Updated: Apr 7, 2022
When you have a BFRB (body-focused repetitive behaviour) such as skin picking (dermatillomania/excoriation disorder) or hair pulling (trichotillomania), you can feel out of control of your thoughts and actions, with low self-esteem and embarrassed. Sometimes those closest to you say: just stop! which makes you feel worse. Because you can’t. Here’s how elephants can help you!
Body focused repetitive behaviour: How to effectively manage it
Recognise the elephant in the room
When you have a compulsive habit, you may want to simply ignore it and hope it will go away on its own. You don’t want to dwell on it. It invades your life enough without spending extra time thinking about it.
You only pick or pull when you’re alone. You have become very clever at covering up the damage to your hair or skin when you’re in public, so outwardly it’s relatively easy to pretend that it doesn’t exist, even though inside you feel the pain.
You don’t want to see or recognise the elephant in the room. You decide to avoid and ignore that big problem you have - just hoping it will spirit itself away. This isn’t going to help you regain control.
In order to treat the problem, you need to recognise the elephant in the room! It’s there and isn’t going anywhere until you see it. Once you have seen the big, grey elephant, you can accept two things:
You can accept that you have an unwanted habit.
You can accept yourself unconditionally despite your habit.
Shame and body-focused repetitive behaviours
Sometimes the shame and guilt associated with a BFRB are so great that you can no longer separate your core being from your behaviour. You consider that you are completely useless, worthless, a failure.
Remember, you are more than your habit.
This is a behaviour and not that core you. Distinguish between the things that make up YOU and the behaviour that you want to change. To take an example:
You can be a bad cook, that doesn’t make you a bad person.
You can be rubbish at painting, that doesn’t mean you’re a rubbish person.
When you start your self-recovery journey from a place of disgust and self-hatred, you put big roadblocks along your path. When you accept yourself but want to change your behaviour, your love and acceptance can help strengthen your determination to stop.
I've accepted the elephant in the room... now what?
Ok, you’ve accepted the elephant in the room what do you do now?
When I was a senior manager in the corporate world, we would resolve big problems by chopping up the ‘elephant’ bit by bit. Let’s see how this could work for hair pulling or skin picking.
The big problem is the habit itself, that huge elephant. It leaves you exhausted, with low self-esteem and doubting your own ability to ever manage your compulsion.
When you decide to stop the habit, you often fail after a day or two simply because you have tried to swallow the whole thing in one go. It’s too big and you give up. All you get is mental indigestion and once again that feeling of failure as you start picking or pulling again. This is what you need to do instead.
Before you decide to eat your elephant, you need to chop it up and then you can eat it bit by bit. Your big habit is made up of lots of different smaller steps, routines and tiny habits. Pulling or picking is the last visible step. You need to get really interested in what happens before, during and after the elephant habit big thing.
Be curious. Become your own Mrs Marples or Sherlock Holmes. Notice what triggers your compulsion, what soothes it, the time of day, activity or place that seems to either activate or reduce your urge?
Keep a diary and note down what your thoughts and feelings are: before, during, and after picking or pulling? What do you actually do?
Notice which room in the house and where in that room you pick or pull? Notice if you sit down, lay down or stand up? Study your elephant so that you can eat it bit by bit.
Rather than focusing on not hair pulling or skin picking, turn your attention to changing, dissolving and stopping the different steps, habits and routines that lead to that final pulling or picking.
Here are a few examples:
Maybe it’s difficult to stop hair pulling, but you can decide to change seats in the evening so that you disrupt your routine.
Maybe it’s hard to stop picking your skin but you can decide to knit, crochet, draw… at the same time as you watch TV.
Maybe it’s tough to keep your hands away from your hair, but you can repeat a strong coping statement every morning, write it on your computer or phone and put it on a post-it on your fridge.
In this way, you attack your habit from its very roots. You investigate and then change the environmental, physical, emotional and mental steps that keep it in place.
It won’t always be easy and some steps will be more difficult than others to dissolve or change, but your determination and self-acceptance can work wonders.
How can cognitive behavioural hypnotherapy help with body-focused repetitive behaviours (BFRB)?
When you are stuck in a habit, you are stuck in a certain way of thinking, feeling and behaving. A little like being on a hamster wheel.
Cognitive-behavioural hypnotherapy lets you explore your current habit in detail to help you make the environmental, emotional, cognitive and physical changes you need to effectively stop or manage your compulsion.
It gives you the opportunity to imagine and experiment doing, feeling and thinking differently within the relaxing comfort of hypnosis. You get off the hamster wheel. Guided by your hypnotherapist you can understand your habit and replace it with a different more useful behaviour. It also gives you the coping skills to act swiftly, effectively and with control if an urge resurfaces. In a nutshell, your hypnotherapist can help you win your elephant battle.
Are you ready to recognise your elephant?
If you would like to find out more 🧡
You can discover the Headstrong Programme for Trich Recovery here
Join the dedicated Headstrong Free yourself from Trichotillomania Facebook group here
You can discover the Determined Programme for Skin Picking Recovery here
Join the dedicated Determined for Skin pickers who want to stop Facebook group here