If you are reading this article, then you are curious, intrigued, or at your wits end because you are seeing firsthand the struggles you and your child are facing when it comes to these behaviors. Trichotillomania (hair pulling) and Excoriation Disorder (skin-picking) can feel confusing or even frightening to a parent. As a mental health clinician who specializes in these behaviors, I have seen parents who have blamed themselves, worried that their children were self-harming, and are concerned about the possibility of their children suffering from a mental illness. Whether or not the child is suffering from a mental illness is not necessarily directly linked; however, there continues to be so much that researchers are unaware of with these behaviors.
Hair pulling and skin picking behaviors are classified as “Body Focused Repetitive Behaviors” or “BFRB” for short. Research indicates that 2 out of 50 people suffer from BFRBs; however, due to the high shame and guilt emotions attached to these behaviors, people who suffer do not typically share their story (bfrb.org.) Parents often wonder why their children cannot simply stop. It is related to the behavior being so complex that often the preventative measures are not complex enough.
The first place to start to help your child, or even you if you are also a sufferer, is education. I have compiled a list of common questions parents have asked me regarding BFRBs to assist parents in beginning a further understanding of these behaviors.
Why does my child do this? Where did it come from?
Research is currently indicating that these behaviors are most likely genetic. BFRBs are not the fault of you or your child.
Are BFRBs harmful? Is my child self-harming?
The intent of someone who self-harms versus someone who has a BFRB is different. Those with BFRBs do not wish to harm themselves; however, due to the repetitive nature of the behavior, harm can absolutely occur. Skin pickers are susceptible to infections and hair pullers who swallow their hair (known as trichophagia) can be at high risk for gastrointestinal distress and/or blockage, which can result in a very serious medical condition (bfrb.org.)
Are BFRBs lifelong behaviors?
The behavior can wax and wane overtime; therefore, it can be difficult to track whether the behavior ever really “goes away.” As of right now, there are no known cures for BFRBs.
Are there other types of BFRBs besides hair pulling and skin picking?
Yes: Nail biting, Cheek Biting, Nose picking, Nail picking, Hair Eating, Skin Eating, Lip Biting, Tongue Chewing; A BFRB is classified as a repetitive behavior that one feels that they cannot stop, and it results in damage to the body. Humans all engage in mild forms of picking/pulling; however, this does not mean they have a BFRB.
Does medication help?
Since it is unknown where the urge to pick/pill originates in the brain, there is no medication that assists directly with the behaviors. Anti-depression and anti-anxiety meds have assisted in calming emotions that may increase urges; however, will not eliminate the behavior entirely.
Is there treatment for BFRBs?
Absolutely! I recommend seeking out a professional who is knowledgeable about BFRBs. Cognitive Behavioral Therapy is currently the most successful treatment for BFRBs.
Where can I locate more information on treatment or BFRBs?
The TLC Foundation for BFRBs is a non-profit organization that provides education, training, and conferences. Their website is: bfrb.org. They have a list of therapists available in your community who are trained to treat these behaviors. Membership is free, and the site is full of information to assist suffers and parents.
Reference: The TLC Foundation for BFRB’s: bfrb.org.
Krista Reed, LSCSW is passionate about her work with children ages 6 and up, teens and young adults. She approaches her work from the standpoint that each person deserves to be heard and to have an advocate, no matter what their circumstances. She loves people and upholds her relationships with her clients as a vital part of the healing process.
She is a Cognitive-Behavioral Therapist, a professional member of the TLC Foundation for BFRBs, a graduate of TLC’s Professional Training Institute and a professional member of the American Association of Suicidology.
