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A person suffering from hair pulling seeking trichotillomania treatment

Body-Focused Repetitive Behaviors (BFRBs)


Body-focused repetitive behaviors (BFRBs) are a cluster of common but often misunderstood conditions involving repetitive behaviors focused on the body that can lead to physical damage. Think of them as intense urges to bite, pick, pull, or scrape at oneself, often resulting in unintentional harm that can be difficult to stop.

Common BFRBs include:

  • Hair pulling (Trichotillomania): Repetitive pulling of hair from the scalp, eyebrows, or other areas, leading to noticeable hair loss.

  • Skin picking (Excoriation): Picking at the skin, scabs, or blemishes, often on the face, arms, or legs, causing scarring and potential infections.

  • Nail biting (Onychophagia): Biting or chewing nails, which can lead to damage to the nail bed and surrounding skin.

  • Lip or cheek biting (Morsicatio buccarum): Biting or chewing on the lips or cheeks, causing pain and potential scarring.


BFRBs are more than just bad habits. They can be triggered by stress, anxiety, boredom, or even positive emotions like excitement or pleasure. The urge to engage in the behavior can be overwhelming, and while some people experience temporary relief during the act, the damage and shame associated with it can cause significant distress.

It's important to understand that BFRBs are not self-harm. While self-harm is often used to intentionally inflict pain, BFRBs are typically not intended to cause harm but rather to manage emotions or cope with stress.

Here are some key points to remember about BFRBs:

  • They are surprisingly common, affecting about 1 in 20 people.

  • They can be highly distressing and lead to social isolation and emotional problems.

  • They are treatable with various therapies, including habit reversal training, cognitive-behavioral therapy (CBT), and medication.


Remember, seeking help is a sign of strength, not weakness. Taking the first step can make a big difference in managing BFRBs and living a more fulfilling life.

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