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Trichotillomania and Excoriation Disorder are listed in the DSMV as subtypes of OCD or Obsessive-Compulsive Disorder.
Hair pulling and skin picking are repetitive self-grooming behaviors in which pulling, picking, biting or scraping of the hair, skin or nails result in damage to the body. Common Body Focused Repetitive Behaviors or BFRBs include skin picking (of scabs, acne, or other skin imperfections, for example), cuticle or nail biting or picking and lip or cheek biting.
These behaviors share similar characteristics. The urges can be very powerful and difficult to stop. They can be “unconscious” movements while reading, talking on the phone, watching TV or engaging in some other activity. Or there may be times when BFRBs are done in a fully focused way, for example when pulling out a hair that “doesn’t feel right” or picking a scab while looking at it in the mirror.
Some people engage in BFRBs when they are bored or to control their emotions when they are feeling anxious, tense or upset. Specifics of BFRBs will vary between individuals.
There is no one identified cause of BFRBs, Trichotillomania (Hair pulling) and Excoriation Disorder (Skin Picking). It may develop due to a combination of genetic, emotional and environmental factors. There is a correlation with having OCD as well as having family members with OCD.
Anxiety Treatment Services provides integrative and comprehensive individual therapy for Trichotillomania (Hair pulling) and Excoriation Disorder (Skin Picking) and other body-focused repetitive behaviors.
Modalities include Cognitive-Behavioral Therapy including Habit Reversal Training (HRT), and Meditation/Mindfulness. Since BFRB issues will vary from person to person, ATS therapists evaluate each case and creates an individualized treatment plan for that person’s unique situation.