What Are Body Focused-Repetitive Behaviors (BFRBs)?
Have you ever found yourself compulsively picking at a scab, pulling at a split end, or biting at your nails until you bleed?
Have these behaviors ever caused you frustration or shame?
Have you told yourself to just stop, only to find your hands moving back to the same spot moments later?
At Oath Therapy, we want you to know these aren't just "bad habits." You aren't lacking in willpower. These are part of a group of related behaviors known as Body Focused Repetitive Behaviors, or BFRBs.
What exactly is a BFRB?
Body-Focused Repetitive Behaviors is an umbrella term for a set of self-grooming behaviors in which an individual pulls, picks, scrapes, or bites their own hair, skin, or nails.
While most people engage in some form of grooming, BFRBs are different because they result in physical damage to the body and cause significant emotional distress.
The most common types of BFRBs include:
Chronic hair pulling from the scalp, eyelashes, eyebrows, or other body parts.
Repetitive skin picking that leads to tissue damage or scarring.
Chronic nail biting that goes beyond occasional grooming.
Why do people engage in these behaviors?
One of the biggest myths about BFRBs is that they are a form of self-harm. In reality, the intent is not to cause pain. Instead, these behaviors often serve as a way to regulate emotions or sensory input.
For some, picking or pulling is a "soothing" mechanism used to cope with anxiety or stress.
For others, it's a way to "fix" a perceived imperfection, like a bumpy follicle or a rough edge of a nail. It can also happen during moments of boredom or sedentary activity, like watching TV, or driving.
Over time, the brain begins to associate this behavior with a temporary sense of relief, making it a difficult cycle to break on your own.
Are BFRBs the same as OCD?
BFRBs share some similarities with Obsessive-Compulsive Disorder. The big similarity is the repetitive nature of the actions. In clinical terms, they are often categorized under the OCD-Spectrum, but they are distinct conditions.
While OCD is usually driven by "obsessions" (intrusive, fearful thoughts), BFRBs are often more about "sensory" or "urge-based" feelings.
Someone with OCD might wash their hands to prevent sickness, while someone with BFRBs might pick at their skin because of a physical urge or a need for a specific tactile sensation.
Because the "why" is different, the treatment approach often needs to be specialized as well.
How can therapy help manage these urges?
BFRBs are treatable. Because these behaviors are often automatic or tied to specific triggers, therapy focuses on increasing awareness and developing new ways to handle the urges.
Approaches like Habit Reversal Training (HRT) and Comprehensive Behavioral (ComB) treatment are considered to be the standard of care. These methods help you identify the cues that lead to the behavior, then provide you with competing responses to replace the behavior.
At Oath Therapy, we work with you to build the toolkit that helps you regain control and treat your body with the kindness it deserves. Are you ready to get started? Schedule your free consultation today if you'd like to find out more.