Understanding Body-Focused Repetitive Behaviours

What are BFRB (Body-Focused Repetitive Behaviours)?

BFRB are a cluster of repetitive self-grooming behaviours that cause damage to the body.  These include four main conditions, hairpulling, skin picking, nail biting and jaw and teeth grinding. They can also include biting the inside of the mouth, inner lip or tongue, foot tapping and finger or knuckle cracking and nose picking.

Whilst a lot of people bite their nails, pick their skin or nose and crack their knuckles on occasion, this doesn’t generally cause them any physical harm, and is a habit they often grow out of.  This should not be confused with BFRB which can result in the sufferer not only causing themselves injury or infection but can affect their mental health and have a negative impact on their lives.

It’s believed that the condition affects between three and twelve per cent of the population, affecting both children and adults, it tends to be more common in women than men.


The cause for BFRB is unknown, but researchers believe that there is a genetic predisposition to the condition.  Some experts also believe that temperament and environmental factors can play a role in its development.

There is also evidence that BFRB has a strong link to OCD (obsessive compulsive disorder), as well as having some over lapping symptoms of GAD (general anxiety disorder).

Clinical Types of BFRB

·      Dermatillomania or Excoriation Disorder

Skin picking which can include repetitive touching, rubbing, scratching, digging or picking of the skin.  This can result in bleeding, infections and scarring of the area.

·      Trichotillomania

Hair pulling which can include picking or pulling of the hair on the head, eyelashes, eyebrows, pubic area, body and in men beard hair. This can lead to infections in the follicle, hair thinning and permanent hair loss.

·      Onychophagia

Nail biting including the skin around the nail and on the fingers which can lead to infections, scaring and permanent damage to the nail and skin.

·      Bruxism

Jaw and teeth grinding or clenching which can result in tooth pain and damage as well as pain in the jaw and ears, poor sleep, tongue indentations damage to the inside of the mouth.

Professional Help

You should always consult your doctor if you are feeling anxious or stressed and if you have developed symptoms of a body-focused repetitive behaviour that are causing you physical harm.  They can check to exclude any underlying physical condition for your symptoms, before they decide the best treatment for you.

Whilst they can prescribe antianxiety medication or SSRI’s (selective serotonin reuptake inhibitors), there are no medications specifically for BFRB.  The best and most common treatment for BFRB is therapy.  Your doctor can recommend a mental health care practitioner who has had experience in dealing with BFRB. 

They can treat you with a variety of different therapies, including psychotherapy, CBT (cognitive behavioural therapy), clinical hypnotherapy, EMDR (eye movement desensitisation and reprocessing) and HRT (habit reversal training), all of which can be successful in helping you overcome your BFRB.  Written by Jan, Jeana and Wendy at Barnsley Hypnosis and Counselling (UK). For more free Information click above link.