Why do I struggle to resist the urge to pick at the bumps on my skin?
Would you like to know how to stop picking at your face or to stop picking at your skin in general? Mosquito bites, acne, scabs, eczema, keratosis pilaris, and various other skin issues can be tempting to pick. We have a natural desire for symmetry and smoothness on our skin. The sensory satisfaction that comes from achieving smoothness after picking can become habit forming for some people. The reward center of the brain, known as the nucleus accumbens, becomes activated and triggers the urge to continue the picking behavior. People may feel pleasure, satisfaction, a sense of calm, or a tension release when they pick.
The self-perpetuating behavior can be difficult to control and can cause a dissociative experience, making it much more difficult to break out of the picking trance.
What are some ways to stop picking my skin?
Stimulus control techniques are very effective in controlling the behavior. Putting barriers on the fingers or blemishes can cut down on the tactile reward of picking and can make it more difficult to access the skin. Covering mirrors and dimming lights can diminish the urge to pick by reducing the ability to see skin imperfections. Fidget rings can also mitigate the urge to pick, as well as other types of interesting sensory objects that can keep the hands and mind occupied.
A well planned out day can help keep anxiety and boredom down. Being overwhelmed with to-dos or being underwhelmed with a lack of activity can set off the compulsion to pick. Planning out the day can also help keep you mindful of and accountable for your actions.
What are some symptoms of skin picking disorder?
Picking, digging, scratching, squeezing, and rubbing the skin excessively can all be symptoms of a skin picking disorder. This disorder is also known as dermatillomania or excoriation disorder and is a spectrum disorder of OCD.
There is often a tension-filled urge to pick at the skin with or without conscious awareness. The act of picking generally causes negative aesthetic consequences like bleeding, swelling, open wounds, discoloration, and scarring. It can also cause pain and infection.
What are some of the emotional consequences of picking?
People who engage in skin picking compulsions often feel a great deal of shame and embarrassment afterwards. They may try to hide the skin damage with makeup, bandages or clothing and may deny or keep it a secret from others.
The shame and the visible damage to their appearance can cause anxiety, depression, social isolation and other mental health problems. People generally feel a loss of control and may not believe that they have the ability to control their compulsive behaviors. They may feel a sense of loneliness if the people in their lives do not understand or sympathize with this body focused repetitive behavior.
Skin picking can also negatively impact relationships. People may fear intimacy because of the embarrassment related to the skin damage. In addition, their partners may feel angry or disgusted by the picking behavior. The person who struggles with the picking behavior may monopolize the bathroom or cancel plans or be chronically late due to their habit. In addition, they may rely on skin picking as a coping mechanism for dealing with relationship difficulties. They may turn to this behavior when they are frustrated by their partner or when they are struggling to assert themselves in an effective way.
How does CBT help you stop picking your skin?
HRT: A specific form of CBT known as habit reversal training (HRT) and stimulus control technique is very helpful in raising awareness, setting up barriers to control the behavior, and gaining a better understanding of the triggers that lead to the picking.
SCAMP: In addition to HRT, the SCAMP model addresses the body focused repetitive behaviors (BFRBs) by identifying the sensory, cognitive, affective, motor and place-related factors that are involved in the urge to pick.
Mindfulness: Mindfulness is another essential component of treatment for BFRBs. It reminds people to pause, reset, breathe, stay present, and take a moment for self compassion.
Progressive Muscle Relaxation (PMR): PMR is a type of muscle relaxation that involves tensing and relaxing isolated muscle groups from head to toe in order to increase body awareness.
Competing Response Training (CRT) : CRT is a CBT technique that teaches the individual to use opposing muscle actions to counteract the unwanted behaviors.
Acceptance and Commitment Therapy: By allowing negative thoughts, feelings and urges to pass through you without picking at your skin, you can learn to self-regulate without emotional reactions.
What causes this disorder?
Genetics: Genetics can be a factor in body focused repetitive behaviors. Skin picking has been shown to run in families.
Brain function: Differences in the structure and function of the brain are other variables found to be involved in skin picking and other habit forming disorders. Reduced gray matter and alterations in white matter have been observed in people with this disorder.
Mental Health Conditions: People with BFRBs are more likely to suffer with OCD, anxiety, trauma, depression, sensory dysregulation issues, ADHD, and executive functioning disorders.
Seeking help for skin picking disorder
If you suffer from body focused repetitive behaviors, reach out to Dr. Suzanne Feinstein at Advanced Behavioral Health. Dr. Feinstein is a Columbia University-trained Clinical Psychologist who specializes in evidence-based treatments such as Habit Reversal Therapy (HRT), cognitive reframing, mindfulness training and other CBT techniques.
Dr. Suzanne Feinstein has been treating clients with BFRBs (Trichotillomania, Dermatillomania, nail biting), OCD, tics and related disorders since 1995. In 2000, she received her NY license and became the Clinical Director of Advanced Behavioral Health, LLP.
Dr. Feinstein also treats the full spectrum of anxiety and mood disorders using CBT among other modalities. She also helps people overcome time management issues, procrastination, perfectionism and symptoms related to Attention Deficit Disorder.