Body-Focused Repetitive Behaviors
Understanding What Body-Focused Repetitive Behaviors Really Are
Body-focused repetitive behaviors, or BFRBs, are more than just habits, and they definitely aren’t just bad nervous tics. They’re a type of behavior where a person repeatedly causes damage to their body—most often by pulling hair, picking skin, biting nails, or chewing inside the cheeks. Many people who deal with these kinds of behaviors don’t do it for attention or out of laziness, but rather as a way of coping with overwhelming emotions, anxiety, or even just zoning out during everyday activities like watching TV or working.
What makes BFRBs particularly frustrating is how damaging they can be not only physically, but emotionally and socially too. You might find it difficult to explain your actions to others, cover up visible signs, or feel ashamed after an episode. This can create a loop where the behavior leads to stress, and that stress adds fuel to the fire—so the behavior keeps happening. It can be incredibly discouraging when you want to stop but can’t seem to.
Here’s a quick list of some common types of BFRBs:
- Hair pulling (trichotillomania): frequently pulling hair from your scalp, eyebrows, eyelashes, or other parts of the body
- Skin picking (excoriation disorder): picking at healthy skin, scabs, or acne to the point of injury
- Nail biting (onychophagia): biting nails down to the quick, often causing pain or bleeding
- Cheek or lip biting: chewing the inside of your mouth until it becomes sore or damaged
These behaviors can lead to visible damage, which brings emotional pain and social anxiety. It becomes a cycle—behavior leads to shame or distress, which leads to more behavior.
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But there is a way forward.
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​Evidence-Based Treatments That Actually Work
Understanding where BFRBs come from is crucial, but knowing what can help you move forward is the next step. Therapy for body-focused repetitive behaviors doesn’t rely on one-size-fits-all advice. There are practical, structured approaches that meet you where you’re at and focus on the patterns you've developed over time. These methods build awareness and help retrain your brain to respond differently to stress, boredom, or emotional overwhelm.
One common strategy used is Habit Reversal Training, which focuses on helping you recognize what leads up to the behavior—like a sensation, emotion, or routine—and then guides you toward replacing it with a behavior that doesn’t cause harm. For example, someone who pulls hair when feeling anxious might learn to clench their fists or hold a textured object instead. Over time, this new behavior becomes the go-to response instead of the old one.
Another helpful approach is Cognitive Behavioral Therapy, which helps untangle the thought patterns feeding the behavior. This isn't about talking yourself out of it with logic—it’s about gently interrupting the loop that reinforces the action. CBT can also explore the perfectionistic thinking or shame cycles that often go hand-in-hand with BFRBs.
Some strategies people find effective over time include:
- Identifying your triggers—what time of day do BFRBs usually happen? What are you feeling beforehand?
- Creating competing responses—any action that keeps your hands busy in a way that doesn’t cause harm
- Modifying your environment—removing mirrors, excess tools like tweezers, or placing visual reminders around your space
- Developing self-soothing tools—deep breathing, sensory items, grounding exercises
- Keeping a log—tracking progress and patterns without judgment
These tools can sound basic on paper, but when they’re introduced in a thoughtful, supportive way, they build a real foundation for change. It’s not just about breaking the habit—it’s about building something new that actually supports your mental and emotional well-being.
Why Personalized Therapy Matters
Reading tips online is helpful—but it’s not the same as sitting in a safe space where you’re truly seen and supported. Therapy tailored to your specific experience with BFRBs offers tools that reflect your unique needs and patterns—not just generalized advice.
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Progress doesn’t mean “no urges.” Sometimes it means fewer episodes, shorter duration, or more moments where you pause before acting. That’s real change. And it matters.
​Take the First Step Toward Healing
Living with body-focused repetitive behaviors doesn’t mean you’re broken or lacking discipline. It means your mind found a coping strategy that made sense at some point—but that no longer serves you. You can change that. And therapy can help.
There's no fixed timeline for change. But what does move the needle is making that first connection with someone who truly sees what you're going through and knows how to help. With the right support, what once felt automatic can become something you're in control of. Healing isn’t about perfection—it’s about creating more space in your life where this behavior isn’t calling all the shots.
If you're recognizing yourself in these patterns and you're ready for something to shift, you're not alone—and it's okay to ask for support. Azra Kim offers compassionate, targeted therapy for adults experiencing challenges related to body-focused repetitive behaviors, and reaching out could be the first step toward real relief.