The title of this blog is misleading, but “how to stop” Picking or pulling habits, is what we all want to know. But, what if there are other more effective routes to take?

We lament, “I should just stop.” Once the “trance” is broken and we see the damage done we often feel overwhelmed with shame, embarrassment, and even disgust. We find ourselves, again, with a bald spot and an aching head or blood under our fingernails, wondering “Why can’t I just stop??” But if it wasn’t so relieving (momentarily) then we wouldn’t do it.

Most skin pickers, Hair pullers, and cuticle biters begin this compulsion in early puberty between 10-14 years old. Most of us have co-occurring challenges like OCD, ADHD, or Autism Spectrum. Most of us experience immediate immense relief when we pull, pick, or bite until it feels “just right.” Most of us never manage to stop completely. 

These conditions are called Dermatillomania (skin picking) and Trichotillomania (hair pulling) or Body-Focused Repetitive Behaviors (BFRBs). Research supports that no singular evidence based treatment has aided pickers/pullers in consistently ceasing the habit. Even in a treatment center or hospital that can protect people from sharp objects or intoxicating substances, there is no abstinence from our hands or bodies. We cannot treat BRFBs like addictions or self harm because they’re not, they present unique challenges.

What if you don’t have to stop entirely? What if it’s actually more effective to take the pressure off of “quitting cold turkey” in service of habit reduction? Borrowing from the principles of Harm Reduction and Habit Reversal Training, pickers and pullers tend to have more satisfying success when they focus on reducing frequency or harm. What if instead of beating yourself up for pulling your hair again you could redirect your attention to something you care about? What if instead of shaming yourself for picking your face you treated the picked area kindly once you were willing to stop?

Here is a short list of strategies that work better than “just stopping,” no sitting on your hands required:

• Present Moment Awareness
  • Start with just noticing when you are getting stuck picking or pulling. It may help to track or write down when you pick/pull, where, and what was happening when you started. You may notice patterns that you can break to reduce the urge to begin in the first place.

• Blocking Measures
  • Once you identify when you tend to pick/pull the most you can engage in blocking measures. If you pull your hair while you watch TV, try putting the hair in a hat, bun, or braid before you start watching. If you skin pick, you may try wearing fake nails, rubber gloves, or even moisturizing gloves whenever you may pick the most. Nail or cuticle biters may try bitter nail polish or bandaids over the cuticles. Even pimple patches and face masks can have a dual purpose.
• Redirecting to Creativity
  • Simply keeping your hands busy can be a huge help, especially if you find the action rewarding. Arts and crafts can transform the lives of BRFB havers. Knitting, crocheting, embroidery, and jewelry making keep your hands busy, relieve stress, and can provide fun fulfillment. 
• Redirecting to Fidgets/Sensory Stims
  • There are many easily accessible fidget toys these days that can keep your hands busy and even imitate the experience of skin picking or hair pulling. Picky Pumice Stones recreate the sensation of digging and picking while Koosh Balls provide a satisfying opportunity to pull. Between Pop-Its, fidget spinners, and sensory rings, there’s a ton of sensations and tools to experiment with. Keep these redirecting tools in the areas or environments you would most need them (ie the car, your desk at work, bathroom mirror).
• Harm Reduction
  • When all else fails. Accept that picking happens. It says absolutely nothing about who you are or your value as a person. It simply means that you needed relief. When picking or hair pulling happens, don’t beat yourself up. Thank yourself for noticing and stopping whenever you did. Treat the area with kindness and medical attention if needed. 

You don’t have to stop. You don’t have to shame yourself. You just need to notice.

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