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Trichotillomania & Body-Focused Repetitive Behaviors

What saves a (wo)man is to take a step. Then another step. It is always the same step, but you have to take it.  – Antoine de Saint-Exupéry

The Pathways Institute for Impulse Control works to help people gain control of their lives by helping them stop their Body-Focused Repetitive Behaviors (BFRBs).

BFRBs, such as Trichotillomania, skin-picking, nail-biting, and others, can be expressed in a variety of ways and be triggered by many different things.  For most people, the behavior is frequently shameful and can involve isolation, depression, and feelings of loss of control.  In spite of this, you find yourself returning to the behavior again and again.

BFRBs can seem extremely mysterious to family members and spouses, who at first, view them merely as bad habits, but then become more concerned when they begin to seriously damage the sufferer’s body or appearance and inflame emotional problems. The fact that many sufferers seem to be unaware they are doing these things, or report that the behaviors can be pleasurable or relaxing, can be even more puzzling and upsetting. Fighting sometimes occurs in families over the issue of these seemingly uncontrollable behaviors. Parents may scold or punish children who persist in doing these things, and spouses or significant others, at times, seem to take the sufferer’s disorder personally, blaming them for their preoccupations. Having a BFRB is a frustrating and upsetting experience, and negative attention from others can add to the stress.

It is important for sufferers to find help when it becomes evident that the behavior is out of control and is starting to limit their lives or affect the sufferer’s relationships. It may be clear at this point that different attempts at stopping have not worked, and are not going to work. Along with these BFRBs, there may also be emotional problems such as depression, substance abuse, or the avoidance of school, social events, or work that can also be warning signs.

Whatever the extent of your BFRB, we work to create a non-judgmental and safe environment so you can begin to trust yourself, fully accept your problems, and gain relief from your behaviors, free to move beyond the compulsions into a life with more freedom and ease.


Treating behaviors such as:

  • Hair pulling
  • Skin picking
  • Skin scratching
  • Scalp scratching
  • Nail biting and cuticle picking
  • Blemish picking or squeezing
  • Biting the inside of the cheek



This Program Will Help Individuals

  • Stop their body-focused repetitive behaviors;
  • Identify situations that trigger the impulses and develop strategies for overcoming them;
  • Restore, repair and gain stability and intimacy in family and personal life;
  • Repair job related problems or revise career plans that may have been neglected due to BFRBs;
  • Explore and understand the roots of their behaviors, including stressors, trauma, mood disorders, etc.;
  • Begin to have deeper and more meaningful relationships with themselves, their body, and with others, based on a more authentic expression of the self;
  • Identify unmet needs and to learn how to meet them in a healthy way, ultimately leading to deeper and more intimate relationships with themselves and others;
  • Help to set boundaries with others;
  • Become more comfortable with what is unknown and what we may not be able to control;
  • Define and implement lifestyle changes that increase self confidence.
  • Get out of the cycle of behaviors and move towards a happier, more intimate, more fulfilling life.


Why Seek Treatment?

Individuals with body-focused repetitive behaviors don’t know why they have these behaviors; often these behaviors will feel mysterious to those who have them, and will cause the person to feel out of control.

They don’t understand how to stop the behaviors.

They experience shameful feelings that prevent them from talking about their problem in order to get help to correct the problem.

They are unaware of common co-occurring mental health problems such as impulse disorders, mood disorders and anxiety disorders.

They are unaware of available cognitive behavioral and psychotherapeutic treatment options.

They are unaware of available psychiatric medication that may benefit them.

For many people, these behaviors are about a longing for connection or an escape from stress or unhappiness. Often these behaviors can be a search for a way to feel soothed, distracted, or comforted.

In spite of underlying  longing for help, the behaviors frequently are kept private out of shamef and can lead to isolation, depression and feelings of loss of control.  Recovery requires compassion and a willingness to look inside oneself with honesty in order to understand the functions these behaviors hold in your life.

Individuals can learn to employ new behaviors in order to resist their impulses. They learn, new ways of coping with the underlying psychological and emotional triggers, create a relapse prevention plan, and cultivate healthy relationships. New behaviors combined with psychological understanding are the foundation of relapse prevention.


All inquiries are strictly confidential. Contact the Pathways Institute to set up an appointment or receive more information.

Insurance reimbursement may be available.