Skin Picking Disorder: Top Twelve Roadblocks to Recovery
By Karen Pickett, MFT and Tom Corboy, MFT
OCD Center of Los Angeles
Here is an excerpt from “Skin Picking Disorder: Top Twelve Roadblocks to Recovery”, a special report from the OCD Center of Los Angeles. To receive your free copy of the entire report, go to: http://www.ocdla.com/skin_picking_ebook_signup.html
What would you call a condition that nobody talks about…except for the millions of people who have it, each of whom thinks that they’re the only person in the world who has it? If you were to do a brief online search, you might find this condition described as Dermatillomania, Compulsive Skin Picking, Chronic Skin Picking, Pathogenic Excoriation, Neurotic Excoriation, or just plain skin picking. And if you were to try to explain it to someone, you might describe it as “that thing I do that I try to hide from everyone but people see anyway – that thing I don’t talk about that is painful, awkward and embarrassing, and makes me want to hide from the world.”
Now, after years of being ignored by the psychiatric community, “that thing I do” has finally been recognized as a legitimate condition and given a formal name. In May 2013, the American Psychiatric Association (APA) published the newly revised version of the Diagnostic and Statistical Manual (fifth edition), better known as the DSM-5. In this updated version of the manual, the editors have at last acknowledged the existence of this common but greatly misunderstood problem, and have given it an “official” and easily recognizable name – “Excoriation (Skin Picking) Disorder”, or less formally, “Skin Picking Disorder”.
Anyone who has suffered with Skin Picking Disorder knows the silent shame that accompanies it every day. Part of that shame is rooted in the belief that a “normal” person doesn’t tear into their skin – that a “normal” person doesn’t lose control of their behavior to the point of causing so much damage to themselves. And part comes from the fact that most psychologists and therapists are absolutely clueless about this condition and how to effectively treat it.
Since 1999, the therapists at the OCD Center of Los Angeles have treated hundreds of people with Skin Picking Disorder. There is no one “type” of person who suffers with this destructive condition. Our clients come in every color and from every walk of life – women, men, teens, college students, waitresses, professionals, stay-at-home-moms, and grandparents. Treatment isn’t quick or easy, but it is effective for those who are willing to commit to taking the steps needed to learn how to manage the powerful urge to pick that is at the core of this condition.
This short e-book won’t attempt to provide you with a full course of treatment for Skin Picking Disorder. But it will give you some easy to understand tips on the steps you will need to take in order to start down the road to freeing yourself from this often devastating condition. Here are the top twelve things you don’t want to do if you are serious about overcoming your skin picking.
- 1. Expecting an instant “cure.” You didn’t get to this level of skin picking overnight, and it won’t go away overnight. So don’t set yourself up for disappointment and failure with this big go-nowhere expectation. Progress takes time and effort, and is often an up and down process. Slip-ups are a normal – picking less, and then more, and then less, is a normal, predictable, and expected part of the process. Think two steps forward, one step back. Also, progress may alternate between internal and external changes. So for some, learning to better express your internal emotions may coincide with a temporary increase in picking. There may be some down days, but as long as the overall trend is towards less picking, then you are on the road to success. It may sound like a cliché, but it is important to remember that this is marathon, not a sprint.
- Thinking that the “right” medication will stop your skin picking. We are licensed psychotherapists, not psychiatrists, so we don’t give “medical” advice. But we can say that we have never seen a medication by itself stop a person from skin picking. Numerous research studies have found that the key to effective treatment for Skin Picking Disorder and related conditions such as Hair Pulling Disorder (Trichotillomania) is Cognitive Behavioral Therapy (CBT) combined with mindfulness strategies. That said, there are lots of medications that are used for the treatment of Skin Picking Disorder, and the correct medication for you may be helpful if you combine it with CBT and mindfulness. But be aware that for many people, medication may be accompanied by side effects that are uncomfortable – agitation, insomnia, exhaustion, weight gain, dry mouth. If you decide to augment CBT with medication, be consistent and be realistic.
- Not dealing with everyday stress. Everyone experiences stress. But how you manage and respond to the stress in your life it is up to you. Individuals with Skin Picking Disorder are often more sensitive than others to over-stimulation from their surroundings. Basic stress management practices can make a world of difference in helping you better manage your urges to pick your skin. Some simple stress management tips include:
- Maintain a healthy, balanced diet
- Don’t smoke
- Don’t drink to excess
- Don’t use recreational drugs
- Get regular exercise
- Get plenty of sleep
- Manage school and work so that you aren’t overwhelmed
- Take up meditation, or yoga, or some other form of relaxation
Stress management is imperative as a foundation to support you in stopping your skin picking. What are you doing to effectively manage your stress? What is one thing you could do today – right now – that would help you to manage your stress?
To read the remainder of this special report, go to:
© 2013 OCD Center of Los Angeles