#pickingme

[skinpickingsupport]

For the last day of BFRB Awareness Week, I want to announce that Scars of Shame is now free to watch online!

Please reblog to spread awareness about compulsive skin picking through this comprehensive documentary, which features top BFRB experts! Let us know what you think by commenting or using #ScarsOfShame in your posts!

[melissa-titanium]

ALRIGH. i cant finish the v tonight cus my aunt is pickingme up b ur :)

[wolfbitingstarboy]

BFRB Resources for Struggles Like Ours

These resources vary from reliable sites and blogs to published journal articles, professional papers, books, and more. If you have any recommendations for me, feel free to Submit something.

A separate post for tips, tricks, and non-affiliate product recommendations will be linked here as soon as I've posted it.

Now then, some of you may be wondering...

What is a BFRB?

Body-focused repetitive behaviors are among the most poorly understood, underdiagnosed, and untreated group of mental health disorders.

According to the TLC Foundation for BFRBs:

"Body-focused repetitive behaviors (BFRBs) include any repetitive self-grooming behavior that involves biting, pulling, picking, or scraping one’s own hair, skin, lips, cheeks, or nails that can lead to physical damage to the body and have been met with multiple attempts to stop or decrease the behavior."

(From the TLC Foundation's webpage, "What is a BFRB?")

The PickingMe Foundation says:

"BFRB's are self-grooming behaviors in which individuals pull, pick, scrape, or bite their own hair, skin, or nails, resulting in damage to the body. Many people are more familiar with its sister disorder, Trichotillomania - Hair Pulling Disorder."

(From the PickingMe Foundation's webpage, "What is Dermatillomania?")

The Recovery Village describes BFRBs as:

"Body-focused repetitive behaviors (BFRBs) are a group of mental health conditions that cause people to bite, pick, pull or scrape their skin, hair or nails compulsively. While some people with BFRBs have awareness and insight into their behaviors, others do them automatically. BFRBs are often linked with disorders like anxiety or substance abuse. Treatment is essential for people with BFRBs, but many often hide evidence of these harmful actions and have trouble asking for help."

(From The Recovery Village's webpage, "Body-Focused Repetitive Behaviors")

According to Angela Hartlin's skin-picking support website:

Body- Focused Repetitive Behaviours (BFRB’s) “is an umbrella term for any chronic behavior that causes a person to consistently cause physical damage to oneself unintentionally through a compulsive act in order to relieve anxiety.” The key difference between BFRB and other compulsive behaviours that cause harm to the body is that BFRBs are characterised by direct body-to-body contact. The website goes on to list other BFRBs such as: hair-pulling disorder (trichotillomania), hair eating disorder (trichophagia), skin biting disorder (dermatophagia), nail biting disorder (onychophagia), and nose picking disorder (rhinotillexomania).

Getting BFRBs officially classified as disorders has been a long, slow process that only hurts those of us who struggle with them daily, as treatments and available resources relating to BFRBs can be very difficult to find. That's the reason why I'm composing this. I'll keep updating this post to the best of my abilities, both for myself and for anyone else it might help.

The good news is that while progress may be slow, there is still progress. Dermatillomania was finally added to the DSM-V-TR under the same OCD-Related Disorders umbrella as Trichotillomania, which has been a big step in the right direction. The more awareness brought to BFRBs, the sooner more can be recognized for what they are so the people suffering from them can receive proper medical and psychiatric help where necessary.

Are BFRBs a type of self-harm?

No.

While the two are not mutually exclusive, the general consensus seems to be that where self-harm is voluntary, BFRBs are grooming behaviors that have gone awry to the point that they are categorized as "OCD-Related Behaviors" in the DSM-V-TR due to their compulsory nature. These behaviors may or may not be driven or worsened by anxiety.

In the case of BFRBs, even though these behaviors cause varying degrees of bodily harm, they're ultimately driven by impulses and urges that cannot easily be controlled. Quite often the triggering event is discovering a physical imperfection in any way for any reason and attempting to "fix" it, despite the behavior being counterintuitive to the goal. The resulting behavior can occur actively or passively, with severe active episodes usually likened to being held hostage in your own body.

There is no desire to harm and very little ability to stop, and then all of it is followed by distressing feelings such as shame, guilt, or embarrassment. We try so hard to "break the habit" that we ultimately beat ourselves up mentally for "failing" yet again. Even though many of us might know we can't control it, it's too easy to blame ourselves for something we feel is somehow our fault.

[Please be advised the purple paragraphs below are personal examples with a few details that may be triggering for some.]

For example, the only way I can come out of bad episodes is when my bodily literally cannot continue. This may look like my back giving out from leaning on the counter in the bathroom, or my legs going completely numb from sitting for too long, or (much more commonly) my fingers or nailbeds hurt too much for me to keep using them, regardless of how much I may or may not have bled.

This is always followed up by what I call the "walk of shame" phase as I clean up every injury, apply Neosporin or other balms/salves, and bandage what I can. I've burst into tears before when I had to use Neosporin like it was lotion in order to cover everything, because I had too many wounds on my arms to be able to safely apply bandages/plasters.

No part of that process, from the trigger response to the cleanup, is something I want to do. If I had a say in it, I'd never pick or bite ever again, and my skin would finally be able to heal.

Self-harm, on the other hand, is a term reserved for bodily harm that is deliberately inflicted on oneself, usually as a way of dealing with difficult emotions, memories, situations, or experiences. Instead of acting on an uncontrollable compulsion, this type of harm stems from a different set of triggers, many of which relate to trauma or other disorders. This makes the behavior more of an unhealthy coping mechanism for people in pain who are desperate for release from those feelings.

Note: If you are unsure if your behaviors are a result of a BFRB or self-harm, Crisis Text Line is a good resource:

"Self-harm is serious. And, while the intention behind self-harm usually is not death, it can still be dangerous—both physically and emotionally. Talking to someone who can help you find alternatives is incredibly important. Of course, you can start by texting us. Also, consider telling someone you know who can help you connect with a professional."

General BFRB Resources:

Sites:

The TLC Foundation - "The TLC Foundation for Body-Focused Repetitive Behaviors helps end isolation and shame for people experiencing hair pulling, skin picking, nail biting, cheek biting, and associated behaviors." They feature a robust website full of information on all BFRBs, including "Medications for BFRBs" and "Evidence-based Therapeutic Treatment for BFRBs."

The Recovery Village - "The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals." (BFRB-specific information can be found here.)

SkinPick.Com - While this site is centered around skin picking/excoriation disorder/dermatillomania, they have excellent resources for other BFRBs as well, including their Glossary page, "Complete List of BFRBs," and the blog section for "Related Disorders." I have also listed their site in the Dermatillomania section below.

Articles:

Online Journal: International Journal of Environmental Research and Public Health, Special Issue: "Body-Focused Repetitive Behaviours (BFRBs). Risk Factors, Prevention, Treatment"

The Recovery Village’s article, "7 Myths About Body-Focused Repetitive Behaviors"

The Recovery Village’s article, "8 Little Known Facts About Body-Focused Repetitive Behaviors"

Outreach:

"Health Education & Community Programs" (the TLC Foundation)

Communities & Support:

PickingMe Foundation's Online Support Group.

TLC Foundation's Support Group Directory for peer-led support groups.

SkinPick's online Forum.

Self-Help:

Nathan Peterson's ComB Model for BFRB Treatment, Part 1 and Part 2 on YouTube. Peterson is a licensed OCD specialist who helps people with OCD, anxiety, and BFRBs in person, through his OCD & Anxiety YouTube channel, and through his site, OCD-Anxiety.Com. (His BFRB specific course can be found on his site here.)

SkinPick's free self-guided program to stop skin-picking.

PickingMe Foundation's Derma Resource Packets "...are our campaign to spread Dermatillomania awareness to skin care providers (Dermatologists, Estheticians, Nail Salons, Clinicians), mental health professionals, and anyone who wants more info! We provide them with tools and the opportunity to point Skin Picking Disorder sufferers in the right direction."

PickingMe Foundation's Management Tips page, a "growing list of tips and management strategies!"

Mobile Apps:

SkinPick App – "A free tool to monitor your skin picking behaviors."

Specific BFRB Resources:

Onychophagia:

Not every instance of nail-biting is considered onychophagia. Most nail-biting behavior dissipates over time. It’s when it doesn’t that the behavior requires a closer look. Chronic nail-biting is categorized as an obsessive-compulsive related disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).

SkinPick's blog post, "Onychophagia: More Than a Nervous Habit"

"Art of Prevention: The importance of tackling the nail biting habit," authored by Mohsen Baghchechi BS, Janice L. Pelletier MD, FAAP, Sharon E. Jacob MD, FAAD, FAAP. Published in the International Journal of Women's Dermatology, Volume 7, Issue 3, June 2021, Pages 309-313.

"Update on Diagnosis and Management of Onychophagia and Onychotillomania," authored by Debra K. Lee and Shari R. Lipner. Published in the International Journal of Environmental Research and Public Health, 2022, 19, no. 6: 3392.

Dermatophagia:

Formerly referred to as "wolf-biting," dermatophagia has yet to be recognized as a diagnosable disorder.

SkinPick's blog post, "Do you eat your own skin after picking? There's a name for that."

SkinPick's blog post, "Dermatophagia - What is it?"

Dermatillomania:

Dermatillomania means “Skin Pulling Madness,” and has only been diagnosable since 2013. It is currently classified as an “Obsessive-Compulsive and related disorder” in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), where it is listed as Excoriation Disorder. However, it is known by many names, such as: Skin Picking Disorder, Compulsive Skin Picking, Acne Excoriée, Pathological Excoriation, Neurotic Excoriation, Pathological Skin Picking, and Psychogenic Excoriation. The many names for this disorder cause interference with its understanding and awareness.

Dermatillomania is often confused with other conditions. Common misdiagnoses result because the picking behavior is a result of a medical condition, confused with OCD, Body Dysmorphic Disorder (BDD) and in some cases, Non-suicidal Self-Injury (NSSI).

PickingMe Foundation - "Picking Me Foundation NFP is the only donor-supported non-profit dedicated to advocating for Dermatillomania (Skin Picking Disorder) sufferers, supporters, and educational communities alike, encouraging individuals to choose themselves over the mental illness that chose them by #PickingMe over Skin-Picking."

Angela Hartlin's Skin Picking Support website. Hartlin is the author of, "FOREVER MARKED: A Dermatillomania Diary" and the creator of the documentary, "Scars of Shame," which you can watch for free here with the password, "Scars1" (Thanks, Angela!)

SkinPick.Com - "SkinPick is the #1 platform to treat excoriation disorder (dermatillomania). Get one-on-one support from a therapist specializing in treating compulsive skin-picking through evidence-based techniques."

SkinPick's "Do I Have Dermatillomania?" Test

SkinPick's blog post. "Skin Picking and Body-Focussed Repetitive Behaviours (BFRB)"

Stuff That Works’ page, “Excoriation (Skin-Picking) Disorder”

Trichotillomania:

Probably the most famous BFRB, Trich has the most resources available thanks to being the first diagnosable BFRB. The resources below are more general as a result:

TrichStop - "TrichStop is the world’s leading platform for Trichotillomania treatment. Get one-on-one support from a therapist specializing in treating compulsive hair pulling through evidence-based techniques." From the same support team behind SkinPick.Com.

TrichStop's "Do I Have Trichotillomania?" Test

TrichStop's blog post, "Trich and Comorbid Disorders: What We Are Learning"

The TLC Foundation's Trichotillomania page.

"Trichotillomania," authored by Aubree D. Pereyra; Abdolreza Saadabadi. Published in StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. (Ongoing)

More to come.

There are more BFRBs than this out there, but I don't have the resources gathered for them yet. Hopefully the General resources help! I'll update this as I have time. In the meantime, I wish you all luck on your BFRB journeys.

-> Anxious? Try This:

[lacymoonchild]

[buzzbuzzgimme-yeyo]

Picking me over skin picking! Trying to over come unhelpful habits, sick of having sore fingers all the time & not being able to do fiddly things. Colourful plasters to distract/fiddle with instead of picking!

They sent me unicorn plasters instead of the Jesus ones. :( you make me sad amazon gods.

[olivia-vida-loca]

Here are my last 4 days! Today I will admit that I picked a few spots. A lot fewer spots than I typically did and not as severely and intently as I used to do, but I still picked (and I'm pretty sure the redness on my face showed up in today's pics :-\). And you know what? That's ok! Progress is never a straight line, and relapses happen. I could choose to be super upset and see this step back as failure, or I can recognize that this relapse is part of my healing process and an opportunity for me to learn new ways to help myself. I choose to continue to celebrate the massive success I've had over the past 17 days rather than let this small setback discourage me to the point of ending my journey 🙌 #dermatillomania #dermatilomania #compulsiveskinpicking #skinpicking #excoriationdisorder #recovery #mentalhealth #PickingMe https://www.instagram.com/p/B8DN3iAJRju/?igshid=1m5jphbyq2277

[owlmylove]

I saw in the notes of one of your posts that you have dermatillomania. I was recently diagnosed with that but it's been a problem for a long time. I've never met anyone else irl with dermatillomania, and I was just wondering if you could share any coping mechanisms you use? I've been getting acrylic mail manicures so I physically can't break skin but that only prevents damage. It's not helping me actually break the habit at all

lmfao oh darling. i love you for thinking i have any answers here

of course, since it's me, i do anyways

congrats on finally getting your diagnosis!! for those who don't know, Dermatillomania is a skin-picking disorder believed to affect as many as 1 out of 20 people, whether they're picking/biting at cuticles and nails, plucking hairs, popping pores or picking at scabs etc. etc. The skin-picking can be compulsive, often serving as a self-soothing behavior against extreme emotions, stress, anxiety, excess energy or simply boredom

first, check out the wonderful folks at the Picking Me Foundation, the largest nonprofit & digital resource for those with dermatillomania. Their website has an online support group, self-logging downloadables, and their "fiddle pack project," for strategically selected (and tailored for dermatillomaniacs [not sure if that's a word but i decided it is now]) $30 multipacks of stim toys!

they're 100% nonprofit, and every pack they sell is matched with the international donation of a pack to a therapist, pediatrician or fellow dermatillomaniac in need!

plus, check out #pickingme on social media for both their advice & solidarity among fellow picking enthusiasts

Picking Me has A++ strategic advice for their stim toys, and thinking strategically about your own behaviors and habits is my biggest advice. what does your picking look like? when do you find yourself doing it?

if a pattern doesn't immediately appear, try logging when & where you find yourself picking, what happened beforehand, and how you feel while doing so.

part of dermatillomania I don't always see discussed is the satisfaction of seeing your body's landscape change; picking as a control tactic, a means of self-soothing and reaffirming your autonomy and power. or it may be an expression of perfectionism, or anxiety, or beyond. pay close attention to yourself. look for the overlap. what is picking doing for you?

once you recognize the mechanisms of picking, what needs it's fulfilling, and when, and how; then you can provide new pathways for your habits to flow down; I realized I tended to pluck my brows (and beyond...) in the bathroom, so boom: stim toy in the bathroom. figure out your unique physical locations and cues and give yourself new options

also, hide or obstruct the ease of access to former habits. acrylic nails are a great personal block; I put my sharp tweezers in a wildly inconvenient place, not out in the open, so it's harder for me to casually grab them. if you bite your nails or cuticles, buy the nail polish that makes it taste gross. if you pick at inflamed pores, use zit stickers (I prefer the cheap and plentiful OG brand, COSRX, which are barely-visible circles, but you can make it fun with any of the 10 zillion novelty shape brands now available at Sephora, Target, Marshalls/T.J. Maxx & most drugstores) make picking difficult, and give yourself other options

similarly, you can challenge yourself to lovingly make growth your focus. smooth cuticle oil into your skin; use growth serums & your favorite-colored polish on your nails; for facial picking, give yourself spa days of clay masks (fun to pick off as they dry!), pore strips (SO satisfying), and scar-reducing facial oils like rosehip; for bodily picking, moisturize with lovely non-comedogenic oils and smooth Mederma or natural scar-reducing remedies to help your skin heal. put all that time and focused attention + love and gratitude into increasing, not reducing, your body (+ self)

re: gratitude, I swear to god Jessica Defino had a post about gratitude as a skincare routine; thanking your skin everyday for its work as a barrier, for it's countless built-in systems that self-exfoliate, self-moisturize, self-heal and grow, all while keeping a harmful world at bay. the skin is our largest living organ, and it is here to keep you warm and safe. your skin is built to touch and hold, to hug and be hugged. you can learn to love it the way it loves you. you can touch yourself as gently, as kindly as you deserve to be touched. this, too, is a kind of growing.

(Also to my facial & pore-picking beauties: just read any and all of Defino's articles about simplifying [like, soap water and moisturizer simplifying] your skincare, skin-fasting, the joys of touching your face gently, and more<333)

figure out what actions and textures you've become accustomed to, and, whether you have the benefit of a pack of stim toys like Pick Me's or just certain blankets, jackets, fidget jewelry, or one Really Good Rock, try to find stims that mimic, replace or even subvert the textures you've been drawn to. you want something satisfying and engaging to play with while still feeling meditative to you.

or if stim toys aren't your thing, (and even if they are!) try tactile pastimes that lead to obvious visual progress: painting, drawing, knitting, woodworking, cooking/baking!, cleaning [dishes, sheets, etc.] gardening, so on & so forth. things that prove your control & show the mark of your will wrought upon the world

the next time you find yourself wanting to pick (hopefully waylaid by an alternate hand function and/or strategic obstructions) take a mental step back. carve out that space between impulse & action. pool the feeling into your palms and examine it, tilt it around to see it catch a different light. how are you feeling right now? what's causing you to feel this way? what else could help you alleviate or accept that feeling?

if it's stress, anxiety, anger or other strong negative emotions, rest one hand over your heart, one over your lovely stomach, and take several deep yoga breaths. Long inhale through the nose, hold for a few seconds, longer exhale out. Let your throat make noise. After a few minutes, make a list of what’s worrying you and help yourself rationalize what tiny steps will help lessen their effects on you.

(Deep breaths, longer exhales and putting a hand over your heart have each individually been shown to alleviate your body's stress response, an immediate way to gift yourself some calm and a sense of safety)

if it's boredom; again, new textures and pasttimes are your friend. try going for a walk or other physical action of your choice (does not need to be long or challenging to be good for you!), listen to a podcast or new music, challenge yourself to try something new you've been wanting to explore, but can never find the time. a desire to pick can indicate you are suffering from a lack of enrichment: so yes, now is the time to try to learn the kalimba.

so, yes, it turns out i do indeed have many answers, but my initial scorn comes from any suggestion i might be above my bad habits; I've picked at my skin several times today. and that's okay. try to recognize and subvert your impulses when they happen, but also acknowledge and accept that they will happen. that's just how it goes babey. progress, not perfection.

love, luck and godspeed<33

[thacrowdmotivatar]

#NewMusic + #Video > Young DrA - #PickingMe prod. by Xcellence via @VirDiKO @DraOfficialmusic @MzOnPointPromo @cocoameka #MsMeka @BiggaRankin00 @CoolRunningDJS #BreezySays @DaQueenBreeze #TeamBiggaRankin #CRDJS #WeWORK Track available on Virdiko.com

[tsuriaa]

I WAS THINKING TO DROP SOMETHING AND WAIT FOR HIM TO PICK IT UP SINCE WE WALK HOME TOGETHER BUT SINCE MY MOTHER IS PICKINGME IP SINCE SHES ON HER MATERNITY LEAVE 😭

NO 😢😢

[darkcrowprincess]

Too frustrated 😤 to apply to a job right now. Ugggggg! Anyway my ocd is adding to it. Why is it that I notice every gross little thing in the house, and I clean it up. But no one else can. Uggggg 😠😡🤬. Oh well think of the postives:

I got new shoes and socks for work(thank you mom for driving me! And always pickingme up from work).

I don't have to get up early tomorrow for work.

I just found out I have the weekend off from work!

I get paid on Wednesday or Thursday.

Have a new cdrama to look forward to when I have the time: word of honor

I have my book Mr mercedes by Stephen King to read( when I have the time to read it)

Tons of fanfiction (saved on my phone) to read for when I'm in the mood.

Tons of shows, movies and anime/cartoons to watch (on Netflix, Hulu, Disney Plus, and crunchy roll) whenever I'm in the mood( but God so many fucking choices 😅 anxiety 😅🙃)

Tons of books to read (to many books! To many choices! Anxiety!).

I'm still alive.

Still healthy(sort of)

Watched tons of movies for free at my job:

Bnha third movie: world heroes mission(saw that with my sister Samantha

Last night in soho( good Halloween night at the movies in costume)

Eternals( saw with family for free on my little vacation)

Sent my friend Jessie her birthday present.

Might not have to take an uber to work.

My friend Donatella is back from her vacation. Got to talk to her today.

My friend Ashely keeps saying I have pretty hair. Maybe I will start to believe her.

Mom found the insurance cards. So one less thing to worry about.

Had a fun rewatch of toy story movies: 1-3 I my favorite. Don't really like 4. But overall it's fun.

Christmas is coming so overall mom will be in a good mood because it's her favorite holiday.

Grandma and grandpa leave on the 17 so we will have the house to ourselves for a while.

All I just need to stay positive. I know it's dramatic, but it's super hard for me to stay positive. All the time. Part of it is my fault. Plus my luck is shit.

Oh well wish me luck. Going to keep trying and moving forward.

[innovatribe]

Argh! Too true! What is visible, what stands out...? — #Repost @pickingmefdn with get_repost ・・・ All too relatable 😑😑 • • • • #Pickingme over #SkinPicking #Excoriation… https://t.co/gyijUyaLXL

Argh! Too true! What is visible, what stands out...? — #Repost @pickingmefdn with get_repost ・・・ All too relatable 😑😑 • • • •#Pickingme over #SkinPicking #Excoriation… https://t.co/gyijUyaLXL

— SaintSoozieSquirrels (@soozietwits) April 17, 2019

from Twitter https://twitter.com/soozietwits April 17, 2019 at 12:52PM via IFTTT

[skinpickingsupport]

Follow me on TikTok! 💜

[lacymoonchild]

Roos Roast French Horns Pickingme Pink Daisies 

[olivia-vida-loca]

Daily posts are overwhelming but I'm still doing daily selfies! ^_^ I notice that I still tend to look and feel for spots to pick out of habit but I've been able to catch myself and stop myself before I pick things for the majority of the time and I'm super proud of myself 😄 I had paper taped over our bathroom mirror for years to try and minimize opportunities to see spots and be triggered to pick, and now I feel confident enough with urge surfing that the papers are off!! :-D I think it's time to celebrate 🎉🎊🤩 #dermatillomania #dermatilomania #compulsiveskinpicking #skinpicking #excoriationdisorder #recovery #mentalhealth #PickingMe https://www.instagram.com/p/B8DMuvUJkGy/?igshid=14zeu6l4lp07l