Offering telehealth services across the United States and in-person services in multiple NY, NJ & PA locations.

Other Body-Focused Repetitive Behaviors

What Are Other Body-Focused Repetitive Behaviors (BFRBs)?

Body-focused repetitive behaviors (BFRBs) encompass a group of self-grooming behaviors that result in damage to the body, despite repeated efforts to reduce or stop the behaviors. While trichotillomania (hair-pulling disorder) and excoriation disorder (skin-picking disorder) are widely recognized, there are numerous other BFRBs that individuals may experience.

Examples of Other BFRBs

  • Onychophagia (Nail Biting): Chronic nail-biting that can lead to nail damage, infections, and functional impairment.
  • Onychotillomania (Nail Picking/Manicuring): Recurrent picking or excessive grooming of nails, often causing pain or tissue damage.
  • Lip Biting: Persistent biting of the lips, which can result in sores, scarring, or discomfort.
  • Cheek Biting: Habitual biting of the inner cheeks, leading to tissue damage, swelling, or irritation.

Impact of Other BFRBs

These lesser-known BFRBs can cause significant distress, medical complications, and disruptions to daily life. Physical effects such as pain, infections, or scarring are common, and individuals often experience shame or embarrassment about their behaviors, which can lead to isolation and avoidance of social situations.

Comprehensive Treatment for Other Body-Focused Repetitive Behaviors

At The Center for Emotional Health (CEH), we provide compassionate, evidence-based care designed to help individuals overcome other body-focused repetitive behaviors and regain control of their lives. Our specialized treatment incorporates scientifically supported therapies to address the unique challenges of hair pulling, skin picking, nail biting, and other body-focused repetitive behaviors.

Evidence-Based Treatment Approaches

Habit Reversal Training (HRT):

HRT focuses on:

  • Awareness Training: Helping individuals identify triggers, patterns, and urges associated with BFRBs.
  • Stimulus Control: Modifying environments to reduce urges and promote healthier behaviors.
  • Competing Response Training: Teaching alternative, less damaging actions to replace BFRBs.

Comprehensive Behavioral Treatment (ComB)

ComB addresses the physical, emotional, and environmental factors contributing to BFRBs. A detailed examination of the factors influencing BFRBs and traditional cognitive behavioral therapy (CBT) interventions are provided with attention to:

  • Sensory Experiences: How physical sensations impact BFRBs.
  • Cognitive Patterns: The role of thoughts and beliefs.
  • Emotional Responses: The connection between emotions and the behavior. tive tract).
  • Motor Behaviors: The actions involved in BFRBs and level of awareness. tive tract).
  • Environmental Factors: How surroundings and context play a role.

Integrative Behavioral Therapy (IBT): Enhancing Psychological Flexibility

IBT combines elements of cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), and dialectical behavioral therapy (DBT) skills.

Steps in IBT for BFRBs include:

  • Building self-understanding:
    Gain awareness through mindfulness and identification of the behavior chain.
  • Narrowing down the MAP:
    Address the external and contextual antecedents that lead to BFRB symptoms, including:

    • Movement and Automaticity – build mindful body awareness and self-observation skills.
    • Awareness of Vulnerabilities – reduce underlying vulnerabilities.
    • People, Places, and Spaces – Respond effectively to the environment.
  • Working with the TIMES:
    Change one’s relationship to internal discomforts which have prompted BFRB symptoms:

    • Thoughts, Images, Memories – Foster a healthy relationship with oneself.
    • Emotions – Build emotion regulation, distress tolerance, and self-compassion.
    • Sensations – Observe, allow, and redirect discomforts.
  • Thriving with a BFRB:
    Build confidence, overcome difficult situations, and master BFRB skills to live a full, meaningful life.

Support and Resources for Long-Term Success

  • The BFRB Recovery Workbook
    Authored by CEH Founder Dr. Marla Deibler and Dr. Renae Reinardy, this workbook offers actionable tools and strategies to support recovery from trichotillomania, excoriation (skin picking) disorder, and other BFRBs.

  • Community Support Groups
    Join our free monthly support groups, where individuals impacted by BFRBs can connect, share experiences, and receive ongoing encouragement in a judgment-free space.

Request Your Appointment

Take the first step toward better mental health. Whether in person or through telehealth, The Center for Emotional Health is here to support you every step of the way. Contact us today with any questions and to schedule your appointment.