For Mental Health Monday this week, we’ve got Laura, a mental health blogger who focuses specifically on body focused repetitive behaviors.
Body focused repetitive behaviors are a sort of spin-off of OCD. The person has an obsession with a certain behavior having to do with the body, and a severe compulsion to complete it. I’ll let Laura talk about it more in a moment, but first I want to talk a bit about what Mental Health Monday is. If you’re a MHM veteran, you can skip down to the good stuff. If you’re a newbie, stick around!
Uninspired’s goal is to help women in their twenties balance building their futures and having fun. On Sundays I write posts that have to do with dating, personal finance, learning to cook, or DIY projects. But on Mondays, there’s another aspect of twenty-something life I like to focus on. That’s mental health (duh). Your twenties are this wild free-for-all where we’re under a ton of pressure. Y’know, to set up the rest of our lives. In the attempt to be perfect, we forget self-care. And when we forget self-care, eventually, we’re going to burn out. More than likely, that burnout will manifest as depression or anxiety, but in some cases, it can manifest as something worse. So, MHM helps readers like you remember to take care of yourselves, and teaches you that you’re not alone.
I could’ve written all the posts myself, but instead, I’ve opened it up to amazing writers and mental health warriors like Laura, whose cause is body focused repetitive behaviors. I only have one personal experience, but there is someone out there who has been through what you’re going through. And I’m going to find them so they can show you that you can do it too. Click here for the very first MHM post.
Laura’s focus on body focused repetitive behaviors comes from her own personal experience.
She has dealt with excoriation, which I’ll let her explain, but it led to her passion for the cause. She has advice that can help you if you’re dealing with it yourself, and also if you’re not sure how to treat someone who deal with it. If you’d like to connect with Laura outside this post, you can find her blogging at the Canadian BFRB Support Network and HealthyPlace.com. She primarily writes about BFRB’s and other mental illnesses like depression and anxiety, but she’s also a fiction writer! If, after this post you’d like more information about body focused repetitive behaviors, you can also read her book series. She’s a multi-talented woman!
Body Focused Repetitive Behaviors
“Walking around with bandages on your skin and scars on my body is like walking around with a neon sign that says, ‘Look at me! I’m different.’
I’m acutely aware of that sign and how people’s eyes are drawn to it. Partly because of the questions I’ve received in the past and partly because I’m hypersensitive how people are perceiving me. Others have tried to tell me I’m overreacting and people aren’t looking for that reason or at all, but when I have people constantly giving me the side-eye, I know better.
And after 22 years of living with dermatillomania, diagnostically referred to as excoriation (skin-picking) disorder, I know that look all too well.
When you’re visibly different, sensing eyes on you is a sixth sense. And seeing the looks cross their faces—looks that’ve been mirrored in the faces of your friends and family—it leaves no question.Two summers ago, I decided to stop melting and wear shorts. I was scared to show my skin for years because of the comments and questions I’ve received. Questions like ‘what happened to your face/arm/insert-other-body-part-here?’ They seem innocent, but these people are not usually really concerned. People seem to be implying, ‘am I going to catch whatever that is?’
I’m a master of excuses when it comes to those questions. Cat scratches, bug bites, and allergic reactions are just a few in my arsenal. And I’ve seen many a skin picker armed with these as well. Nonetheless, the questions still feel awkward and the tone was never lost on me. So, avoiding them was best.
But I decided I wasn’t going to care anymore. One because I’m finally comfortable enough talking about this issue. Two because I legitimately hate being sweaty. My mind equates it with being unclean (even if it’s not entirely true).
I’ve picked my skin since I was five. Summer after summer I’d be extremely uncomfortable in warm clothes. But at the time, I figured the discomfort was worth it. The discomfort of stares and questions would be worse, especially for the years I didn’t understand what I was dealing with.
And what exactly am I dealing with?
Dermatillomania falls under the category of body focused repetitive behaviors (BFRBs). It affects two-to-five percent of the population and is an OCD related disorders in the DSM-V. Dermatillomania (and other BFRBs) is seen as a grooming behavior in overdrive, because, really, we all pick skin to some extent. My brain’s stop switch for that behavior is just faulty, so I pick my skin to the point of damage, wounds, bleeding, scars…you get the picture.
Before I go farther, this is not self-harm behavior. At the risk of confusing things, the act of skin picking can be used by those who self-harm, but the condition dermatillomania is not self-harm because it lacks the intent of harm. When I’m picking my skin, I’m not thinking of harming myself at all; if I could do this without the damage to my skin, I would probably still do it. That’s the way my brain is wired. If someone is picking his or her skin exclusively for the sake of harm, it is diagnostically not dermatillomania.
The reason I make the distinction is for treatment’s sake. If you try to medically treat dermatillomania and other body-focused repetitive behaviors as if they were self-harm, the results just won’t be seen.
Research on body-focused repetitive behaviors is minimal, but there is some.
Other kinds of body focused repetitive behaviors include trichotillomania (hair pulling disorder), onychophagia (nail biting disorder), dermatophagia (skin biting disorder), and rhinotillexomania (nose picking disorder). There are more, potentially even some that we’re not aware of because research for BFRBs is in its infancy. For instance, the DSM only added Dermatillomania in 2013, and it still has not listed onychophagia, dermatophagia, and rhinotillexomania.
There are only a handful or two of doctors and researchers really doing work focusing on these behaviours, so the research is somewhat hard to come by. Also, very few people are talking about BFRBs. Even most medical professionals don’t know about them.
The two-to-five percent statistic may even be higher because of how few people actually get diagnosed with these disorders. With the age of the internet, it’s becoming more prominent online, but in real life it is still severely stigmatized.
Although it came from a place of concern and trying to help, my family was probably the worst when it came to stigma. They would try to shame or scare me out of picking my skin, which a) doesn’t work and b) only made me feel worse about myself. I developed a deep, deep feelings of worthlessness and felt like a failure because I couldn’t just stop.
Beyond my inner circle, stigma came and comes in many forms.
Strangers and people on the internet (where I share my story and about dermatillomania through blogging) gave me disgusted looks. They’d tell me I’m just doing this for attention and could stop if I wanted to, or I’m diseased and shouldn’t leave my house, or just flat out that I’m disgusting.
And those who don’t stigmatize are prone to offering unsolicited advice. Again, they’re well-meaning, but telling me about this skin product or this healing method isn’t conducive to my recovery. When I was a young child, my mother took me to my pediatrician to try to find out what was wrong with me. The end result was my doctor prescribing me ointment or cream to help my skin heal. The problem with that is my skin isn’t slow to heal or needs a little boost, it’s because I literally tear it open over and over again. For me, the average picking spot lasts at least a month because I keep going at it.
If you’re reading this as someone who’s never heard of dermatillomania, you might think this is a really horrible existence to have. Truth be told, for me, it was.
Was because I now accept my disorder and understand that it’s going to be exhausting. It’s going to be physically painful (for instance, showering is an adventure because the water stings). Sometimes it’s going to royally suck whether it’s because of ignorant comments or because I’m just at my exhaustion limit.
No, I’ve not given into it. One of my favourite quotations comes from Michael J. Fox: “Acceptance doesn’t mean resignation. It means understanding that something is what it is and there’s got to be a way through it.”
For me, my way through it is to stop beating myself up for not being able to stop. One of the hardest realities those with body focused repetitive behaviors face at this time is there is no cure. There are treatments and recovery absolutely is possible. Although, you may need to tweak the way you think of recovery if, for you, recovery means stopping or cured. I used to cry over the fact that I still picked my skin and I hated myself for not having the willpower to stop. But here are the two biggest secrets (that aren’t really secrets since I tell everyone) that I have, which tie into one another.
Dermatillomania and other BFRBs are not about willpower.
The faulty stop mechanism I mentioned earlier is literally a difference in our brains.
Does that remove responsibility from ourselves in terms of taking care of ourselves? Absolutely not. We have to be active participants in our own recoveries and have to actively pursue self-care, but we are not at fault for our disorders.
Because I’ve realized these things, I’ve been able to do things like wear shorts even though my skin isn’t perfect. This summer, I’ve had my leg wrapped in a tensor wrap over gauze. Sometimes I feel that self-consciousness, but now I know the world won’t crumble.
Having a solid support network plays a big part in my ability to do this. I have a community who cheers me on and lifts my spirits. I also have the love of my significant other and my family to back me up, too. If you don’t have that support in your life, start with online communities.
Here’s another hard truth: some people are going to be assholes.
The good thing about this is their words aren’t reflections of our reality. Misinformation and ignorance (sometimes willful) fuel these people’s comments. Sometimes we can help these people see reason by explaining our situation or steering them toward reputable resources. But sometimes we can’t and we have to know when to pick our battles.
My point is that dermatillomania and other body focused repetitive behaviors do not have to be our end. And our situations don’t have to be tragic. It can be a really difficult path, but we can make it through it with the right resources and support. I didn’t believe that for many years, but now that I’m living it, I know that reality is completely obtainable.