Understanding Body-Focused Repetitive Behavior (BFRB) Disorders
Body-focused repetitive behaviors (BFRBs) are any repetitive self-grooming behaviors that can lead to unintentional physical damage to individual’s body through actions such as picking, biting, tearing, scraping, or pulling their skin, nails, hair, or mouth. For some, these behaviors can significantly impact a person’s physical and emotional well-being and quality of life. At MindfulMD Psychiatry, we specialize in diagnosing and treating BFRBs, offering compassionate, evidence-based care tailored to each individual.
What Are Body-Focused Repetitive Disorders?
While some may think of BFRBs as simple nervous habits, such as picking at the skin around your nails or pulling at your hair, with BFRBs these behaviors go beyond just fidgeting. Research shows that very likely genetic factors are involved as well as psychological factors can contribute to why these behaviors occur.
There are many types of BFRBs, including:
Bruxism (Teeth Grinding)
Crepitus (Finger Joint Cracking)
Dermatophagia (Repeated biting or chewing of the skin, often on fingers, hands, or knuckles)
Excoriation Disorder (Skin-Picking Disorder)
Finger Sucking
Hair-Chewing or Hair-Eating (Trichophagia)
Lip Bite Keratosis (Lip Biting)
Lip-Chewing or Biting
Morsicatio Buccarum (Cheek Biting)
Onychophagia (Nail-Biting)
Onychotillomania (Nail-Picking, Cuticle-Picking)
Rhinotillexomania (Nose Picking)
Scab-Picking (A form of excoriation disorder)
Tongue-Chewing or Biting
Trichotillomania (Hair-Pulling Disorder)
BFRBs are classified as obsessive-compulsive and related disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). With Trichotillomania (Hair-Pulling ), Excoriation Disorder (Skin-Picking), and Onychophagia (Nail-Biting) being the most common types of BFRBs.
If you have a BFRB, do you have OCD?
Despite these being in the category of obsessive-compulsive and related disorders in the DSM-5, having a BFRB does not mean that the individual has Obsessive Compulsive Disorder (OCD). BFRBs and OCD are two distinct conditions, with some similarities between them as well as many differences. Both conditions involve repetitive behaviors that can affect an individual’s daily life; however, their underlying mechanisms, triggers, and treatments are believed to be different.
Who is Affected by BFRBs?
BFRBs can affect people of all ages, genders, and backgrounds. These disorders often develop in childhood or adolescence and can persist into adulthood if left untreated. Stress, anxiety, or underlying mental health conditions can exacerbate these behaviors. BFRBs can vary in severity from person to person.
Although you might try to reduce how often you engage in these actions, it can be challenging to stop. BFRBs are often driven by intense, uncontrollable urges and may bring a sense of relief or satisfaction when performed. For many, these behaviors occur without the individual even realizing they are doing it, occuring subconsciously or without full awareness.
How are BFRBs treated?
Fortunately, effective treatment options are available to help manage these behaviors and can significantly improve the quality of life for many.
BFRB treatment may include one or a combination of the following:
Therapy: A psychotherapy approach called Cognitive Behavior Therapy (CBT) is often the first line treatment of choice for BFRBs. There are a few of unique approaches for treating BFRBs that have been found to be very helpful, Habit Reversal Training (HRT) and Comprehensive Behavioral treatment (ComB) being some of the most common. Therapy modalities such as Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT) are known to also be for some individuals with BFRBs.
Medications: For some people with BFRBs, medications can be a useful part of their treatment plan. A provider may recommend medications such as selective serotonin reuptake inhibitors (SSRIs), memantine, naltrexone, and/or the supplement NAC (N-acetylcysteine).
**Remember to always consult your physician or provider before altering your treatment plan or discontinuing medications as without professional guidance making changes may disrupt your progress and potentially lead to a recurrence of symptoms. Always take your medications as prescribed and consult your healthcare provider before making any changes. They can help assess your situation and adjust your treatment safely if needed, ensuring the best long-term outcomes for your health.
Why Choose MindfulMD Psychiatry for treating BFRBs?
At MindfulMD Psychiatry, we understand the complexity of BFRBs and the profound impact they can have on a person’s life. Our approach combines expertise, empathy, holistic care, and evidence based treatments to help our patients regain control and improve their mental health.
Our Treatment Approach
Comprehensive Assessment: We conduct a thorough evaluation to understand your specific BFRB, your triggers, and any co-occurring conditions such as anxiety, depression, OCD, etc.
Customized Treatment Plans: Our team develops personalized treatment plans that may include a combination of:
Cognitive Behavioral Therapy (CBT): We often will work with you to match you with excellent therapists in the community who have expert experience in working with BFRBs using CBT, ComB method, DBT, ART and/or Habit Reversal Training (HRT) depending on your unique treatment plan.
Mindfulness-Based Interventions: We will often work with patients on integrating mindfulness techniques to increase awareness of triggers and reduce compulsive urges.
Medication Management: If necessary, medications like SSRIs or other evidence-based medication options may be prescribed to address underlying mental health concerns. Our goal is always using the least amount of medications necessary to help treat your symptoms. We want to minimize side effects and help people taper down or taper off medications when appropriate.
Supportive Care: We provide ongoing support and guidance to help patients navigate their recovery journey, build coping strategies, and maintain progress. At MindfulMD Psychiatry, we believe in thoughtful, holistic care that takes the whole person into consideration; you are not just another number.
The MindfulMD Difference
Specialized Expertise: Our lead psychiatrist Dr. Allison Jackson has extensive experience in treating BFRBs and related disorders, and utilizes her Harvard training to provide expert level care to our patients.
Compassionate Care: We create a safe, judgment-free environment where patients feel supported and understood.
Holistic Focus: We address the whole person, considering emotional, physical, and social factors in our treatment plans.
Take the First Step Toward Healing
If you or a loved one is struggling with body-focused repetitive behaviors (BFRBs) and are seeking compassionate psychiatric care in Tampa or telehealth services across Florida, you are not alone. At MindfulMD Psychiatry, we specialize in helping individuals overcome BFRBs like hair-pulling, skin-picking, and nail-biting through evidence-based treatments tailored to your unique needs. Our personalized approach empowers you to break free from the cycle of repetitive behaviors and regain control of your life.
Contact us today to schedule an appointment and learn more about our specialized care for BFRBs. Together, we can help you move toward a healthier, more mindful future.
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