Understanding: Body Focused Repetitive Behaviours

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Do you have a ‘bad habit’? Maybe you chew at your nail beds or bite your lip. It’s not unusual to have some small repeated behaviour that keeps your body occupied during moments of stress or uncertainty. It’s only natural in life to have a little coping mechanism that brings some relief. But what happens when a bad habit starts to wreak havoc on your life? When an absentminded scratching session leaves your skin bleeding, or some innocuous tugging on your hair reveals a bald patch?

If this sounds familiar; you’re not alone. Body Focused Repetitive Behaviours, or BFRB’s, are incredibly common – and they can be a bitch to kick. 

Unfortunately for some people, minor habits can escalate into something more serious. BFRB’s are characterised as self grooming behaviours that lead to physical damage, and that can’t be curbed after multiple attempts. They can be related to stress, trauma, or mental health issues, but they can also happen to people who aren’t suffering from these things. Cora, 27, has been struggling with a BFRB called dermatillomania for years; she compulsively picks at her skin.

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“It started when I was around 15, and going through a tough time at home. Initially I was just picking at spots, but eventually I started picking when there was nothing there. I wouldn’t even know I was doing it, and when I’d come to realise, I wouldn’t be able to stop myself. It was like an itch I couldn’t scratch.”

Cora explains how a bad habit can start to interfere with your life. “My face will be red raw from picking. Most people assume I struggle with acne or rosacea or something when I’m not wearing makeup, but really it’s all my own doing. It brings me a lot of shame, because it’s self-inflicted…it consumes so much of my life. If I feel the urge to pick, nothing’s going to stop me. I’ll avoid going out, going to work. Because I don’t want anyone to see me doing it, or to see the damage afterwards. I just wish I knew how to stop.” 

Cora is part of the 1 in every 20 people who suffer from a BFRB, though many don’t realise that their behaviour even has a name. There is help out there; it’s just about taking that brave step forward to look for it.

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Seeking Help

I caught up with Dr Anne Kehoe, President of the Psychological Society of Ireland, to get her insight into these behaviours. She tells me that when it comes to BFRB’s, there’s a spectrum, and what’s really key is how it makes you feel. “Many people will have done something like this at one point. Sometimes it’s just a coping behaviour; you over plucked your eyebrows, or kept picking at a spot more than you wanted to – and that’s okay.

When it comes to seeking help, it’s about the personal impact. You might have someone who is really self conscious about it, but they’re not actually doing that much [of the action], or you might have someone who’s like, ‘this has taken over my thinking, it’s damaging my appearance’.” She assures me that in both of these instances, looking for help is valid. “You want to ask, is this stopping me from having a happy, normal life? Then, it’s no harm to seek help. You can talk to your GP, you might see a therapist…there are a lot of treatment options.”

Dr Anne also wants to highlight what she calls “behaviour modifications”. This might be blunting your tweezers; keeping your hands busy with drawing or knitting; or avoiding things you know will trigger you, like magnified mirrors or spot squeezing TikToks.

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You’re Not Alone

Caroline Harbison is the Irish representative and treasurer of BFRB UK and Ireland, an organisation designed to support people struggling with BFRB’s, set up by people who’ve experienced them. Caroline tells me that it’s a compassionate space for those suffering, because everyone involved knows what it’s like.

They run peer led online support groups and events, plus a private Facebook group with the same name, which can involve everything from themed discussions and meditation sessions to simply chatting about how you’ve been. “There’s no pressure to talk, you can just sit and listen too”, Caroline adds. She also wants to remind people that BFRB’s aren’t rare, so not to feel ashamed or alone.

“5% of the population in Ireland and the UK suffer…that’s millions of people! One of the best things you can do is to come, talk to other people who understand.” 

The Road To Recovery

Jenny, 24, used to compulsively pull out her eyelashes and eyebrows, but has since stopped, thanks to a combination of cognitive behavioural therapy and self improvements. “I remember realising it had been two weeks and I hadn’t pulled once. That feeling – I wish I could bottle it!” she laughs. “It was a combination of things for me alongside therapy. I opened up to my friends, started journaling and exercising more, eating better, the usual. But really what did it, I think, was letting go of the shame. I started saying to myself, it’s not your fault! And you have the power to stop this…I sort of shifted my mindset from ‘you’re hopeless’ to ‘you’re trying’.”

Jenny is two years in to being BFRB free, and counting. She remarks that it hasn’t been easy, but recovery is possible. “There’s a light at the end of the tunnel”, she tells me. “You just have to keep digging!”. 

This article first appeared in the September 2023 issue of STELLAR magazine. 

• Bad habit
• BFRB
• CBT
• compulsion
• dermatillomania
• hair pulling
• mental health
• Nail Biting
• therapy
• trichotillomania
• Understanding