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Compulsive Skin Picking (CSP)
Compulsive Skin Picking (CSP) – or dermatillomania – is the repetitive picking of your own skin. It varies in severity, from just a bad habit, to a problem which shares many characteristics with OCD (Obsessive Compulsive Disorder). At its worst it can cause cause pain, injury and permanent scarring, in addition to requiring a large amount of time and attention, which is hugely disruptive to your ability to live your life to the full. Hypnosis helps both the bad habit of skin picking and the more severe OCD form, treating the bad habit in the same way hypnosis is used for nail biting and other bad habits, weight loss, to stop smoking, and treats the more severe compulsion by helping you to overcome the underlying anxiety, stress and (in some cases) perfectionism and body issues which cause it. A technique called Exposure and Response Prevention (scroll down for more information about this) is also used when your skin picking is a symptom of OCD . Skin picking is more common in women than in men, and it is thought to affect about 2% of patients who see a dermatologist, and between 2 and 4% of students.
Skin picking, anxiety and OCD
If you pick your skin, you may do this because it provides – temporary – relief from anxiety, stress or boredom, or provides a distraction from your emotional problems. Or you may be trying to make your skin as perfect as possible, picking your skin to remove (real or imaginary) spots, scabs, blemishes, dry skin, lumps and bumps. Of course, the more you pick, the worse the imperfections appear, leading to a vicious circle of further skin picking. More severe cases of Compulsive Skin Picking have obsessive compulsive aspects that are similar to OCD, Body Dysmorphic Disorder (BDD) and compulsive hair pulling (or trichotillomania – TTM). All are ritualistic, compulsive, repetitive and temporarily relieve stress, anxiety and tension, but are ultimately self destructive. Around a quarter of people diagnosed with OCD or BDDalso have CSP.
Exposure and Response Prevention for Skin Picking which is a symptom ofOCD
If your skin picking is more severe and is part of your OCD, then Exposure and Response Prevention (ERP) will be used in addition, to help deal with the OCD. This means that although you feel the compulsion to pick your skin (or count, check, or wash your hands – whatever your own compulsion is), you stop yourself from doing it, for a given period of time. This period of time gradually gets longer. The idea is that rather than relieving the anxiety you feel by carrying out your compulsion (skin picking, counting, checking, washing or whatever), you live with the feeling of anxiety. Usually, if you suffer withOCD, you will not allow yourself to remain feeling uncomfortable or anxious for long enough to realize that, even if you don’t carry out your compulsion, the anxiety will subside on its own. You concentrate on feeling better in the short term, rather than on dealing with the larger problem of the OCD. ERPencourages OCD sufferers to expose themselves to their obsessions and anxieties, but without resorting to the compulsions which normally make them those thoughts and anxieties go away. This type of therapy is known to work extremely well. Hypnosis and self hypnosis are also taught , alongside a programme ofERP, in order to keep your general levels of anxiety lower than would normally be the case, so that when you try ERP your anxiety does not become overwhelming.
What are the symptoms of Compulsive Skin Picking?
The most commonly affected areas are the face, gums, lips, back, shoulders, arms, scalp, stomach, chest, and the nails and cuticles (on both the fingers and toes). This in turn causes pain, scarring, swelling, bleeding, and callusing. Some damage is irreversible. Most sufferers of skin picking disorder experience stress or tension before picking, which is decreased by skin picking. If your skin picking is merely a habit you may not even be aware that you are doing it; it goes on beneath the level of consciousness. Many habits are like this, and there is more information below in the paragraph headed “What are the most common bad habits?”
When skin picking is more severe you may use your fingers or nails for skin picking, or perhaps tweezers, needles, pins or toothpicks.
There are many problems which can arise because of your skin picking, including a dislike of being looked at, self consciousness, relationships deteriorating badly because of it, hating the way you look, and not going out because it takes you so long to get ready. If you pick your skin, you may feel the need to camouflage your scars of blemishes with make-up, or to cover up affected areas with clothing, even in the height of summer. Compulsive skin picking can cause or worsen social anxiety, making you feel self conscious, perhaps leading you to stay at home, avoid your friends, and to be constantly late as your skin picking and subsequent camouflaging routines takes up so much time. Skin picking interferes with daily life.
What are the most common bad habits ?
When skin picking is in its milder form, it is really best described as just a bad habit. Bad habits come in all shapes and sizes, and hypnosis is a very effective and powerful treatment for any habit – not just skin picking but hair pulling (trichotillomania), nail biting, teeth grinding, binge drinking, compulsive eating,smoking, wasting hours playing computer games on or Facebook when there’s really something else which you should be doing, compulsive eating; what all of these bad habits have in common is that you find yourself doing them, or wanting to do them, subconsciously – in other words, you don’t consciously go through a thought process of telling yourself to do it. You may not even notice that you’re picking your skin until someone tells you you’re doing it. Similarly, if you have a nail biting habit, you suddenly find that you are biting your nails without having thought “I should put my hand towards my mouth now”. Or you find yourself twisting or pulling your hair, seemingly unaware of what you are doing until you have actually pulled the hair out or made it snap. It just seems to happen without you really noticing, until it’s too late. Or perhaps you suddenly find that a thought appears from nowhere – “I really want a packet of crisps” – but you’re not at all hungry; in fact you’re trying to lose weight and eat well – the thought just seems to pop up. Bad habits are things that you find ourselves doing or thinking when in fact you really want NOTto do, or think, those things.
Hypnosis to treat skin picking; and CBT, medication and other treatments which help
Hypnosis is very well regarded in the treatment of compulsive skin picking. Hypnosis can be used alone or in conjunction with either or both medication and Cognitive Behavioural Therapy – CBT. Medications used for OCD (Obsessive Compulsive Disorder) and depression have proved very effective for some sufferers. Medication should not be seen as a stand alone treatment but as a tool which makes it easier for you to do the therapeutic work you need to do to overcome this problem.
Cognitive Behavioural Therapy – CBT – is also used very effectively to treat skin picking. CBT is a broad term for all therapies dealing with thoughts, beliefs, behaviours and assumptions which cause and are otherwise linked with negative and unhelpful emotions like anxiety, stress and depression. CBT teaches you recognize faulty thinking – such as panicking, worrying, always assuming the worst, over-generalising in a negative way, taking things too personally, and jumping to pessimistic conclusions – and replacing them with positive, realistic, and helpful thoughts. CBT can help you to overcome the anxiety and stress which are the underlying causes of your skin picking; it helps you understand that the skin picking does not in fact help you to feel better but worsens your situation, and it also helps you to stop thinking about imperfections in your appearance in a disproportionate and distorted way.
When do bad habits strike? And how do habits start?
Skin picking usually starts in adolescence, but can start at any time. In common with many bad habits, skin picking is more likely to happen when you are feeling anxious or stressed, restless, tired, stressed at work, hungry, bored, nervous, too busy, fed up, or when you are trying to concentrate on something important. You may also use bad habits such as skin picking to distract yourself, to take a moment out, to think about fewer than five things at once, to make yourself feel better. Although it’s usually very hard to remember exactly when and how your bad habit started, the chances are that back when it started, you got something out of it; it did make you feel better. The first time you bite your nails, or pull your hair, it succeeds in distracting you from whatever it was which made you stressed or anxious. Grinding your teeth probably made you feel stronger, in control, more determined to beat whatever problem was bothering you. But as you repeat the habit which made you feel better when you first tried it, it brings its own problems. Comfort eating and binge eating eventually leads you to put weight on; you’re embarrassed by the way your bitten nails look; you begin to get headaches or earache because of the teeth grinding, or it stops you from sleeping properly; your family worry about your health because you can’t stop smoking; your head is sore and you are ashamed that patches of hair are missing. Skin picking doesn’t make you feel one bit better in the long run. In fact you feel worse, because it’s painful, it takes up increasing amounts of time, your appearance suffers and you feel that you cannot control what is happening. But you CAN control your actions, stop skin picking, stop nail biting, stop hair pulling, stop smoking, lose weight – you can break your bad habits. This is where hypnosis is so effective.
How does hypnosis break bad habits?
Hypnosis speaks directly to your subconcious and makes you more aware of what you are doing when you pick your skin. Rather than subconciously – unthinkingly – indulging your bad habit, hypnosis makes you become very mindful of what you are doing. This means you notice your hand reaching towards your mouth, or towards the plate of biscuits, or that you are clenching your jaw and grinding your teeth, or hair pulling, rather than just automatically doing it. Your bad habit is subconscious so you don’t even think about it or make a choice when you do it – no wonder it is hard to control it! Hypnosis makes you aware of what you are doing. One of the hypnosis techniques used to stop skin picking is a suggestion that whenever you want to pick your skin, you must turn your hand upside down to do it; there are many variations on this. This technique is known as Habit Reversal Training. Habit Reversal Training also involves hypnosis and teaching you to do self hypnosis. Habit Reversal Training works by making you very conscious of when your bad habits are happening. It is appropriate when your skin picking is just a habit; if skin picking is severe and is a symptom of OCD, however (and this will usually mean that you are already very conscious of what you are doing) then Exposure and Response Prevention will be used.
It is much easier to stop something when you become fully aware that you are doing it. And when you find yourself habitually thinking something – “I’ve really got to have chocolate right now” – hypnosis enables you to override this thought with thoughts which are more accurate, appropriate and useful – “Yes, I do want chocolate now, but not as much as I want to lose weight” “The taste of chocolate lasts only a few seconds – my weight and appearance affect me for the other 18 hours a day I’m awake!”
Hypnosis reduces stress and anxiety to break bad habits and stop compulsive behaviour
As well as the specific suggestions which you will be given whilst in hypnosis to help you break your habit, the very deep state of relaxation which hypnosis gives you means that you are far less likely to develop the state of anxiety which leads to your carrying our your bad habit, too. Hypnosis helps you feel calmer and more relaxed, enables you to manage stress, to feel more in control of your actions and much more aware of them, and to break bad habits by replacing them with a more positive response.
How quickly does hypnosis break bad habits?
You may notice the change very quickly, particularly if your skin picking is mild and really just a habit – after just one session of hypnosis. Not everyone can break their habit so quickly, however – it will depend on the reasons you started in the first place, whether or not you are anxious generally, how much you really want to stop picking your skin, nail biting, hair pulling, teeth grinding, or whatever your habit is. Because everyone makes progress at a different speed, you should be wary of any hypnotherapist who promises instant success – hypnosis is not one size fits all; what works for one individual may not work for another. If someone absolutely guarantees that they can cure you in one session, the likelihood is that they are just desperate for your business. Look for a properly qualified and registered hypnotherapist – a reputable hypnotherapist will be happy to meet with you without charge, in order to get to know you and the background to your problem, and to make sure that you feel comfortable with them and the approach they take. They will be honest with you about how long the process is likely to take. If you choose to come here to Manchester Hypnotherapy you will be given CDs to listen to, to help you to relax and to do self hypnosis. Breaking bad habits such as skin picking is a process – you may get instant results, of course, but equally it may take some time. Hypnosis gives you the relaxation and peace of mind to be patient with yourself for as long as it takes to stop your habit completely.
Self hypnosis to stop skin picking and bad habits
Ultimately, all hypnosis is self hypnosis – the thoughts which you repeat to yourself. The most important part of learning self hypnosis for many people who want to break bad habits is learning to relax, quickly and easily. Most bad habits develop when you are feeling stressed. Bad habits bring the immediate reward of focusing your mind away from the stressful situation, of distracting you, of making you feel a bit better. But these habits have a downside – skin picking causes painful and unsightly scarring, chocolate and other comfort food makes you gain weight, the bitten nails are embarrassing and painful, you feel fed up just because you have the bad habit. With more severe forms of skin picking, you may feel isolated and ashamed, and unable to tell people about the problem. Habits work, a little, at first. But if you are reading this page then the habit isn’t really working for you any more. The deep state of relaxation which you experience whilst in hypnosis lets you feel better, less stressed and more in control WITHOUTresorting to skin picking, or whatever your bad habit is.
What kind of bad habit can hypnosis stop?
Any type of habit can be stopped. Most commonly treated are nail biting, hair pulling, smoking, over eating, skin picking, fidgeting, teeth grinding, drinking too much caffeine, binge eating (usually eating too much of one type of food such as chocolate, cake or biscuits), binge drinking, and swearing – but the hypnosis techniques used for these bad habits, and for weight loss, are the same hypnosis techniques that work to break all bad habits. If you have got to the stage where you really want to break your bad habit, then hypnosis will help you to stop it for good. Hypnosis helps you to break the cycle of stress and anxiety which often cause bad habits to form, so that not only will you finish your treatment habit free, you will also feel generally calmer, more relaxed, and in control.
Hypnosis in Manchester
The therapists at Manchester Hypnotherapy are Manchester’s top independently rated therapists in anxiety, insomnia and phobia treatment. If you want to find a hypnotherapist in south Manchester to helpstress and anxiety, claustrophobia, fear of flying, emotional problems such as jealousy and insecurity,panic attacks, or low self esteem, then go to any of the independent websites which list and give reviews of hypnotherapists (for example www.freeindex.co.uk – you can also see reviews on Google) and see what others say about us. If you would like further information about hypnosis in Manchester, forinsomnia, to stop smoking, self esteem and confidence, depression, for help with weight loss, to nail biting, teeth grinding, or for any other problem, please call 07779 575 816 for a free, no obligation, confidential discussion.
Our Manchester Hypnotherapy clinicis based in lovely, peaceful surroundings in Didsbury, south Manchester, easily accessible from the centre of Manchester, Hale, Altrincham, and also Gatley, Cheadle, Chorlton, Stockport, and outlying areas. Further information on how to find us is on our location page.