Skin-picking and hair-pulling: How to heal yourself from inside

Over the past four years, I’ve worked with over 100 clients experiencing a compulsive, overwhelming urge to pick their skin or pull their hair. These behaviours often lead to lasting physical damage, and clients describe feeling stuck in a painful cycle of guilt, shame, and helplessness.

If this sounds familiar, know this: you are not alone, and you are not beyond help.

What are body-focused repetitive behaviours (BFRBs)?

Hair pulling (trichotillomania) and skin picking (dermatillomania ) are two different examples of body-focused repetitive behaviours (BFRBs). These behaviours usually begin in childhood or adolescence and seem to affect women more than men.

There is no firm conclusion as to why some people compulsively pick their skin or pull their hair, and today, there is no medication that can treat this compulsion. It is not ‘caused’ by trauma, although trauma can trigger or spark a picking/pulling episode. It is not an OCD (obsessive compulsive disorder). With OCD, there is not the relief or feeling of release that you have immediately after picking or pulling. It is not intentional self-harming behaviour. It is in its own category.

However, BFRB sufferers often also suffer with anxiety, depression, low mood and low self-esteem. Whether this is caused by the physical damage resulting from the behaviour or came before it is difficult to say. What is clear, however, is that when these are treated and overcome, the behaviour lessens or disappears.

Coping strategies for skin picking and hair pulling

Behavioural coping strategies can lessen the impact of compulsive picking or pulling. You can divide them into techniques that help to distract you away from the behaviour and those that help you to disrupt the behaviour.

Distraction techniques

Use a fidget toy.
Take up a hobby that keeps your hands occupied (knitting, beading, drawing, crocheting, puzzles, etc).
Take regular movement breaks, especially when you work in front of a screen.
Use a habit reversal technique.

Disruption techniques

Wear gloves or a hat or a scarf.
Wear acrylic nails.
Keep hair oiled or skin hidden.

These are all effective ways of distracting and disrupting the behaviour and have their place in recovery. Most of the people I work with have all tried these to varying degrees of success. However, when they are not associated with deep transformative inner work, they remain a sticking plaster for these behaviours that will inevitably ‘come back’ again and again to mar your life and happiness.

Why deeper inner work is essential

What I believe will be the game-changer for you is ‘digging deep’. If you don’t dig deep, you will continue to react to the symptom (the picking or pulling) and not address the causes. I deliberately write causes in plural, as I believe there are multiple triggers.

Your unwanted compulsive behaviour is a result of physical tension (often unnoticed), difficult emotions or thoughts that you find it hard to cope with, and that are usually muddled and hard to recognise, and low self-esteem.

Digging deep means standing back and identifying the physical tension, feelings and thoughts that compel you to pick or pull as a self-soothing, releasing, relieving mechanism.

There are three main areas to dig deep into:

The physical tension in your muscles and breathing and your ability to notice this, release the tightness and truly relax.
Your mental tension and your ability to recognise, release and switch off anxiety and negative thinking spirals.
Your self-belief and self-worth and your ability to heal your damaged self-esteem and love yourself completely.

Just imagine if you no longer have to stay on the frantic cognitive hamster wheel of having a trigger, feeling anxious or overwhelmed, resorting to picking or pulling to alleviate or push away these thoughts and then feeling terrible because of the physical aftermath and the psychological feeling of worthlessness.

Just imagine how this could change your life!

You may feel at the moment that the picking or pulling ‘just happens’, that you go into an almost trance-like state and that nothing seems to be able to stop your nervous, maybe feverish hands from doing their damaging work.

You can change this!

How cognitive behavioural hypnotherapy helps with BFRBs

Cognitive behavioural therapy lets you discover your triggers, whether they be emotional, physical, spatial (rooms, places I tend to pick pull in), times of day, etc. Cognitive behavioural therapy will help you put in place effective and personalised distraction and disruption techniques, including the very effective habit reversal.

However, it is hypnosis that lets you plug into a powerful, dreamy, imaginative, calm and deeply reflective state of mind that strengthens this work.

Hypnosis roots healing images, feelings and thoughts just as a tree roots itself in the earth and stands firm. Just as you don’t see the roots feeding and nourishing the tree, your conscious mind and physical body will be nourished and strengthened by your empowering hypnotic experience long after the sessions in your day-to-day life.

It’s almost as if the unhelpful ‘trance’ that you often describe when you lose yourself in picking or pulling is replaced with a forceful unconscious replacement strategy that sweeps away your unwanted behaviour, as if a wave has broken it up and disintegrated it.

And so, both on the surface, the visible part of your life with your behaviour, and below the surface of your life with your thoughts and feelings, you will feel anchored, deeply connected, and so much more in control.

Cognitive behavioural hypnotherapy is collaborative and very empowering as you are active in the solution. Your confidence grows, your self-belief blossoms as you experience true lasting change to what you thought was a ‘lost cause’. It is always wonderful to see that change can happen, old habits and compulsive behaviours can be overcome with work, the right tools and focused attention.

One last thing. Never ever believe that you have to have trichotillomania or dermotillomania for life. You can write the rest of your story. The next page is waiting to be written.

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