with both anxiety and a BFRB often find that their anxiety exacerbates their BFRB.
MYTH: BFRBs are rare.
No. On the contrary, researchers estimate that between 3% and 5% of the human population experiences a BFRB. OCD, by contrast, affects less than 2% of the population. Experts also suspect that the actual number of those contending with BFRBs is even higher–the behavior is often underreported because of embarrassment or shame.
MYTH: Nothing really works to help people reduce their pulling and picking.
Untrue. One of the most promising therapies used with BFRBs, called Comprehensive Behavioral Treatment (ComB), has helped many people reduce their picking or pulling behaviors or even abandon them entirely. ComB helps people: 1) understand the situations, thoughts, and feelings that trigger and sustain their pulling or picking, 2) identify strategies to prevent the behaviors from occurring, and 3) replace the behaviors with satisfying actions that do not harm their bodies.
For more information, visit www.bfrb.org.
Sarah Ince, LCSW
Licensed Clinical Social Worker