Compulsive Skin Picking: Habit Reversal Training

By Lisa B Mason
Often people are seen picking at scabs, blemishes or dry skin. However, there is another form of picking that adopts a more sinister obsessive nature -- one that results in not being able to resist the urge or need to pick at certain parts of the skin. This condition is medically known as Dermatillomania or Compulsive Skin Picking (CSP). Only recently has CSP started to become recognized as a serious disorder, as the numbers of reported sufferers continues to steadily increase.

Skin picking often occurs as an impulsive reaction. There have been numerous cases that suggest many of the sufferers remain unaware that they are in fact picking at blemishes or dry scabs, while others have claimed that it produces a feeling of comfort and satisfaction.

Treatments for compulsive skin picking generally include medical treatments as well as behavioral treatments. One behavioral method is known as habit reversal training. In its simplest form, habit reversal training involves monitoring and tracking of your skin picking habit and then replacing your behavior with a competing response that you choose to do in place of your unde sirable behavior.

The first step is to keep a diary that captures key information about your skin habit. You'll want to get a notebook that you can record in, and keep it handy in the area(s) that you generally do your skin picking. In your diary you should record the date, time and behaviors for each time you pick your skin. You'll want t

o be sure to record the circumstances in which you desire to pick. Does it happen when you are overstimulated and feeling stressed, anxious or excited? Or do you get the urge to pick when you are bored or inactive? You'll want to record when the skin picking episodes occur, how long they last, what you were doing at the time, and what was your emotional state. Recording this information for a week or two can give you valuable insight into the triggers that lead up to your skin picking sessions.

The next step in habit reversal training is to adopt a competing response. This involves choosing a different behavior that you choose to do instead of picking. For example, if you were going to pop a pimple or pick at your face, you could clench your fist or pinch your two index fingers away from your face as if popping an imaginary pimple. Personally, I like to do things at my computer where I have to use two hands typing rather than picking. Sometimes, I just play Solitaire or Sudoku just to keep my mind off of picking.



Lastly, you should also do things that help reduce stress since this can often trigger picking episodes. Try breathing in deeply though your nose and exhaling out your mouth. Do this numerous times until you feel your body beginning to relax. You can use this as your competing response to avoid picking your skin.