Categories
Adolescence Communication Mental Health Parenting Recovery Therapy Trauma

Healthy Boundaries Make for Healthy Teens

© sarit z rogers

What steps can you take to ensure that you aren’t in violation of someone’s boundaries? For example, not everyone enjoys being hugged, nor is it always appropriate to express that level of touch. From the perspective of a teacher or a therapist, one must understand the innate power differential that exists between teacher and student or therapist and client. One is looking to the other for advice and pedagogic elucidation, and one is holding the power to elicit such information. We therefore need to be thoughtful in our approach to employing touch in these situations.

 

In a therapeutic environment such as Visions, we address more than substance abuse and mental illness; we are facilitating the excavation of trauma and creating safe boundaries. It’s important to maintain awareness around our own sense of boundaries and how execute them. Asking ourselves these questions and contemplating the answers through talking to our peers and writing them out will help you discern where you may need some work, and where you are strongest:

 

  1. What does it mean to set boundaries?
  2. Is it hard to say “no”? If so, what does saying “no” feel like?
  3. How do I feel when my boundaries are crossed?
  4. What is my reaction internally and externally?
  5. Am I afraid to set boundaries? Why?
  6. What is my history around setting boundaries?

 

As clinicians and teachers, it’s imperative that we know and understand where our weak spots are so we can work on them. For some people, it’s not uncommon to wait until someone pushes us to our edge before we set a limit. The desire to please others or to be liked plays a part here, and our own backgrounds and upbringing will also effect how we interact with others. Perhaps we come from a family where hugging and touch is part of the norm. It may be natural for us to reach out and hug someone when they are suffering, but it’s not always appropriate.

 

Hugging a client may be a violation of a boundary, but if the client has been traumatized in some way, they may not know how to set that boundary. Likewise, if a client persistently tries to hug you, you have to maintain a firm boundary so they learn to understand what is and what is not appropriate. I was volunteering at my son’s school recently, and a kid came up and hugged me, not wanting to let go. It was a child I don’t know and it was a clear violation of my boundaries and the school’s rules. I gently moved away and held a boundary with this child until he moved on. Teens look to us as examples to learn from and to emulate. If we don’t show strong, safe boundaries, they won’t be able to either. Understand that the boundaries we create encourage freedom to be who you are while creating a safe container for healing and recovery.

Respecting boundaries applies to parents too. If the family dynamic has been compromised, parents have to work to rebuild a healthy and safe family structure. Creating solid boundaries is key in that process. Adolescents love to push buttons and stretch boundaries; they are smack dab in the center of their individuation process. That doesn’t mean you, the parent, have to give in. Remember: “No” is a complete sentence, and when it’s said with certainty and conviction, it makes all the difference. A wishy-washy, non-committal “no” may as well be a “maybe” or a “yes.” Poor limits leave room for negotiation where there shouldn’t be.

We all have a part to play in creating safe limits whether we are parents, teachers, or clinicians. Kids, in their infinite wisdom and testing behaviors, demand strong limits, whether they admit it or not. Boundaries create safety. They provide defined parameters in which to develop and grow. So as much as a teen may push, inside, they really do respect a firm “No” and a defined environment.

Categories
Dialectical Behavioral Therapy (DBT) Mental Health Recovery Therapy Trauma

Redefining Your Emotional Landscape With DBT

mindfulness 1.0 (Photo credit: Mrs Janet R)

The ideology behind therapeutic tools like DBT is to facilitate and encourage an emotional and psychological paradigm shift towards a more sustainable relationship to one’s mental health challenges. The foundational tenant of DBT (Dialectical Behavioral Therapy) is mindfulness training. By using core mindfulness skills, one becomes personally active in redefining their relationship to their suffering.  Using these tools, one can learn to be non-reactive to their discomfort while staying emotionally present.  In a nutshell, they are taking what is a learned response to stress and dismantling it. DBT teaches you how to put it back together in a healthier, more sustainable and manageable way.

 

Are we programmed to fix things? Is being present with “what is” simply too much? For many, the answer to these questions is a wholehearted “Yes!” We come to recovery in deep suffering, and often times, this suffering is precluded by failed attempts at “fixing” what was “wrong” with us. Substance abuse, sex, shopping, self-harming, video games, the Internet, and gambling are used as ways to mollify our pain; these things are temporary and eventually, they cease to work. What we are left with are the frayed shadows of unaddressed traumas, hurt, loss, shame, sadness, depression, anxiety, et cetera.

 

Redefining the way we approach our difficulties takes patience. It takes effort. It takes acceptance. It requires us to sit with our discomfort without trying to fix it or change it in any way. Imagine someone clutching something with all of their might, because letting go would be unfathomable. But their grip is so tight, what they are holding onto is crushed, creating sheer devastation and heartbreak. What if we look at our difficulties the same way: if we hold onto them so tightly, we create heartbreak and devastation. Instead, we can hold them gently, giving those same difficulties room to breathe and change.

 

There is no magic bullet. There is work to be done, and it takes effort and patience and support. With tremendous tools like DBT elicited by skilled clinicians, it’s clear the temperature of mental health recovery is changing; it’s more inclusive and collaborative.

Categories
Mental Health Recovery Therapy Treatment

Mental Health Care: The Only Way Out is Through

(Photo credit: Wikipedia)

Mental health is not something to be meddled with. It’s not something that can be fixed by prayer or meditation or going to yoga or by thinking positively. It requires legitimate clinically supported psychological care.  For some that may require a long-term in-patient program, for some, that may require an intensive outpatient program, and for some that may require weekly meetings with a therapist. The spiritual practices of prayer, meditation and yoga can and ought to be integrated into any therapeutic work but they are not the end all be all.

 

Stepping onto the path of recovery is about change. It’s about shifting one’s perspective and learning how to redefine and shift old paradigms so we can create new ones. We must first begin with our old thought patterns and old ideals, which are heavily ingrained in us. The older we are, the deeper the planting, and often the more difficult the change, though not impossible.

 

It is imperative that we seek help for our mental health needs when we need it. If we are confronted with clinical depression, anxiety, OCD, panic disorders, or PTSD, this is where a skilled psychologist or therapist or possibly a psychiatrist should come in.  Bypassing it is dangerous and causes us more harm than it does good. Often times, we seek that magic bullet that will make everything just go away, but it doesn’t. We have to walk through it, or stumble through it, whatever the case may be.

 

I am reminded of my newcomer years: I was a mess. And when I say mess, I mean, a real mess. I was angry, resistant, but I was full of fire. I was ultimately convinced that I was going to be killed by my feelings (clearly, that didn’t happen!), and I would wax poetic dramatically that it was so.  If it weren’t for people pulling me out of myself and into reality, I wouldn’t be where I am today. Part of that process was also learning to walk through my issues not around them, because wherever I went, they were right there with me, like a trusted companion, ready and willing to make my life miserable.

 

You don’t have to do this alone. In fact, you can’t. There is a network of mental health care that avails you and a network of support groups at the ready. One step at a time, one breath at time, one minute at time, recovery is possible. Mental health care is possible but one thing is for sure, the only way out is through.

 

Categories
Mental Health Recovery Therapy Trauma Treatment

Boston Marathon: Emotional Care During Tragedy

Boston Marathon Finish Line.1910. Author: Unknown. (Photo credit: Wikipedia)

We are once again faced with the darkness of another tragedy: the bombing at the Boston Marathon. Events like this inevitably bring up our past traumas, leading to feelings of deep sadness, and often confronted by some of our unfettered grief. There is also a huge sense of confusion when we are faced with the unanswerable question of “Why?”

 

As parents, it is important to be transparent and honest with our kids in times like this. This does not mean sharing gruesome photographs of the event with them or feeding them gory details. Talking to our kids and allowing them to have a voice in a traumatic time is important. When the bombing at the Boston Marathon happened, we sat down with our son and talked to him about it. We wanted to make sure he heard it from us and not from the rumor mill of middle school, where hyperbole and fear mongering are the norm. He felt shock, confusion, and sadness. For parents, it was and continues to be our responsibility to honor the feelings of our kids and provide a safe container for them to express themselves. The world can be a scary place, especially with the effects of random acts of violence. Our son had many questions about what happened in Boston, many of which mirrored the questions of so many—kids and adults alike: “Am I safe?” “Why is there so much violence?” “Why would someone do that?” “Should I be worried?” “Will it happen here?” It’s important that his questions are answered and that he is allowed to process what he’s heard, lest we create another environment of trauma.

 

The tragedy those in Boston are confronted with never should have happened; but it did. It is real and it is heinous. Those directly affected by the devastation at the Boston Marathon will have deep trauma and grief to process and they will need support. When I see and hear of things this atrocious, I am reminded of a few things we can and should do in times like this:

  • lean into our circles of support,
  • be of service,
  • remember and honor those thrust into sudden loss and tragedy of senseless acts of violence.
  • Look at the positive: the people helping, the survivors, the community that reaches out to strangers.

 

In his book Trauma-Proofing Your Kids Dr. Peter Levine talks about the ways Somatic Experiencing is used in a crisis. Somatic Experiencing is focused on “symptom relief and in resolving the underlying ‘energy’ that feeds those symptoms.” (p.214)  Instead of asking kids to “tell the story” of what happened, they are asked to share their “post-event difficulties,” i.e., the physical or emotional fall-out they are experiencing after the event occurred. For example: fatigue, headaches, difficulty sleeping or eating, stomach aches, spaciness, emotional numbing, worry, guilt, et cetera.  The goal is not to re-traumatize the individual, but to help the process of self-regulation and emotional discharge.

 

Please make sure you are getting what you need if you are experiencing emotional difficulty since the tragedy at the Boston Marathon. If you find that you are having a hard time:

  • Take a break from the media.
  • Do some movement: jump rope, hike, do yoga, just move your body.
  • Be kind to yourself.

“Trauma can be prevented or transformed; it does not have to be a life sentence.”

Dr. Peter Levine

Categories
Addiction Recovery Therapy Treatment

The Value of an Outpatient Program

Outpatient programs have a unique position for those seeking treatment. They are sometimes looked upon as a softer way to approach treatment when a family is seeking help for their teen. There are some who think they can recover via our outpatient program alone, only to find out they need the more intensive care of our residential facility.  There are those who resist our outpatient program after spending time in residential only to discover that it is through our outpatient program where they learn to apply the tools they learned in our residential program.

 

Our outpatient program provides a therapeutic and safe container to continue the inner work that was being focused on at residential as well as to discover and tangibly experience how to live and love life as a sober, recovering person.  We treat males and females, 13-18 years of age and require the involvement of a family member. The first level of our outpatient program is called First Step. It is an introduction to treatment and takes place over an 8-week period. Here a teen will be provided with clinical support, group support, an individual session, a family session, and drug testing. The next level of our outpatient program is our Intensive Outpatient Program, and that takes place over the span of 1 year. This really is the continuation of our programs and provides a higher level of focused, outpatient care, which is broken down into 3 phases: Primary Care, Continuing Care, and After Care. In this way, your teen is being provided with the roots of treatment and wings of recovery all in the same, clinically supported environment.

For more information about our outpatient program, please read here. We can recover, one step at a time.

Categories
Dialectical Behavioral Therapy (DBT) Mental Health Mood Disorders Recovery Therapy Treatment

DBT With Dr. Georgina Smith, Ph.D

We are pleased to welcome Dr. Georgina Smith, Ph.D to the Visions clinical team. She has been working with adults, families, and children since 2001, making her vast knowledge of neurofeedback and Dialectical Behavorial Therapy (DBT) accessible to a wide range of clientele. Dr. Smith specializes in treating survivors of trauma, abuse, and those suffering from eating disorders, and addiction. She also treats individuals suffering from chronic depression, self-injury, mood, personality, and anxiety disorders. Her knowledge and use of neurofeedback and DBT allows her to help her clients in a way that empowers them be engaged in their own recovery. Dr. Smith’s approach is holistic, and caring, and she ardently believes in ensuring that her clients feel seen. Her work with adolescents has built an authentic treatment style where she is able to form a genuine connection with her clients, so they feel seen, heard, validated and challenged. Dr. Smith encourages them to be ok in the skin they’re in. That particular tenant of treatment spreads healing throughout one’s mind, body, and spirit.

With the addition of Dr. Georgina Smith, clients have access to DBT in all phases of their treatment. DBT, in particular, is one of the most efficacious treatments for mood disorders, namely Borderline Personality Disorder. DBT uses mindfulness, self-awareness, and skill building in the areas of trauma, emotional regulation, interpersonal effectiveness and crisis management.  One of the most remarkable pieces of DBT is its effectiveness in teaching clients to regulate their emotions and recognize when they are becoming deregulated. Self-awareness in someone trying to manage extreme emotions is undeniably helpful.

Currently, Dr. Smith is seeing Visions’ clients for DBT as well as running a DBT group on a weekly basis. We are looking forward to working with Dr. Smith and are excited to have her as part of our clinical staff.  She is down to earth, and brings a sense of realness to her groups and throughout her clinical practice. She says it best, “So many of the kids I’ve worked with are struggling to make sense of things they’ve been through, struggling with their sense of self and others, and a confusing, chaotic world. The space I create with them is about being ok wherever they are, whoever they are, so we can open the doors to choice and change. It is about ownership, realness & empowerment.” Welcome to the VTeam, Georgina!

Categories
Feelings Recovery Self-Care Therapy Treatment

Working With Our Addiction to Anger

Angry Talk (Comic Style) (Photo credit: Wikipedia)

Can you be addicted to anger? Does the adrenaline rush of being angry dictate your response to the world? Better yet, are you even aware this is happening? Or have you become so used to the rage response, it’s become part of your normative behavior.

We know anger is a natural occurrence, but for some, it becomes so deeply problematic, it devolves into an addiction. When we become our anger (or any emotion, for that matter), we disable our ability to communicate. In those moments when we are lost in the rage and its resulting dissension, our hearts are frozen; our eyes are blinded; our tongues are tied. No good can come from this.  But what can we do? How can we change this innately negative response to our frustration?

Anger management courses and other therapeutic modalities teach and use various methods in which one can learn to recognize the emotional and physical response to anger and rage. By first recognizing what is happening, one is allowed to begin to shift their response. First, we must familiarize ourselves with the addictive anger cycle itself:

1: You find yourself becoming uncomfortable or you aren’t getting something you want or think you need. You may be subconsciously or consciously reminded of feelings from long ago (childhood, for example), which are bringing untouched emotions to the surface.

2: You feel like no one understands you:  “No one gets it. They just don’t get it.” “I’m all alone.” “Whatever. I’m fine.” “No one listens to me.”

3: The frustration is building internally, but talking about it isn’t an option because you always deal with your anger and frustration alone. In fact, talking about it with others feels too difficult.

4: Stress begins to builds until you blow up. Someone or something is usually caught in the crossfire and they get hurt, either emotionally or physically. There is the part of you that doesn’t want this, but you have lost control. The guilt and shame begin to build.

5: You feel better after the explosion, perhaps even a bit relieved, until you look around and see the wreckage of your presence.

6: Now the guilt and shame really sets in. You find yourself ardently apologizing and promising not to repeat the behavior. Unfortunately, those on the receiving end may not accept your apology. What? Once again, “No one listens to me” becomes the inner mantra.

7: You internally justify your anger; it was really their fault anyway, right? (Wrong!)

8: You feel no better than before the explosion. In fact, the discomfort and frustration are still there, gnawing at you from the inside.

 

Processing anger like this is similar to releasing pressure from a pressure cooker while leaving it on the heat. Sure, some of the steam is released, but there is still steam building within. This technique is tantamount to placing a Band-Aid on a gaping wound. It’s just not large enough, or effective enough to alleviate the problem. This circular pattern of frustration à anger à explosion à remorse is ultimately a dead end. What is really needed is a salve for the anger: a calming, healthy way in which to release the pressure.

 

1: Learn to understand and take care of your needs: Holding your emotions in cannot be an option.

2: Find a good therapist who can help teach you how to touch upon the things that trigger your anger and help you devise a healthier way to allow it to dissipate.

3:  Learn ways to let go of your anger which are healthy and non-harmful. Rather than beating a pillow, which only adds coals to the fire, discover how to gently cool the anger: take a walk, take 10 deep breaths, write, drink some water.

3: Ask for help. This may be difficult, but you can do this! You are not broken, you are not a bad person. You are struggling with an overpowering, difficult emotion and it is OK to ask for help.

4: Laugh. Laugh for no reason, just laugh. It not only opens your heart and softens your belly, it helps you see the ridiculousness in many things.

At some point, instead of your anger controlling you, you will learn to control your anger. Developing a practice of self-care will be paramount to paving a new path and changing the face of your addiction to anger.  Discovering ways to recognize the triggers to your anger and how to respond to them skillfully is going to be key. Remember, recognizing there is a problem is the first step to finding the solution. It takes time, and work, but it’s worth it. You can recover.

 

Categories
Adolescence Cognitive Behavioral Therapy (CBT) Dialectical Behavioral Therapy (DBT) Mental Health Recovery Spirituality Therapy Treatment

Recovery: Redefining Normal

(Photo credit: Wikipedia)

Stepping onto a path of recovery and beginning the removal of toxicity from one’s life is an arduous, often painful, but beautiful process. But I like to believe that some of our greatest lessons come from our difficulties. Those are the times that provide us with the most insight into what is actually going on with us. Take for instance your relationships with others. Is there a pattern? Have you continued to add links to an unhealthy chain be it consciously or subconsciously? Are you happy?

When there is a history of toxicity in one’s life, particularly when it’s introduced at an early age, what is considered “normal” tends to become skewed. For example, someone raised in a home with an abusive parent may inadvertently seek out relationships with similar personality types. This isn’t a conscious act but rather a direct result of being taught how to be in this world through violence (emotional, physical, visual, etc.). It feels familiar and therefore “normal” to be around toxicity. The question is, how do you break the chain? How do you make new, better choices that are healthy and nurturing?  How do you place yourself in environments that celebrate you for who you are instead of those that persistently denigrate you?

The 12 steps are a brilliant start. They allow us to begin the process of unpeeling the layers of the onion by asking us to turn our eyes inward and check out what’s going on in our minds and in our hearts. That oft-dreaded fourth step tends to help identify a pattern, particularly if we are honest with ourselves when we write it.  Personally, I’ve always liked that process because it feels like I’m stripping the layers of emotional dirt off of me. It’s uncomfortable, but it’s worth it. Frankly, it hurts like hell to look at ourselves and at our lives with a magnifying glass, but dang it, it’s liberating. You just don’t need to carry that stuff around anymore. Twelve-step work is just the start. If it were only that easy, right?

Taking a clinical approach is incredibly beneficial, especially when dealing with trauma, addiction, and mental-health issues.  Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT), to name a few, are invaluable tools to help identify the psychological triggers and hooks we have embedded within us.

But you know what really seals the deal for me? Creating space for Spirituality. I can’t emphasize enough how invaluable it is to develop a spiritual practice. It is the very thing that will feed your soul. No, I’m not selling you religion or a canon of idealized thought. I am, however, urging you to find the calm in your breath, the grounding notion of having your feet planted to the earth, and the healing weight of your hand on your heart. You can break the chain of abuse. You can shut out the tapes that play in your mind, telling you you’re a piece of crap, a failure, not enough, stupid, fat, ugly, useless. You can take your power back. It takes work, but it’s worth all the sweat and tears. Trust me. Be patient. Understand that this process of recovery takes time. Nothing and no one is perfect.

I’ll leave you with this. I was involved in a series of abusive relationships growing up. I was doing the same thing, expecting different results. I eventually discovered I was continuing the pattern of emotional denigration established in my childhood and nurtured in my adolescence. When I finally smashed through that chain several years into my recovery and only after working tirelessly with a therapist, meditation, yoga, 12 steps, I was free. This doesn’t mean the trauma or triggers went away. It means I finally learned to identify them, and have garnered tools to help me respond to them differently. When I met my husband, I quickly discovered he was different. For one thing, he showed me unconditional support, which I hesitated to believe was true. It took me almost two years to accept the fact that I had, in fact, broken that chain and was capable of having relationships that were built on trust and respect. I realized I could believe someone; something this traumatized gal was never able to do. This was proof that I had redefined my “normal” and surrounded myself with a healthy, loving new family. In fact, I redefined my response to the world and its triggers, not just within my family, but also in my life. Ultimately, I took my power back. You can too.  You just have to do the work!

Categories
Addiction Eating Disorders Mental Health Recovery Service Therapy Treatment

Visions’ Los Angeles Outpatient

Los Angeles outpatient facilities are typically where one goes in order to transition from the intensive setting of being in an inpatient treatment facility to the wide-open world.  The outpatient setting is the perfect environment for clients to reintegrate themselves into their new mode of living a life in recovery. On occasion, outpatient can also be the first place one goes to get help when an inpatient facility seems like too much and trying to recover on his or her own has been futile..

At Visions’ Los Angeles outpatient facility, we focus on the entire family, ardently continuing the work that was begun at inpatient. We not only work with the clients but with their families in order to provide a continuum of support. We do this via schooling, team-building activities, therapeutic support, 12-step meetings, and various process groups. We address building and refining communication skills as well as nurturing the spiritual well being of our clients, all of which helps them understand how to be in recovery. We teach our families problem-solving skills, and help them develop new, healthy friendships. We host a variety of alumni and unity events, all of which foster a better relationship to being in recovery. The beauty of these events is, they naturally build community among the clients, showing them that they have sober support and a recovery community. Additionally, we encourage relationships with 12-step sponsors and participation in 12-step meetings, which inspires clients to be active participants in the continuum of their recovery.

In addition to our Intensive Outpatient program, we also have Launch, which is a wonderful Los Angeles outpatient program geared toward young adults transitioning out of adolescence and into adulthood. Launch is a life-skills program focusing on vocational, educational, and social skills.

Outpatient provides an amazing opportunity for our families: it’s the stepping stone between being in the controlled environment of a facility and interacting with the world at large but with the helping hand of a skilled support team. Entering recovery is frightening. It’s new, different, and at times overwhelming, but nothing is impossible when you have a support team guiding you along.

Categories
Cognitive Behavioral Therapy (CBT) Dialectical Behavioral Therapy (DBT) Mental Health Obsessive-Compulsive Disorder (OCD) Recovery Therapy

Body-Focused Repetitive Disorders

Trichotillomania (TTM) is a type of body-focused repetitive behavior (BFRB) specifically characterized by impulsive pulling out of one’s hair from the scalp, eyebrows, eyelashes, or elsewhere on the body. According to the DSM-IV of the American Psychiatric Association, TTM must meet the following five criteria:

  1. Repetitive pulling of one’s own hair that results in noticeable hair loss.
  2. A feeling of tension prior to pulling or when trying to resist the behavior.
  3. Pleasure, gratification, or relief while engaging in the behavior.
  4. The behavior is not accounted for by another medical (or dermatological) or psychiatric problem (such as schizophrenia).
  5. Hair pulling leads to significant distress or impairment in one or more areas of the person’s life (social, occupational, or work).

Though this criteria is useful, there is some debate within the clinical and scientific communities about whether or not all five of these criteria are present in every case. Since there are many who suffer from debilitating hair pulling behaviors but don’t meet all of these criteria, efficient and effective treatment is still paramount to one’s health and well-being.

Signs and symptoms of Trichotillomania often include:

  • Repeatedly pulling your hair out, typically from your scalp, eyebrows or eyelashes, but it can be from other body areas as well;
  • A strong urge to pull hair, followed by feelings of relief after the hair is pulled;
  • Patchy bald areas on the scalp or other areas of your body;
  • Sparse or missing eyelashes or eyebrows;
  • Chewing or eating pulled-out hair;
  • Playing with pulled-out hair;
  • Rubbing pulled-out hair across your lips or face.

Onychophagia (nail-biting) and Dermatillomania (skin-picking) are other BFRBs but are characterized by compulsive skin picking and nail biting. Nail-biting is the most common of “nervous habit.” I’m not talking about the occasional cuticle or hangnail, or the occasional blemish that someone may pick or squeeze. Instead, someone who suffers from onychophagia picks or bites their nails or skin until they bleed, finding themselves using Band-Aids like accessories. As those suffering from TTM will wear hats to cover bald spots and the like, nail-biters will keep their hands in their pockets, sit on them, wear gloves or those Band-Aids I mentioned. Those who excessively pick at the skin on their faces will try to cover up with makeup or when things get really bad, go so far as to stay inside and isolate. I mention these two together, because they often make intermittent appearances in the same individual.

Nail-biting (onychophagia) facts include:

  • Common in individuals of all ages.
  • Up to 33% of children ages 7-10 bite their nails.
  • Nail-biting can be triggered by stress, boredom, or nervousness.
  • About half of all children between the ages of 10 and 18 bite their nails at one time or another. Nail-biting occurs most often during puberty.
  • Some young adults, ages 18 to 22 years, bite their nails.
  • Only a small number of other adults bite their nails. Most people stop biting their nails on their own by age 30.
  • Boys bite their nails more often than girls after age 10

Chronic skin picking (dermatillomania)is characterized by:

  • Inability to resist urges to pick at real or perceived blemishes in one’s skin
  • For some, mounting tension before one picks
  • For some, gratification and relaxation while picking
  • Noticeable sores or scarring on the skin
  • Increased distress and/or interference with daily life

BFRBs have been linked to obsessive-compulsive disorder (OCD). They can sometimes be linked to a sign of emotional or psychological disorders. They are all compulsive disorders, but their manifestations have varying presentations: For some, the picking or pulling will occur during sedentary activities like watching TV, reading, driving or being a passenger in a car, talking on the phone, sitting in class, or sitting at a computer or a desk. At times, there might be focused intent which drives the behavior–for example, planning on picking or pulling at an area as soon as one arrives home. At other times, it’s happens without conscious awareness, and the individual only realizes they’ve picked or pulled when they see the resulting pile of hair, open scabs or bleeding fingers.

This can feel overwhelming, but there is help. For starters, you have to say something to someone and let them know you’re suffering.  Your doctor and/or therapist will then work with you and help you redirect the negative behaviors and create new, innocuous behaviors.

The following therapeutic modalities are typically used to treat BFRB:

(Sometimes, elements from some or all of the aforementioned modalities are used to meet the BFRB client’s needs.):

Alternative therapies are also used, but are not as researched or predictable in terms of their success.

Support groups can provide a wonderful place for fellowship and to create positive social reinforcements.

Keep in mind, What works for one person may not work for another. The key will be in finding the treatments that do work and committing to them. Nothing is impossible, but everything takes effort. Feeling better is worth your treatment endeavors.

 

For more info, check out:

https://www.trich.org/

Mayo Clinic

https://www.trich.org/dnld/ExpertGuidelines_000.pdf

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