Alright, this is for those who have body focused repetitive behaviours (BFRB) that include your face or hands (e.g, eyelash or eyebrow hair pulling; skin picking on face; picking skin on hands/sides of nails; biting nails/chewing nails or fingers etc.). Anyone who experiences BFRBs knows how hard it can be at the best of times to manage these behaviours. Most of us cognitively know the outcomes of many of these behaviours, such as infection, bald spots, blotchy skin or scars etc., but these are not enough to stop the behaviour. For myself, this form of self-soothing started in grade eight and despite berating myself, setting up rewards or suffering the consequences, it is something that is not simply controlled with will power.
For many (not all), BFRB are used when we feel anxiety or require self soothing, however, sometimes the act of engaging in the behaviour, while bringing temporary relief, will escalate feelings of shame or self-judgment which in turn drive anxiety higher. It is an exhausting cycle at times. For others BFRB may be due to irrational thoughts, done habitually, out of boredom or dealing with other emotions such as sadness or anger.
Enter COVID -19 – we are inundated with messages of don’t touch your face and wash your hands. Even those without BFRBs touch their face dozens to hundreds of times per day. COVID-19 may have also brought significant changes, stressors, and other life disruptions. Such factors may have likely exacerbated your BFRB. While everyone’s experiences are different, here are a few tips that may be helpful to some:
- Do not shame yourself! Easier said than done, but offer some compassion to the part of you that craves or engages in the behaviour
- If you do not already know what triggers your BFRB (e.g., boredom, anxiety, stress), build awareness by noticing when and where you are most likely to engage in your behavior. What are the thoughts or feelings that occur before or during?
- For those that may skin pick blemishes, try those blemish patches. They can serve as a visual cue to not touch, but also heal up the blemish.
- Keep your hands moisturized if you can. The constant washing can aggravate skin and if you are already fixated on picking at nail beds or hands, the dryer skin will bring all sorts of new spots to dig, scratch and pull at. Some people wear the moisture gloves at night to help with moisture but also prevent some of the nocturnal, unconscious scratching and picking that so many of us may engage in.
- If you are comfortable, ask for someone to point out when you are engaging in the behaviour. This is not for everyone, as it can increase shame, but some may find it helpful to bring their attention to the behaviour.
- Redirect your attention to alternative tools/keep your hands busy. Mindfully notice the urge to engage in the BFRB and redirect to an alternative:
- Twirl straws or pipe cleaners
- Slime or putty
- Squishy or stress balls
- Spinner rings
- “fidget for your digit” (coiled ring that you can move up and down your finger)
- Track triggers and urges. This can be done manually or through apps. There are also devices that are pricier that the person wears, and the device vibrates when you move your arm to engage in the behaviour.
- Muscle tensing and relaxing. For example, when you feel the urge, clench your fists, hold, then release opening your hands wide and wiggling your fingers. Do this for 5 -10 times, while also deep breathing if that feels good.
- Keep hair pulled off your face (less tickly hairs may help with the urge to touch or pull at them or itch at your face). I apply light Vaseline to eyelashes, but you can also try that on lips or nail beds. Slippery eyelashes are harder to pull out and lubricated lips and nail beds can perhaps cut down on the skin to pull
- Cognitive behavioural therapy and Acceptance and Commitment Therapy have been found to be helpful for management of BFRB. There are tools online or you can talk to a therapist to formulate a comprehensive treatment plan based on your individual needs.
We are also here, offering online or phone sessions if you are interested in learning more. You can visit our website at www.serenitynowwellness.ca, call 403.454.7600 or email firstname.lastname@example.org
Jennifer Mitchell, Registered Psychologist