The Emotional Toll of Hair-Pulling, Skin-Picking, and other BFRB’s: How Therapy can Help
Living with a Body-Focused Repetitive Behavior (BFRB) can feel like an endless cycle of frustration and disappointment. Whether it's hair-pulling (trichotillomania), skin-picking (dermatillomania), or nail-biting (onychophagia), BFRBs often leave individuals struggling with intense emotions that go beyond the physical aspects of the behavior. While much attention is given to the visible impact of BFRBs, the emotional toll can be just as significant, if not more so. Feelings of grief, guilt, and shame are common, but they are also deeply personal and often hidden from others.
Understanding and acknowledging these emotions is a crucial step on the path toward healing. Let’s explore the emotional landscape of BFRBs and how getting help from a BFRB therapist can assist in beginning the journey of self-compassion and recovery.
Grief: Mourning the Loss of Control
Grief might not be the first emotion people associate with BFRBs, but for many, it is one of the most powerful. People with BFRBs often experience a sense of loss—the loss of control over their own bodies, the loss of self-confidence, and sometimes even the loss of parts of their physical appearance, such as hair, smooth skin, or healthy nails. Each time a person gives in to their urge, it can feel like a defeat, fueling a deep sense of sorrow.
This grief can be compounded by missed opportunities or altered life experiences. For example, someone who avoids social situations, swimming, or wearing certain clothes due to shame over their appearance may grieve the carefree life they wish they could have. Over time, this can lead to a profound sense of mourning for a life lived without the constant struggle against the urge to pick, pull, or bite. Shame also prevents many from reaching out to obtain support, but getting therapy from a counselor with expertise in hair pulling, skin picking, and other BFRB’s can be game-changing.
Guilt and Shame: The Unseen Weight
BFRBs are often misunderstood by those who don’t experience them. They can be dismissed as mere "bad habits," leading those who suffer from them to internalize feelings of guilt and shame. Individuals with BFRBs may berate themselves for their inability to stop, asking, “Why can’t I just quit?” or “What’s wrong with me?”
The guilt comes not only from the behavior itself but also from the physical consequences. Each time someone pulls a hair or picks at their skin, there’s an immediate sense of regret, knowing that the damage is visible and can take time to heal. For those who are trying to hide their BFRBs from others, the guilt often intensifies as they attempt to cover up the evidence—leading to an ongoing cycle of secrecy and shame. However, shame thrives in silence, and talking about it in therapy with a BFRB counselor can offer a safe space to experience compassion and understanding.
Self-Compassion: The Key to Healing
Healing from the emotional toll of skin picking or hair pulling is not about instantly stopping the behavior, nor is it about achieving perfect control over your urges. Instead, healing begins with self-compassion—the ability to recognize that you are human, that you are struggling, and that your worth is not defined by this behavior.
Learning to be gentle with yourself is crucial. This means acknowledging that BFRBs are not a reflection of your character or self-discipline, but rather, they are a coping mechanism rooted in complex emotional and neurological factors. You didn’t choose this, and blaming yourself only deepens the emotional wounds.
A compassionate approach also involves celebrating small victories rather than focusing on perceived failures. Maybe you managed to reduce the frequency of your behavior, or perhaps you reached out for support from a BFRB therapist or a loved one. Every step matters.
Healing Through Acceptance and Support
While there may not be a quick fix for BFRBs, acceptance can be a powerful tool for emotional healing. Acceptance doesn’t mean giving up on managing the behavior—it means recognizing that skin picking or hair pulling is a part of your journey right now, and learning how to navigate them without judgment or harshness.
Seeking support from others, whether through therapy with a BFRB expert, or through joining a skin picking/hair pulling support group, can also alleviate some of the emotional burdens. Knowing that you are not alone in your experience helps combat the isolation and shame that so often accompany BFRBs.
Moving Forward: Embracing Imperfection
Living with a BFRB is an ongoing process, and it’s important to remember that setbacks are part of recovery. Healing doesn’t mean never pulling, picking, or biting again—it means learning to forgive yourself when it happens and moving forward with kindness. It means recognizing your emotions, whether they are grief, guilt, or shame, and understanding that they are valid.
Through self-compassion and support, you can begin to heal the emotional wounds of living with a BFRB. It’s about embracing imperfection, understanding your triggers, and working towards a place of acceptance. Over time, you may find that while the urges still exist, the heavy emotional toll begins to lift.
By shifting the focus from self-blame to self-compassion and obtaining the right treatment, the emotional journey of BFRBs becomes one of healing rather than despair. Everyone’s path is different, but getting help can be the first step toward freeing yourself from the guilt and grief that so often accompanies skin picking or hair pulling.
If you want to reduce the emotional pain of your BFRB, please reach out to see how working with a BFRB therapist can support you. I use evidence based treatment and offer both individual therapy as well as lead a BFRB support group, but let’s start with a free consult call. To learn more about how we can help with Skin-Picking Therapy, call, text, or email me to take the first step in breaking free from the emotional and physical burden of this disorder.