Guest writer for Wake Up World
Compulsive skin picking (aka Dermatillomania) is a disorder that affects an estimated 2% of the US population.
Picking at an annoying pimple or blackhead every once in awhile is something we all do. It’s a normal grooming behavior that occurs for only split seconds of a day and then is forgotten once the imperfection has been gotten rid of. But, along with thousands of others, I am a part of the 2% of the population who struggles with not being able to stop picking or scratching their skin repetitively.
I have a condition called Dermatillomania, or “Excoriation Disorder” as it is classified in the American Psychiatric Association’s Diagnostic and Statistical Manual, Vol. 5 (DSM 5), which caused me to continuously pick at my skin since I was a teenager.
How did this start?
As a child I had a fascination with peeling off scabs from normal childhood injuries, such as those incurred from falling off the monkey bars, or other usual childhood incidents, which then grew from there into a need to remove any mark I found on myself. After being teased by peers and chastised by relatives for my speckled appearance I believed that removing the heads off of my zits would lead to a smoother complexion. But of course after doing this so often, the result was the opposite – scarring! I found myself in a cycle I couldn’t break because the intense emotional relief that came from picking overrode any other priority in my life, even the constant scarring that resulted.
At the age of 10, this constant urge to pick had spread to other areas of my body — my upper back and chest. This all happened prior to my father suffering a blood clot to the brain, and in the years that followed, trying to cope with this traumatic event, I entered my teenage years and began picking at ingrown hairs on my legs. It only took a year of this constant picking for the resulting scarring to become too much of an embarrassment for me to show my legs in public, and this was the case right through until 2015, a few days shy of my 29th birthday.
Scars of shame
I was invited to appear on the CBS show “The Doctors” with one of the world’s top Body-Focused Repetitive Behaviors (BFRB) specialists, Psychotherapist Karen Pickett, MFT – see video below. I was given 12 one-on-one sessions that combined Cognitive Behavioral Therapy (CBT) with Acceptance-Commitment Therapy (ACT). My expectations weren’t high going into therapy because I knew this behavior was programmed into me from years of reinforcement that turned into a full-fledged disorder. I assured Karen that I would do everything that she advised, even if it made me uncomfortable, so that at the end of the 12 weeks I could at least say that I did my very best even if the the results were not that great.
Following a treatment protocol
It’s difficult to obtain treatment for a condition that only made it into the mental health diagnostic manual in May of 2013. Not many therapists have the skills to treat BFRBs, which can lead to ineffective treatment and a sense of hopelessness for the person seeking help. Like myself, many have faced discrimination from professionals in all fields with their harmful quips such as “you’ve done this to yourself” and “you can stop at any time”. These reactions can prevent sufferers from seeing doctors out of fear of being humiliated, ridiculed, and not believed.
Through the uncomfortable process of recognizing my urges, to slowly weaning from my picking, Karen’s treatment allowed me to analyze my thoughts and feelings preceding the behavior. Fiddle/fidget toys are helpful distractions from BFRB urges, and barriers are useful by blocking a step in “the habit chain”. Being able to interrupt my cycle in order to see it from an observer’s view point-of-view was more eye-opening than “tips and tricks”, that alone hadn’t worked for me in the past. Instead of instantly picking at what I saw, I began naturally learning how to accept unsettling feelings that comes from abstaining from the wants of the disorder.
Its an on-going process
As I continue to practice mindfulness and challenge my cognitive distortions, my recovery grows stronger. Whether or not I’ll ever be rid of the urges, at least I now have a choice on what action I’ll take when Dermatillomania lies to me.
About the author:
Learn more about Angela’s advocacy at www.skinpickingsupport.com