In support of BFRB awareness week, I thought I'd go into the more medical side of things for once and give an insight into the category in which trichotillomania is placed. BFRB stands for 'body-focused repetitive behaviours' and broadly covers all disorders which display these characteristics. Rather than mild habits or 'tics' (such as picking your nails every now and then), these disorders focus on touching the body and/or hair in ways which are incredibly damaging; they have more extreme consequences than the mannerisms which people are most used to seeing. Rather than just being habits, there is a deeply complex emotional root in these BFRBs which needs treating in some way. The emotional trauma and physical damage these disorders can cause make them something dangerous to undermine and hurtful to minimise the severity of.
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To use the same example again, there is a difference between someone who picks there nails every now and again and someone who picks their nails and cuticles compulsively until they are sore and bleeding, unable to stop themselves from causing this extreme physical harm. Common BFRBs include trichotillomania (hair-pulling), dermotillomania (skin-picking), extreme nail-biting, hair and skin eating, and the repetitive biting of your lips or inside of your cheeks. If you suffer from one of these, it is likely that you will also experience some of the related disorders at some point.
For example, my trichotillomania is paired with dermotillomania. At first I thought that my skin-picking was just an extension of nail-picking that I would grow out of, but it developed into something a lot more serious. I realised I had a problem when my thumb nails became permanently disfigured and my cuticles looked constantly bloody- others would start questioning why I was making myself bleed and why I'd do something that hurt myself so much. It made me question my actions. I didn't want that awful sore feeling the next morning, but there was something about needing to keep picking at the skin until it looked uniform and felt like there were nothing sticking out. It's the same mindset with trichotillomania for me; any lashes or brows that feel different or look out of place just need to go, as I have previously described here. Something which I thought was just a habit I picked up from my Mum was biting my the inside of my cheeks and lips. In fact, before researching what the category of BFRBs meant for this post, I had no idea it actually fell under this group; it now makes perfect sense why I do it! Again, in comparison to the other two it is far milder, but it's all still related.
BFRBs are all linked to anxiety. We never want to hurt ourselves so badly (often mistaken for a form of self-harm), but often use it as a way to subconsciously relieve ourselves from anxiety or stress or 'fix' something we perceive to be wrong with our body. With some, the anxiety may be so deep-rooted that BFRBs are just an ingrained way of dealing with the emotional issues behind the action. I have discussed forms of therapy for trichotillomania and my own personal experiences with them, and a lot of the same therapies are used across the umbrella of BFRBs too. They all deal with the impulsive urges and what skinpickingsupport.com describe as "pathological grooming behaviours" (a term which I find a tad too strong...it makes me feel like a psychopath!).
It is important to distinguish the relatively new term of BFRB from the long-standing recognition of OCDs and similar disorders. An OCD works on the basis of 'X will happen if I don't do Y', while BFRBs are just impulsive, often uncontrollable, urges to do something to the body (even if we don't mean harm) without necessarily being driven by a possible consequence. Addiction, according to skinpickingsupport.com, is also different as it is chemically-induced or has external factors to a certain extent. Whilst I do sometimes feel like my trichotillomania is an addiction (and find it easiest to describe in this way), BFRBs are still separate from this category.
What is most important to remember is that you are not alone in this. It is estimated that 1 in 50 people will experience one of these BFRBs at some point in their lives, so it is far more common than you would ever think. Although they can be lonely disorders, you are most definitely not on your own.
I hope you've found my 'condensed' summary of BFRBs helpful; there are tons of useful resources out there that will pop up with even a quick Google. I'm glad that more research and information on these disorders have become so readily available as it was previously very sparse!
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