BFRB Book Tip: Heal Your BFRB

I recently read the book How to heal your BFRB by Lauren Bloise, who gained control over her skin picking. 

Heal Your BFRB is a complete step-by-step guide to better control BFRBs at any healing stage, whether you are about to set in place your first coping methods, or you just need some more ideas or new insights on coping with BFRBs.

This BFRB book is packed with actional tips, making it an excellent resource for anyone who struggles with dermatillomania, trichotillomania, or any other BFRB.

It is helpful and inspiring to read about another BFRBer’s healing journey. I’ve found myself in many examples and situations, which helped me optimize my coping strategy.

Another great BFRB book is: Overcoming Body-Focused Receptive Behaviors.


Use a Chopstick as a Barrier Against Cheek Biting

Managing cheek biting is difficult. Unless you’re wearing a mouth guard, it’s nearly impossible to create a barrier against it. So far, chopsticks and popsicle sticks have proven to be an okay-ish solution for me to do just that.  

I nibble and bite a lot on my cheeks and the inside of my lips. If I don’t actively do something about it, I can’t stop it once I have started.

As with other BFRBs, the problem is that the more I bite, the more damage I do. Which in turn triggers the biting even more. It is a vicious cycle.

The common ways to deal with cheek biting include chewing gum or nibbling on sunflower seeds, sour candy, or whatever preoccupies the teeth and jaw. But they only do so much. 

So I started looking at home for things that could be helpful additions to my BFRB toolbox.

Look badass by holding a chopstick in your mouth 😉

First, I tried toothpicks. You know, how the bad guys in the old western chewed them in the corner of their mouths. That didn’t work that well though, because toothpicks are too slim and pointy–pretty dangerous.

Chopsticks turned out to be a better alternative. I cut the chopstick down to a third, so it isn’t that heavy and easier to handle. 

Then I put the pointed part between my cheek and teeth, with the rough part sticking out. That’s how I create a kind of barrier.

Or, I just hold the chopstick loosely between my lips with a loose jaw so my tongue can fidget with it.

As an alternative to chopsticks, you can also try a popsicle stick!

Benefits of this cheek biting coping method

With this coping technique, you create some sort of barrier against cheek biting. Also, holding the chopstick in your mouth will make you aware of your BFRB. Which, in turn, could help you deal with the emotional discomfort that triggers the behavior.

❗️Please be careful not to bite the chopstick as you could chip your teeth!?

If you need to get some energy out of your jaw, I recommend using a sensory chewing toy. 

This toy also helps against nail-biting when you’re anxious or stressed. I’ll talk about that in more detail in another post. 

I hope this tip will give your cheeks a little break so they can heal! 

Fun fact about toothpicks

At one point, humans used small twigs to clean their teeth by even chewing on them. They are basically the first toothbrushes. 

Coping Cards

It’s Okay to Slip. The Goal Is Not to Slip as Hard or as Often.

Healing is not linear, so don’t be too hard with yourself when you have a setback. Feeling bad about relapses only fuels negative emotions and thus BFRB episodes.

While your ultimate goal is likely to stop your BFRBs completely, the chances of achieving that goal overnight are very slim.

Therefore, it can be helpful to focus on smaller goals first, such as not slipping as hard or as often.

That way, instead of feeling like a failure because you can’t achieve the big goal of being BFRB-free, you can focus on smaller victories. The resulting positive feelings will aid your healing progress. 

Pat yourself on the shoulder if you managed to back off after just picking a spot or two and not ending up in a full BFRB episode.

Or be proud if you haven’t chewed your nails for several days when you couldn’t leave them alone for a few minutes beforehand.

Take it step by step. Over time, you will get more and more control over you­­r BFRBs. And thus, the picking- and pulling-free periods will last longer, and the setbacks will not be as damaging as they were before.


Track Your BFRB Habits

Do you track your BFRB habits? Tracking them is key for getting them under control and, hopefully, even curing your dermatillomania, trichotillomania, nail or cheek biting over time.

How many times have you picked, pulled, or scratched without even realizing it? How many times have you yelled at yourself to stop but couldn’t? 

I think we all have been there. We pick our skin or pull our hair because this is our coping mechanism for trauma, stressful times, anxiety-induced situations, procrastination, or boredom. 

BFRBs are ingrained habits that often happen automatically. The most important thing is to cultivate awareness of the patterns and disrupt them before responding to the triggers. Because, as you maybe know, once you give in to the urge, the downward spiral is pretty much unavoidable.

How to track your BFRB habits

By tracking your BFRB habits, you will become aware of when, where, and even why you pick your skin, bite your nails or pull your hair. You will better understand your triggers and feelings that call for relief through your BFRBs. 

So every time you’ve had a relapse, make a note of the following:

  1. Date & Time
  2. Place: e.g., bathroom, car, work desk, doctors waiting room
  3. Situation: e.g., while grooming, in a meeting, in front of the mirror, studying, working, driving, reading, watching TV, …
  4. Thoughts & Feelings: What did you think and feel while you “zoned out.” What was the sensation you got from picking or pulling?
  5. Affected Areas: e.g., skin picking: fingers, face, shoulders, arms, legs, back, neck, lips, feet … hair pulling: scalp, eyelashes, eyebrows, legs, arms, chest, face, pubic hair, …
  6. Time spent picking: 5 minutes, an hour?
  7. Urge Intensity: Rate the intensity of your urge to pick or pull from a scale of 1 to 10. 
  8. Thoughts & Feelings after picking: How did you feel after am BFRB episode? 

To track my dermatillomania, nail and cheek biting setbacks, I use the SkinPick App. The same app for trichotillomania is called TrichStop.

If you prefer, just write down your observations on paper.

With this information you can then develop your own coping strategy and hopefully intervene early enough the next time you get triggered. Get some inspiration on how to do that by following this link.

By tracking my body-focused repetitive behaviors, I was able to eliminate some “lighter triggers,” such as when watching TV, reading, or talking on the phone. 

Seeing the positives of BFRB relapses by tracking them 

I know, I know. How on earth can BFRB relapses be positive, right? I used to feel so angry, defeated, and hopeless after an episode of picking or biting. Sometimes I still am when I see the damage I’ve done. 

However, ever since I’m tracking my BFRB habits, I see setbacks as an opportunity to optimize my coping strategy. 

Also, the more I am aware of my body-focused repetitive behaviors, the more I become aware of the triggers. And knowing the triggers is quite empowering because I learn a lot about myself. 

It might sound weird, but I feel like my nervous system is talking to me through my BFRBs? As if the scars, fresh wounds, or flaky fingers were to alert me to take better care of myself and my mental health. But that’s the topic for another post 💛

Give it a try and track your BFRB habits. I hope it gives you some insights!

This is a screenshot of the SkinPick App that I use to track my BFRB habits.
Coping Cards

I Owe Myself the Same Love I Give to Other People

This coping card is a friendly reminder to be more compassionate with yourself. To give you the same love that you give to other people. 

I used to have very strong negative self-talk, especially after picking episodes. I was mad at myself for not having enough willpower to stop picking. Furthermore, I told myself that it was my fault that my skin is so damaged and that I was weak for not having my anxiety under control. 

Sometimes I even purposely picked and scratched my skin in revenge for my ineptitude. According to the motto: since one arm is fu*%ed up, let’s continue with the other one and, on and on. 

The thing is, I would never speak like this to a friend who has a similar problem. Why don’t I show myself more love?

Stop the negative self-talk by looking for the positive

Harmful self-talk fuels negative emotions and thus the intensity of the picking. To break out of the toxic state of mind, I listen inward and try to find out where my thoughts and feelings are coming from. Doing that gives me a better understanding of myself and my BFRBs. 

I ask myself if my thoughts are valid, or is my mind convincing me of something that isn’t really true? Then, I actively refute and replace negative thinking with more rational and balanced thoughts.

For example, despite having setbacks, I tell myself to be proud of the progress I’ve made. Or instead of feeling shameful for my skin, I want to be grateful for it. I know it’s hard to love the skin with all the blemishes, scabs, and scars. However, it is easier to help and support the skin to heal when you are optimistic about it.

I invite you to examine your thoughts and become aware of your anxiety and stress factors. Try to find ways to turn your negative thoughts into positive ones and have some quality “Me Time”: go for a walk, take some mindful breaks, exercise, take a nap or celebrate your skincare routine. Yes, you deserve it!

To sum it up, reducing stress and anxiety is key to getting the picking under control. Don’t beat yourself up if you slip. On the contrary, be more compassionate with yourself because that will help you better fight your BFRB.

With each setback, you gain more knowledge, which in turn is an opportunity to move forward and heal. Don’t give up and keep trying – perseverance will lead you to your goal! 

Sending you positive healing vibes 💙