Therapy for Body-Focused Repetitive Behaviors (BFRBs) in San Francisco
What are BFRBs?
Body-Focused Repetitive Behaviors (BFRBs) are a group of related issues that involve touching or engaging with body parts in ways that cause physical damage. Common BFRBs include skin picking, nail biting, and hair pulling. BFRBs are complex behaviors that often result in feelings of shame and guilt. This can make reaching out for help difficult. It’s not uncommon for people who experience BFRBs to hide their symptoms from partners and family members. If you experience one or more of these types of behaviors, you do not need to struggle alone. Our therapists are trained in evidence-based treatment methods that are time limited and effective for gaining freedom from these behaviors. More information about BFRBs can be found here.
Common BFRBs
Trichotillomania aka Hair Pulling
Common Symptoms: Pulling out hair from various parts of the body (e.g.,scalp, pubic region, eyelashes, eyebrows) resulting in hair loss, eating/swallowing hair, and preoccupation with hair pulling.
Excoriation aka Skin Picking
Common Symptoms: Repetitive picking of one’s own skin to the extent that it causes noticeable tissue damage. Picking can occur with fingers or commonly with tools such as tweezers, scissors, etc.
Onychophagia aka Nail Biting/Picking
Common Symptoms: Habitual biting of nails that causes noticeable damage.
Treatment for BFRBs
By the time clients come to work with us for support with BFRBs, it is not uncommon that they have tried multiple times to stop engaging in the behavior. It is not that easy. Because BFRBs are complex behaviors, effective treatment is complex as well. If it was as simple as just stopping, you probably wouldn’t be reading this page right now. For this reason, cultivating compassionate responses to the difficult and sometimes confusing feelings surrounding BFRBs is an important part of overcoming them. At mindfulSF, we treat BFRBs using an enhanced habit reversal training protocol called the Comprehensive Behavioral Model (ComB).
How we work with clients using the Comprehensive Behavioral Model (ComB):
Conduct a detailed assessment of the BFRB along with how it is getting in the way.
Work together to create goals and identify reasons that are uniquely important to you to change the behavior.
Engage in monitoring and awareness training.
Use the assessment along with the monitoring to identify and practice specific coping strategies. Strategies are unique to fit the needs of each person, but examples of common strategies include implementation of sensory replacement behaviors, cognitive restructuring, mindfulness, progressive muscle relaxation, and modifications of environment (e.g., getting rid of tweezers, covering mirrors, etc.).
Looking for support with BFRBs?
mindfulSF offers treatment for body-focused repetitive behaviors (BFRBs) in San Francisco and throughout the Bay Area. Online services also offered across California.