Body-focused repetitive behaviours

[TheMostHappy]

I thought I might start a thread for people living with chronic body-focused repetitive behaviours including trichotillomania (hair pulling), excoriation (skin picking) and morsicatio buccarum (chewing the inside of the mouth). I have lived with the latter two for as long as I can remember, even as a very young child. I can go for long periods of time without a flare up, and have noted stress and anxiety to be significant triggers for me. It's something that not many people talk about. It might just seem like an irritating habit but living with it can sometimes get a bit miserable - living with constant sores in my mouth is uncomfortable, and the more jagged the sores, the more I chew so it's never ending. I also persistently pick the skin around my finger nails in the same way, to the point where it bleeds and I am still not able to stop if I can see or feel an edge or it isn't perfectly smooth.

I was wondering if anyone has managed to break the cycle permanently and can share some tips?

I scalp pick. I was glad to find this thread as these related conditions don't get mentioned that often.

I wish I could stop. last night I did it quite badly in one area just as it was starting to heal. I think I seem to part out of habit (my hand gets drawn up to my head when I'm alone) and part as a relief when I'm winding down from the day's stresses. I've tried a few ideas to stop.

I'm trying ADs at the moment for anxiety. I think they're helping my mood in general but unfortunately not the picking. Sometimes I'm aware I'm doing it but other times not until it's too late. Then I often wash my hair afterwards but sometimes the "clean" scalp feeling or it being itchy as it dries can start the cycle again.

I'm going to buy some silicone finger covers to see if it helps me (worth a try. I've tried cutting my nails short, it tends to be a few specific fingers).

@TheMostHappy hi OP, how are you doing? And others reading if you feel like posting.

I wanted to post an update in case it helps someone. I seem to have kicked my years old habit! I've now stopped for a month or 2. I do still occasionally pull a rag nail, for example, but I've stopped my more regular scalp picking that was really compulsive. I think the final factor that helped me was using a medicated shampoo. I started getting red, dry skin on my face recently and found some Mumsnet threads about seborrheic dermatitis. I tried one of the suggestions other than Head& Shoulders. I think this helped my scalp not feel the way that was encouraging me to pick it. I was also already on antidepressants (since the summer) and had started a short course of telephone CBT/"coping with worry" appointments. So it's likely to be the combination of things that helped. I'd already tried fidget toys, gloves etc.

Wishing you the best if you are reading and stopping still feels impossible. At least this thread shows you aren't alone.

When I looked into it about a decade ago I remember there was some kind of debate about whether these behaviours fit into OCD/compulsion or addiction category, with implications for treatment approach. I think the recommended behaviour therapy was Habit Reversal Training which involved catching yourself early in the act and replacing the second half of the action with an alternative. It was also suggested that it may be used as an avoidance or soothing behaviour when the sufferer cannot properly process and cope with difficult emotions. Mindfulness and basic talking therapies were supposed to help acknowledge and deal with these big feelings in a healthier way.
As well as NAC a PP mentioned above, Inositol was another recommended supplement.

Recently I heard that in America there were suggestions it was associated with ADHD/ADD because it was at least partially caused by dopamine disregulation, with the behaviour driven by seeking tiny dopamine hits. This actually makes the most sense to me. A friend of mine with compulsive skin picking got diagnosed as an adult with ADD, got put on medication, and the picking stopped as a completely unintended side effect!