5 Questions About Body-Focused Repetitive Behaviors (BFRB), Answered
What does BFRB Mean? Body-Focused Repetitive Behaviors (BFRB) is a term that describes repetitive, compulsive self-grooming behaviors such as picking, pulling, or biting some part of the body including the hair, skin, nails, or lips that persists despite attempts to stop. Although these behaviors are not a form of self-harm, they may result in physical damage such as infection and tissue damage. Additionally, they often bring shame, a loss of self-confidence, social withdrawal, and family distress. While occasional self-grooming like picking and biting are completely normal human behaviors, for about 2-5% of the population, these repetitive behaviors cross over the line into disorder. As common as BFRBs are, they remain under-researched and under-diagnosed.
What are common BFRBs? The most common manifestations of BFRBs are hair-pulling disorder (trichotillomania), skin-picking disorder (excoriation), and nail and cheek biting. Trichotillomania involves pulling hair from any part of the body, sometimes resulting in bald patches and hair loss, while excoriation involves digging into or picking at areas of the skin, resulting in pain and scarring. The first two are disorders in the DSM-5 (the current diagnostic manual for mental health professionals) classified under the Obsessive-Compulsive category. This does not mean that you have OCD if you engage in BFRB, however, it simply means that BFRBs involve a compulsion to pick, bite, or pull.
Who does BFRBs affect? A common misconception about BFRBs is that they only affect women. While the majority of those diagnosed with BFRB disorders are women, this may just reflect the fact that women are much more likely than men to seek mental health treatment.
Are BFRBs a symptom of another disorder? Those with ADHD or Autism Spectrum Disorder may use BFRB as a ‘stim’ behavior, and those with anxiety may use it as a self-soothing mechanism; however, simply engaging with BFRB is not an immediate indicator of a more serious underlying condition. That being said, BFRBs can be symptoms of many different conditions, so if you are worried about your or your child’s repetitive behaviors, it’s important to seek professional counseling to receive an accurate diagnosis.
Is there a treatment for BFRBs? BFRBs can be reduced through specialized forms of Cognitive-Behavioral Therapy. Habit Reversal Training involves teaching people to recognise the compulsion to pick or pull and then replace the BFRB with a completely different behavior. The replacement behavior might be as simple as sitting on one’s hands, or some people prefer to use fidget toys instead to keep their hands busy. The Comprehensive Behavioral Model is a treatment framework that aims to understand what needs the BFRB is meeting for the individual, substituting personalized strategies to meet those needs in a healthier way, and manage the triggers that cause repetitive behaviors.
BFRBs can cause not only physical but mental and emotional pain. While these behaviors might be completely harmless for some, if they are impacting your quality of life and mental health, it’s time to get an assessment from a qualified mental health professional. Looking for a therapist near Shelby Township, MI? The experienced counselors at AWC are ready to help you.
References
The TLC Foundation for Body-Focused Repetitive Behaviors. (n.d.). Body-Focused Repetitive Behavior | BFRB | BFRB Awareness. https://www.bfrb.org/your-journey/what-is-a-bfrb
