The Truth About BFRB Disorder, and What a BFRB Program Can Do
Pulling, picking, and biting can feel like a private thing you should be able to stop on your own. You've tried, and it keeps coming back. There's a treatment made for this, and you don't need a specialist down the street to start it.
By Nathan Peterson, LCSW, OCD and BFRB therapistWhat is a BFRB?
BFRB stands for body-focused repetitive behavior. It's a group of behaviors where you pull, pick, bite, or scrape at your own body over and over, to the point of damage, and can't stop even when you try. Hair pulling (trichotillomania), skin picking (dermatillomania), and nail biting are the most common.
They're called body-focused because they're aimed at your hair, skin, or nails, and repetitive because they happen over and over, often without noticing. BFRBs aren't a form of self-harm, even though some older articles describe them that way.
What are the causes?
There isn't one known cause. BFRBs tend to run in families, and they often start in the preteen or teen years. What keeps them going is easier to see: the behavior brings a moment of relief or satisfaction, and your brain remembers that. Over time it gets more automatic.
Risk factors
- Family history. Having a close relative with a BFRB
- Stress and anxiety. These can make urges louder, though pulling and picking also happen when you're calm and bored
- Other conditions. BFRBs often show up alongside anxiety, depression, OCD, or ADHD
- Boredom and sitting still. Screens, reading, driving, and waiting are common setups
Symptoms
- Skin picking or scratching that leads to sores, scabs, or scars
- Hair pulling from the scalp, eyebrows, eyelashes, or body
- Eating or chewing pulled hair (trichophagia)
- Biting nails, fingers, or the skin around the nails
- Picking at cuticles and hangnails
- Biting or chewing the inside of the cheeks or lips
- Trying to stop over and over without it lasting
- Hiding the results, or avoiding people and places because of them
A lot of this happens without full awareness. You notice after, not during.
What a BFRB program is
A BFRB program is a structured, step-by-step course that teaches the treatment for BFRBs, habit reversal training (HRT) and the ComB model, so you can practice it on your own schedule. For how the treatment itself works, see BFRB treatment explained.
What to look for in a BFRB program
- Taught by a licensed professional who treats BFRBs
- Built on habit reversal training and the ComB model, not willpower
- Worksheets or tracking tools, not only videos
- Covers the BFRB you have, including more than one if you have a few
- Self-paced, so you can go back over the parts you need
I know, a course sounds less serious than therapy. The skills are the same ones a BFRB therapist teaches. The difference is you're the one running the plan.
Inside Overcome Hair Pulling and Skin Picking
This is the BFRB program I teach. It's self-directed and includes 21+ videos and worksheets that walk you through the steps of treatment. It covers hair pulling, skin picking, nail biting, and the other BFRBs.
- Learn your own pattern, including focused and automatic pulling or picking
- Build a competing response that works for your hands
- Change your setup in the places you pull or pick most
- Handle slips without starting over from zero
You can watch a free lesson first, or see the full course below.
Before you buy anything, write down the one place you pull, pick, or bite the most. That's where the program will have you start.
Then watch the free lesson. If the way I teach makes sense to you, the full program is right below.
Common questions about the BFRB program
Is a BFRB program as good as therapy?
They do different jobs. A therapist can adjust the plan to you week by week. A program teaches the same core skills at your own pace, for a lot less money, with no waitlist. Some people use a program on its own, and some use it alongside a therapist.
Does the program work for nail biting and cheek biting?
Yes. The skills in habit reversal training work across BFRBs, so the course covers hair pulling, skin picking, nail biting, and the others.
How long does it take?
The course is self-paced, so you can move as fast or slow as you need. The skills take practice, and the urges usually get easier to ride out over weeks, not days.
Can I try it before I buy?
Yes. You can watch a free lesson first to see if the way I teach works for you.
