Four Exercises to Understand Your BFRB Better
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Body-focused repetitive behaviors (BFRBs) are wildly under researched and mental health professionals often aren’t sure how to approach them. Those who struggle with them, and their loved ones, frequently feel equally lost - and understandably so. One of the unfortunate theories about BFRBs that arose because of this underwhelming state of affairs is the „just a habit“ theory, or the idea that there’s nothing more to skin picking or hair pulling than the habitual motion of one’s hands that produce undesirable outcomes. Such a reductionist theory produces an equally reductive advice, the infamous „just stop“.
If you struggle with BFRBs and „just stop“ isn’t working for you, consider changing the theory it comes from, the „just a habit“ approach. From a constructivist point of view, there is no such thing as „just a habit“. Habits are behaviors or patterns of behavior that are often repeated in a specific context, and for something to be often repeated in a specific context, it has to serve a purpose. Think of the habits you have established and/or have been taught to do like showering, brushing your teeth, eating at a certain time, etc. All these are habits but they aren’t „just“ habits, there are good reasons why you do all that – and you don’t have to remind yourself actively why every time you’re about to repeat your habit. The same goes for „just“ habits that produce less desirable results – they serve a purpose. Otherwise, why would they become habits in the first place?
Finding out what’s the meaning (or what are the meanings) of a symptom is almost never an easy task. Our unconscious minds speak in their own languages, and we don’t have the dictionary or even the basic rules of the grammar. Here are a few exercises that you can do on your own to start exploring those layers underneath the obvious, the habitual.
Spend 3 minutes observing the urge to pick/pull
When you feel like you are going to pick or pull, or if you catch yourself doing that, put your hands in your lap. Sit with your back straight and close your eyes. Direct your attention to your hands. Try to feel what’s happening in every finger individually. Then, direct your attention at your shoulders, chest, and abdomen too. Note any sensations that you become aware of, as well as any thoughts that may come about. Stay like this for 2 – 5 minutes. Push yourself a bit, but don’t torture yourself. Pushing serves a mild therapeutic purpose too. It’s not just that you’re becoming more aware of your feelings, you’re also learning how to be with them but not react to them.
Preferably in a journal, so that you can follow the patterns as you repeat the exercise, reflect on the following:
Where did I notice particularly „noisy“ sensations?
Describe what you felt in the most concrete terms (location, size, shape, color, etc.)
When your mind was wondering, where was it going?
What was happening with the intensity of the urge as you were holding your hands still?
Clench your fists a few times
When you feel the urge to pick/pull, put your hands in your lap or let them fall naturally. Clench both of your fists at the same time. Clench them as hard as you can. Clench them as if your life depended on it. Hold while you slowly count to 5, then release by opening your fist slowly. Pay attention to the effect of this on the urge for a few moments. Repeat once more but counting should be even slower as well as the subsequent opening of the fist. Then notice what’s happening to the urge once more. Repeat for the third time, only now count to 10.
Reflecting on the exercise:
How did the exercise alter the intensity of the urge?
Where was your attention, on the clenched fist or on the counting?
Repeat the exercise while counting out loud and see the difference.
Try self-compassion, but without words
When the urge comes about, put your right hand over your chest and your left hand on your belly. But don’t do that over the clothes, the idea is to feel the warmth from skn-to-skin contact. Focus on that warmth for a few minutes. Whenever your thoughts wander away, bring them back to the warmth. Stay with the warmth, focus on it intensely, amplify it, allow it to overcome you.
Reflecting on the exercise:
What was the experience like?
Can you compare that feeling to something else in your experience?
What did the warmth do to the urge?
Accept responsibility for what you are about to do
If the urge is particularly overwhelming and you are starting to feel like you won’t have another choice, especially if you’re approaching a mirror or touching your skin or hair already, take responsibility for what you’re about to do. Say to yourself, out loud: „I am about to choose to pick/pull.“ Then see how you feel about that. Then say it again, now with a gentler voice. See how that feels. One more time, but this time very slowly and loudly, in a slightly angrier voce: „I am about to choose to pick/pull.“
Reflecting on the exercise:
What did it feel like to hear your own decision out loud like that?
What tone of voice caused the biggest change in the intensity of the urge and why?
A few more tips
Don’t do all of these at once. One at a time is better. In fact, do one for a week before moving on to others.
Take your time. These are all exercises that involves awareness. The idea is to be more attuned to those nonverbal aspects of your experience.
Write things down, draw, paint, collage – whatever works for you, but make sure to somehow record your experiences.
Once you repeat each of these 5 – 7 times, go over your notes and look for patterns.
Feelings are always more informative than your thoughts.
