Body-Focused Repetitive Behaviors (BFRBs)
Body-Focused Repetitive Behaviors (BFRBs) are what happens when normal grooming behaviors go awry. This includes things like Trichotillomania (hair pulling), Excoriation (skin-picking), as well as nail biting, nose-picking, and more. These disorders are categorized in the DSM-V along with “OCD & Related Disorders”, though they differ in several ways. While OCD and BFRBs both involve repetitive behaviors and can be used to minimize distress, BFRBs can also produce euphoric feelings of relief. There is no distinct obsessional fear; rather, individuals often experience a feeling of tension or incompleteness. Some individuals are keenly aware of their behavior, while others find themselves pulling or picking without having noticed that they had begun. BFRBs also don’t respond especially well to treatments like ERP; instead, Habit Reversal and the Comprehensive Behavioral Model (ComB) are the current gold standard, evidence-based treatments.
While BFRBs commonly evoke shame and embarrassment for sufferers, they are actually quite common. Prevalence studies suggest that about 3% of the world’s population struggles with BFRBs, though they are frequently underreported and misdiagnosed. BFRBs can have a profound impact on quality of life, as individuals experience physical consequences of their behavior and often struggle with comorbid depression and anxiety.
BFRB Resources: