Body Focused Repetitive Behavior… | Counseling | Therapy

Body Focused Repetitive Behavior Therapy (BFRB)

Virtual & InPerson Therapy in Philadelphia, Ocean City, Mechanicsville, Santa Fe, Providence RI

Excoriation Therapy: Trichotillomania Therapy: Onychophagia Therapy: Morsicatio Buccarum Therapy

Skin Picking Therapy: Hair Pulling Therapy: Nail Biting Therapy: Cheek Biting Therapy

Body Focused Repetitive Behavior Therapy (BFRB): Virtual & In Person Therapy in Philadelphia, PA, Ocean City, NJ, Mechanicsville VA, Santa Fe NM, Providence RI

  • Excoriation (Skin picking) therapy services
  • Trichotillomania (Hair pulling) therapy services
  • Onychophagia (Nail biting) therapy services
  • Morsicatio Buccarum (Cheek biting) therapy services

We all have our nervous habits. Maybe you fidget, twirl your hair, crack your knuckles, bite your nails, or grind your teeth. What may start out as a seemingly harmless habit can sometimes evolve into a problem that impacts your quality of life. But at what point will you know if your “harmless habit” actually warrants a visit to a therapist in Philadelphia, Ocean City, Mechanicsville, Providence, Santa Fe specializing in the treatment of trichotillomania / hair pulling, excoriation / skin picking, morsicatio buccarum / cheek biting, onychophagia / nail biting, knuckle cracking, and grinding your teeth ?

Body Focused Repetitive Behaviors (BFRB) therapy refers to a group of conditions where people continuously engage in repetitive behaviors that cause physical damage to their own body. Hair-pulling, skin-picking, nail-biting, and cheek-biting are just a few examples. BFRBs are surprisingly common with 1 in 20 people experiencing them. While hair-pulling, skin picking, cheek biting and nail biting usually develop during adolescence, Body Focused Repetitive Behaviors (BFRB) can occur at any age. People with Body Focused Repetitive Behaviors (BFRB)s tend to engage in these behaviors when they are stressed or bored, as children, adolescents and adults may find these behaviors soothing or stimulating.

What differentiates BFRBs from a “harmless habit” is that it is a compulsive, irresistible, well-ingrained routine that results in physical damage (e.g. bald spots, sores, wounds, bleeding, infections) and emotional damage (shame, guilt and embarrassment). While some children, adolescents and / or adults may have awareness of what triggers their BFRB, others may engage in the behavior automatically and are only able to come to the realization of what has happened after the damage has been done. Most people with BFRBs struggle to control these behaviors and often keep them secret because they fear being judged. Hair pullers often wear their hair in such a way to cover the bald spots, skin pickers often only pick the skin that can be easily covered by clothing, nail biters might wear gloves.

Body Focused Repetitive Behavior therapy in Philadelphia, Ocean City, Santa Fe and Mechanicsville, Providence is designed to help children, adolescents and adults who struggle with BFRBs to gain awareness of their condition, to separate their urges from their behaviors, and to improve their quality of life.

Through a combination of evidence-based techniques and tailored interventions, BFRB therapy offers a comprehensive behavioral model that aims to reduce the frequency and severity of BFRBs by:

  • Providing psychoeducation on BFRBs and normalizing experiences/emotions
  • Creating an atmosphere of acceptance and understanding
  • Offering a comprehensive assessment of your unique internal and external triggers across SCAMP (sensory, cognitive, affective, motor, place) domains
  • Guiding awareness of your unique cycle of behaviors (pre, during, post)
  • Developing an individualized plan with healthier coping mechanisms to manage stress and anxiety
  • Addressing underlying emotional and psychological factors
  • Empowering individuals to overcome the shame and isolation

Our approach at The Center For Growth, to Body Focused Repetitive Behavior Therapy (ie: excoriation, trichotillomania, onychophagia, morsicatio buccarum) in Philadelphia PA, Ocean City NJ, Mechanicsville VA, Providence RI and Santa Fe NM is designed to help you explore your urges and habits that cause damage to your body in a compassionate and non-judgmental environment where you feel seen, heard, and validated, while learning coping tools and strategies to understand and manage your condition with patience, confidence, and care.

Left untreated, body focused repetitive behaviors can lead to a variety of negative consequences on an individual’s physical and mental health, including:

  • Physical harm: Hair pulling can lead to hair loss or bald patches. Skin picking can cause scarring, infections, and nerve damage.
  • Emotional distress: Shame, guilt, frustration, and embarrassment are common emotions experienced by those with BFRBs. Left untreated these feelings can lead to anxiety and/or depression. It can also affect an individual’s self-esteem.
  • Social isolation: People with BFRBs may isolate themselves, avoid social situations, or hide their condition due to shame.
  • Impaired daily functioning: Having a BFRB take up a considerable amount of time and energy, impacting a person’s daily routine and productivity. Managing the urges can be distracting and can cause disruptions to everyday tasks like working and studying.

Body Focused Repetitive Behavior Therapy for Hair Pulling Disorder (Trichotillomania): Trichotillomania, also known as hair pulling disorder, is a condition characterized by the repeated and compulsive urge to pull your hair. The hair pulling may involve any hair on the body, including the scalp, eyebrows, eyelashes, or pubic region. Physical consequences include noticeable bald patches on their scalp or damage in other areas due to the repeated pulling of hair. Individuals with trichotillomania may have specific rituals or routines, such as pulling out only certain types of hairs or in specific locations. In severe cases, people may need to conceal their hair loss with hats or wigs.

Body Focused Repetitive Behavior Therapy for Skin Picking Disorder (Excoriation): Excoriation, also known as skin picking disorder, refers to the repeated urge to scratch or pick at one's skin, which often leads to tissue damage, scarring, and infections. Those with excoriation may be particularly vulnerable to engage in unhealthy urges if they have a preexisting condition like acne, eczema, or prurigo nodularis, that causes itching and discomfort.

Body Focused Repetitive Behavior Therapy for Nail Biting Disorder (Onychophagia): Onychophagia, also known as nail biting disorder, is a compulsive habit that involves biting, chewing, or picking at the nails and the surrounding skin. This behavior includes biting or chewing on the nails or cuticles, picking at the skin around the nails, biting or chewing the skin around the nails, swallowing nails or pieces of skin, and using teeth or other tools and objects to remove the nails or skin around the nails. In severe cases, people with onychophagia may bite their nails until they bleed or develop infections.

Body Focused Repetitive Behavior Therapy for Cheek Biting Disorder (Morsicatio Buccarum): Morsicatio Buccarum, or cheek biting disorder, is a chronic condition where an individual repeatedly bites the inside of the cheeks or lips. This behavior includes biting or chewing on the inside of the cheeks or lips, sucking on the inside of the cheeks or lips, rubbing the tongue or teeth against the cheeks or lips, or using teeth or other tools and objects to remove loose or rough tissue from the inside of the cheeks or lips. In severe cases, it can cause pain, swelling, and infections in the mouth.

What does healing look like? Fortunately, with increased awareness and repeated practice, you can develop the tools to notice and change the entrenched behavior patterns that fuel your body focused repetitive behaviors. With time and effort, new neural pathways can be formed and new experiences, behaviors, and thoughts can be used to weaken the triggers that fuel your BFRB.

Because BFRBs are such an individualized issue with each person having their own unique patterns and cycle of behaviors, individual therapy is the gold standard of care. In Body Focused Repetitive Behavior therapy, our goal is to help individuals maintain a positive and compassionate attitude during treatment, as they explore, experiment, and establish a sustainable plan to help them move forward.

At the Center for Growth, therapists in Philadelphia, Pennsylvania, Providence RI, Ocean City, New Jersey, Mechanicsville, Virginia, and Santa Fe, New Mexico all use the same comprehensive evidence-based approach, which includes Cognitive Behavioral Therapy (CBT) and Habit Reversal Training (HRT) to help you understand your triggers and develop new habits and behaviors that are healthier and less damaging to your body.

Our approach to treating body focused repetitive behaviors involves three main phases:

Explore: The first step in managing a BFRB is to become aware of all the factors that trigger the behavior. Therapists work with individuals to look at which levers are activated as it relates to Sensory, Cognitive, Affective, Motor, and Place. Gaining a comprehensive understanding also includes looking at the entire cycle of behavior, as far as what happens before you pull/pick, what happens during, and what happens after. As an example, those who struggle with a BFRB may feel a sense of stress or anxiety before engaging in their urge, which is followed by a sense of relief or pleasure after they pull/pick.

Experiment: Once a child, adolescent or adult gains awareness of their unique patterns, therapists can introduce potential interventions that can disrupt the cycle and make it more difficult for the individual to engage in their BFRB. This may involve things like using a stress ball or fidget toy to keep your hands occupied, wearing gloves or bandages to make it more difficult to engage in the behavior, or using a competing response, such as clenching your fists or crossing your arms, to replace the behavior. It may also involve identifying and challenging distorted thinking, developing coping strategies for stressful situations, or working on self-esteem and body image issues that may be contributing to the behaviors. The specific interuption might look different for each client due to their age and symptom(s) experienced.

Establish a plan: Because BFRBs are deeply ingrained with many potential triggers, it is important to develop a toolbox of interventions that you can leverage with your therapist. Once you have explored how your triggers are activated in different environments and have experimented with different interventions, you will have a better sense of what works best for you. Moving forward it will be important to look at the combination of interventions that can be leveraged in different scenarios to give you the best chance of recovery. As an example, addressing boredom and anxiety will look completely different. Your therapist may also help you identify mindfulness practices to incorporate into daily life and ways to leverage social support.

During your therapy sessions, our therapists will work with you to develop a personalized treatment plan based on your individual needs and goals. We will help you understand the root causes of your BFRBs, identify triggers, and develop strategies to manage the urges and behaviors associated with BFRBs. We will also work with you to address any underlying mental health conditions, such as anxiety or depression, that may be contributing to your BFRBs. During treatment, our therapists help you to set realistic expectations while maintaining an attitude of hope. The journey to recovery is not easy. While you may experience setbacks during treatment it is par for the course and insignificant in the long run.

Struggling with Excoriation, Trichotillomania, Onychophagia or Morsicatio Buccarum and living in Philadelphia, Pennsylvania, Ocean City, New Jersey, Santa Fe, New Mexico, Providence RI and Mechanicsville, Virginia? If so, call today. Our therapist are trained in body focused repetitive behavior therapy. We can help you gain an awareness of your habits and provide you with the guidance to manage these behaviors, while helping you to develop compassion for yourself as you work towards a happier, healthier life. Call 215 - 922 - 5683 x 100. We have 2 physical offices in Philadelphia, PA, Art Museum Office and Society Hill Office, and a physical office in Ocean City Office Ocean City NJ, Mechanicsville Office Mechanicsville VA, Providence Office Providence RI and Santa Fe Office in Santa Fe NM. We also offer virtual sessions in PA and virtual therapy in NJ, virtual therapy in VA and virtual therapy in NM, and virtual therapy in GA and virtual therapy in Fl and virtual therapy in Connecticut.

The Center for Growth Therapy Offices in PA, NJ, VA, RI, NM

InPerson Therapy & Virtual Counseling: Child, Teens, Adults, Couples, Family Therapy and Support Groups. Anxiety, OCD, Panic Attack Therapy, Depression Therapy, FND Therapy, Grief Therapy, Neurodiversity Counseling, Sex Therapy, Trauma Therapy: Therapy in Providence RI, Philadelphia PA, Ocean City NJ, Santa Fe NM, Mechanicsville VA