The emotional consequences of body-focused repetitive behaviors

Body-focused repetitive behaviors is a disorder similar to obsessive-compulsive disorder. In the treatment of this disorder, the person repeatedly performs activities that involve the body itself, such as biting the nails, biting the lip or cheek, and repeatedly tries to stop performing these behaviors.

It’s possible that the person with this disorder may feel tense or anxious just before doing so, and poking or biting parts of the body can relieve that feeling.

Cognitive-behavioral therapy with a specific focus on body-focused repetitive behavior disorder and certain antidepressants can help to decrease symptoms.

Symptoms of body-focused repetitive behaviors

Some people with body-focused repetitive behaviors do these things automatically, without thinking. Others are more aware of the behaviors.

The person does not have these behaviours because they’re obsessed or concerned with appearance (as is the case with body dysmorphic disorder). However, it’s possible for the person to feel tense or anxious just before acting that way, and the act can alleviate that feeling. It’s possible that the person may also feel distressed by the loss of control and repeatedly try to stop doing the activity or do it less often, but they cannot.

If the person bites or pokes the nails too much, they may be deformed. Grooves and edges can form on the nails or it is possible that there is an accumulation of blood under the nail causing the appearance of a purplish black spot.

Diagnosis

A doctor’s assessment based on specific diagnostic criteria is important. The doctor diagnoses the body-focused repetitive behaviors disorder based on the symptoms:

• Poking or otherwise manipulating a body part, sometimes resulting in injury;
• Try repeatedly to stop or decrease the frequency of the activity;
• Feeling very distressed or suffering reduced function due to activity.

Treatment

Treatment of body-focused repetitive behaviors disorder may include medications, such as selective serotonin and cognitive-behavioral therapy.

Cognitive-behavioral therapy with a specific focus on this disorder can decrease symptoms. One example is habit reversal training (HRT). In this therapy, the person learns how:

• Become more aware of what you are doing;
• Identify situations that trigger the activity;
• Use strategies to stop having the behavior, for example, replacing the activity with another one (for example, clenching your fists, knitting or sitting on your hands).