Master Your OCD
OCD Family Support
Hair Pulling/Skin Picking
OCD Groups!

Most therapist won't tell you this if you have a BFRB

bfrb hair pulling skin picking trichotillomania Feb 22, 2023
BFRB Treatment

Do you know what's important in life? Living life. You know what's not important? Beating ourselves up and causing unnecessary shame. This is often what individuals do who experience a BFRB. BFRwhat?

Body focused repetitive behavior. This is hair pulling and skin picking. It actually is anything someone does repetitively over and over again focusing on a specific body part. Get it? Body focused repetitive behavior. Other names include trichotillomania and excoriation disorder.

We know individuals can do this behavior out of a compulsion for OCD. To help relieve symptoms or nervousness. But for others, it's an entirely separate disorder.

Example of someone with trichotillomania

Let me tell you about Emily and see if you can relate: She had always been self-conscious about her appearance, but there was one thing in particular that made her feel particularly insecure: her hair. For some reason one day she started to pull a few hair out. There was no rhyme or reason to it, it just happened. She couldn't help but do it, but she didn't know what it was.

Emily had always been fascinated with her hair and spent hours brushing and playing with her hair. However, she began to notice that she was pulling out her hair more and more. She would find herself doing it without even realizing it, and she would often wake up with a handful of hair in her bed. She tried to stop, but she couldn't. She began to notice that she had bald patches on her scalp, and she felt ashamed and embarrassed. These feelings fueled her thoughts and feelings to pull more and more.

One day, Emily's mother noticed her daughter's hair loss and asked her what was going on. Emily didn't know how to explain it to her mother, she felt ashamed and didn't know what was happening to her.

Stories like this happen often. Replace hair with skin picking and these individuals experience the same thing. It's not just a bad habit. There is a biological component to this. The brain is simply wired differently.

As you heard in this story there tends to be some shame and embarrassment, to me this is one of the most important things to treat. I want people to be happy with who they are. Whether you're pulling or not. Whether they are picking or not. Naturally, the world will say, WELL STOP. If it brings you shame, stop. If you don't want a bald spot...stop. Well, it's not that simple. Whenever I see a client in my office, we of course work on reducing these symptoms of hair pulling, but we also come up with a realistic expectation. Do you still want to pull 30% of the time and you're okay with that? Do you want to be done with it all together? Treatment for this can be very individualized, it's always an all or nothing approach.

So to remove the shame, I'm going to tell you a secret that sounds like something a therapist shouldn't say.....allow yourself to do the behavior....ahhh, what? But wait, with a caveat, allow yourself to do the behavior if it doesn't interfere with life and you've fully embraced yourself and are happy with who you are. We take shame away from a hair pulling or skin picking by allowing it to be and not putting judgement of it being "bad". It just is what it is.
BUT, if your goals are to stop, we've got treatment for that and it tends to work really well if someone can do it right way. I've got this all outlined step by step with my online course, "overcome hair pulling and skin picking". Tons of videos, worksheets, and support. I'll link that down in the description.

How to start with trichotillomania treatment

If you're just starting your journey of recovery, this is a great place to start. Be kind to yourself. Feel all the emotions, but you still be you. We learn from experiences, we need to know what all the thoughts, feelings, emotions, places, sensory feelings, etc that trigger you to possibly want to give in and we're going to interrupt the process by using "habit reversal and the ComB model." (Comprehensive Model for Behavioral Treatment) - We'll create your SCAMP profile and then create competing responses to break some patterns. Woah, a lot of foreign terms..but with more research and the online course, you're going to learn to be the boss.

What I want you to get out of this video is this:
If you want to stop doing your BFRB, there is hope. Start with tracking your symptoms to become more aware, I have these worksheets in my course.
If you don't want to stop...that's okay. Embrace you! You are not broken.
Work on embracing who you are, take shame away and see if this behavior belongs in your future through all aspects of life.
Parents and supports, it's tough to sometimes accept that my child may continue pulling or picking for a while, but love them anyway. Meet them where they are, this can and will help reduce any shame.

I want to know for you, have you struggled with a BFRB? What has been your treatment journey? Also, to enhance your skills even further, go watch this video right now to understand more what a BFRB is and where it comes from.

Thanks so much for watching and I'll see you next time.

It's time to recover. Let me help you!

Master Your OCD 

A guided step-by-step OCD course that teaches you how to lower anxiety, overthinking, and compulsions.

Learn all the OCD tricks and create a customized game plan to stay one step ahead. 


Try for free

Extra support for your OCD

-For OCD sufferers, parents, spouses, etc.

-Monthly LIVE Q&A with Nathan Peterson

-LIVE chat with others

-Early access to YouTube videos

-Get discounts on Merch

Sign up now

Rise From Depression

Self-guided course to help you kick depression to the curb and live life the way you want to. 

Learn the evidence treatment skills that is proven to work for depression.


Try for free

How to Support Someone with OCD

Finally learn how to help your loved one with OCD.

Build confidence, set boundaries, and work together effectively.

Sign up now

Overcome Hair Pulling & Skin Picking

Step-by-step course that teaches you how to stop pulling hair and stop picking skin.

Learn the evidence treatment skills to help you overcome your BFRB.


Try for free


Ready to slay your OCD like a hero?

Let me show you LIVE how I do OCD treatment step-by-step. It's authentic and real. See the question and answer at the end.



Sign up now

OCD and Anxiety Shop

To help remind yourself of your treatment goals, check out the OCD and anxiety merch.


Show yourself that you're worth it and that you can do hard things.



Visit the shop