BFRBs – what are they are and what therapy offers

Body-focused repetitive behavior (BFRB) disorders involve compulsive behaviours that go far beyond occasional fidgeting. Two of the most common BFRBs are:

• Skin picking disorder – Repeated skin picking that causes sores, scabs, or scarring
• Hair pulling disorder – Compulsive hair pulling from the scalp, eyebrows, eyelashes, or other areas

These conditions are often misunderstood; it’s not merely a habit or attention-seeking behaviour. These actions are driven by anxiety, stress, boredom, or an urge to self-soothe and emotionally regulate. Over time, they can lead to emotional distress, shame, and even physical harm. 

The signs of a BFRB are usually clear:

• Inability to stop picking or pulling despite repeated attempts
• Noticeable hair loss, skin damage, or infections
• Feelings of relief followed by guilt or embarrassment
• Avoiding social situations due to visible effects
• Rituals around specific times, places, or triggers

Unfortunately, because these behaviours can be private or misunderstood, many people struggle silently for years.

How Therapy Breaks the Cycle

Psychologists who specialize in BFRBs use evidence-based techniques to help you gain control and reduce harm. Treatment options include:

• Cognitive Behavioural Therapy (CBT) – provides a structural framework to understand the complexity of BFRB behaviours and identify treatment targets. 
• Acceptance and Commitment Therapy – works to explore how the individual perceives their BFRB and aims to start to modify assumptions and beliefs through a process of acceptance and behavioural observation. 
• Habit Reversal Training (HRT) – Learning to recognize triggers and replace behaviours. 
• Supportive coaching – Building routines and accountability
• Medication – Anxiety, depression, and/or OCD medications can sometimes help
• Mindfulness and distress tolerance – Managing emotional discomfort without BFRB behaviours

If you struggle with skin picking, hair pulling, or another body-focused repetitive behaviour, know that help is available. Connect with Dr. Corrick Woodfin today! Dr. Woodfin has developed expertise in the psychological treatment of BFRBs and can guide you toward lasting change!