Body-Focused Repetitive Behaviours

Body-Focused Repetitive Behaviours or BFRBS are a group of compulsive actions in which individuals repeatedly damage or alter their bodies, often without realizing it. They include, but are not limited to: hair-pulling (trichotillomania), skin-picking (dermatillomania), and nail-biting. These behaviours are often linked to stress, anxiety, emotional distress or OCD.

Although individuals with BFRBs often feel a sense of relief or satisfaction while performing these actions, they may experience guilt, frustration, or embarrassment afterward. These conditions can also cause physical harm, such as hair loss, skin lesions and infections.

Treatment for BFRBs

BFRBs are usually treated with behavioral therapies, such as Habit Reversal Training (HRT), Cognitive Behavioral Therapy (CBT), and mindfulness practices, which aim to reduce compulsions and provide healthier coping mechanisms.

I primarily use HRT and mindfulness techniques to help identify high-risk times, manage urges and create replacement coping strategies that are easy and accessible.

Habit Reversal Trianing consists of the following components:

  • Awareness Training: individuals learn to recognize when and where the unwanted behavior occurs, including triggers and urges.

  • Competing Response Training: clients are taught to replace the unwanted behavior with a less harmful, physically incompatible action.

  • Relaxation Training: Learning relaxation techniques to help reduce stress/emotional dysregulation.