If you just can’t stop biting your nails, picking at your skin, or pulling out a hair, especially when you’re stressed, here’s something to try that might work.
Instead of nipping, picking or pulling, simply touch your skin gently, e.g. by lightly rubbing the fingertips, palm or back of the arm, at least twice a day.
This strategy, called “habit replacement,” helped 53% of participants in a new six-week study cut back on their unwanted behaviors, a new study shows.
“The rule is just to touch your body lightly,” study author leads Steffen Moritzsaid head of the clinical neuropsychological working group at the University Medical Center Hamburg-Eppendorf in Germany NBC News. “If you’re under stress, you can perform the movements faster, but not with more self-imposed pressure.”
These body-focused repetitive behaviors (BFRB) are thought to affect about 5% of people worldwide.
The new study included 268 people. They either had trichotillomania, a condition in which people respond to stress or soothe themselves by pulling out their hair, or they repeatedly bit their nails or the inside of their cheek.
Members of the control group were told that they were on a waiting list for treatment (which they received after the study was completed). Other participants were taught how to form a replacement habit through a manual and video.
Those who bit their nails seemed to benefit the most. About 80% of people in the treatment group said they were satisfied with the training, and 86% would recommend it.
Although more research is needed, this strategy may join existing behavioral techniques such as disengagement and habituation training that are used to help people with BFRB.
In decoupling, someone may replace a behavior like nail biting with something that starts in a similar way, such as raising the hand to the face, but ends up touching an earlobe instead of chewing the nails.
In habit reversal training, someone can similarly engage in another behavior.
“So they can involve, for example, clenching your fists properly when you have an urge to pull your hair or pick your skin. It can be on your hands.” Natasha Bailensaid a clinical psychologist at the Center for OCD and Related Disorders at Massachusetts General Hospital and Harvard Medical School. NBC News.
Medications such as antidepressants are sometimes prescribed for people with this behavior, and cognitive behavioral therapy may be another treatment option.
Moritz estimated that one-third to one-half of patients benefit from decoupling, but the rest do not.
“And so the idea was to find another technique that might be more suitable for these non-responders,” he said.
John Piacentini, Chairman of the Board of TLC Foundation for Body-Focused Repetitive Behaviorsaid the study raises awareness of these conditions.
“There are reasonably good treatments out there that most clinicians aren’t aware of or don’t do,” he said. NBC News.
“In this population, we’re really looking for treatments that will really affect or really reduce the severity of these specific symptoms,” Piacentini added.
The “proof-of-concept” research needs further confirmation, but experts were encouraged by the results.
“I was very excited that there is more work being done in this self-help area,” Bailen said.
“Accessing mental health services can be a real challenge these days and waiting lists can be incredibly long,” she said. “But I think the more research we’re able to do and the more we’re able to develop these self-help materials, we can help narrow that treatment gap. And that’s definitely important.”
The results were published online July 19 in the journal JAMA Dermatology.
Steffen Moritz et al, Self-Help Habit Replacement in Individuals With Body-Focused Repetitive Behaviors, JAMA Dermatology (2023). DOI: 10.1001/jamadermatol.2023.2167
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