Most people with body-focused repetitive behaviors (BFRBs) like compulsive skin-picking, hair pulling, or cheek, lip or nail biting are very hard on themselves. Their self-judgments and criticisms are usually quite harsh. If you have a BFRB, you are probably much harder on yourself than you are to others. These judgments and criticisms usually make you feel horrible about yourself, which likely makes you do the behavior more. If you feel like you’re a failure or ugly, why would you even try to stop the behavior? Therefore, a lot of your suffering is caused by your own self-judgment, which leads to more of the behavior, then more suffering, and the cycle of suffering seems endless.
What if on the other hand you could be kind and loving towards yourself? How do you think you’d feel if you could forgive yourself for what you’ve done to your skin or hair? Self-compassion can give you the support, empathy, and understanding that you get from good friends who are really there for you and make you feel good about yourself. If you can give this to yourself, you will be able to access these good feelings anytime. When you are feeling better you are likely to do the behavior less, which will make you feel even better, putting into effect a cycle of healthy behaviors, thoughts, and feelings.
Let’s go through an example using the experience of one of the members of our BFRB group treatment, with all identifying information changed to protect her confidentiality.
Sally has spent most of her life picking the skin on her arms, legs, chest, back, and face. Before she started the group she had several picking episodes per week where she’d spend hours picking her skin, and then would beat herself up for the damage she caused. She’d call herself a failure for not being able to stop, and was convinced that she could never overcome this. This feeling bad about herself would then lead to her picking more as a way to try to cope with this feeling. This is what we commonly refer to as the shame spiral.
Eight weeks into group therapy, Sally had learned many strategies to reduce the skin picking, and had not picked at all for the past couple of weeks. In this ninth session she reported that she had gotten into an argument with her partner, and started picking again. While she wasn’t happy with herself for picking, she responded differently than she had in the past.
In the group session she reported that she was disappointed that she had picked, but that she hadn’t beat herself up like she did before. In fact, she responded by praising herself for stopping when she did. She then paused to remind herself that she has done a lot of hard work to improve her skin-picking, and that this was just a slip. She asked herself what she needed at that moment, and realized that she was tired and needed to get in bed with a good book and just relax and go to bed. The next day, she went to the course website and watched this week’s class material to learn about how to sit with difficult emotions. This practice wasn’t easy for her given what she’d just gone through, but it allowed her to stop fighting her frustration and to just allow it to be as it was. Afterwards she reported feeling a little better, and was proud of herself for how she responded.
If you have a BFRB and have been beating yourself up for doing the behaviors you’re trying so hard to stop, try these three steps at least once a day when you are engaging in your BFRB or not feeling good about yourself.
- Pause and ask yourself, “What do I need right now?”
- Consider how you might be able to meet that need. For example, if you need a hug, ask your partner or schedule time with a friend or family member.
- Think about what you would say to a friend who was going through what you’re experiencing right now, and say that to yourself. For instance, “I know this is so hard. I’m here for you.”
Use a journal or your notes app on your phone to track the intensity of your emotions from 1-10 before and after doing these three steps. If you want to take the exercise further, try one of Dr. Kristen Neff’s meditations or writing exercises from her website, https://self-compassion.org/self-compassion-practices/.
If you have a BFRB and are ready to take our signature 11-week online course/group therapy, we have a section starting April 2nd. Click here to learn more or grab one of the 7 remaining spots.
