This year, international BFRB Awareness Week runs from October 3rd - 7th. To mark the occasion, healthcare expert and co-founder of Nudge Luisa Zettinig shares her advice on supporting friends and family members with ‘trich’ or ‘derm’.
It’s always tough to watch someone you care about going through a difficult time with their mental health. Indeed, it’s common to feel distressed and powerless when you notice that your friend or family member’s life is being negatively impacted by something which you have no control over.
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Unfortunately, you can’t force anyone to recover from trichotillomania or dermatillomania, and you can’t recover on their behalf. The difficult truth is that the sufferer has to actively choose to tackle their behaviours head-on before any progress can be made.
However, this does not mean that you can’t help them at all. In fact, there are a number of positive actions and behaviours which you can adopt in order to support your loved one and possibly aid their recovery journey.
Below, I’ve shared my top pieces of practical advice that the parents, siblings and friends of BFRB sufferers can put into practice this BFRB Awareness Week.
But first, some definitions:
- Trichotillomania (‘trich’) is the clinical name for compulsive hair pulling disorder, a condition characterised by repeated pulling of body hair, including from the eyebrows, eyelashes and scalp, usually resulting in hair loss.
- Dermatillomania (‘derm’) is used to refer to compulsive skin picking disorder, a condition which can be experienced alongside trich or independently. It is characterised by repeated picking or scratching of skin on the face or body, especially where blemishes are present, often resulting in scarring.
Both trich and derm come under the category of Body Focused Repetitive Behaviours or BFRBs. Often people just experience one of these disorders at a time, but it’s not uncommon to experience both of them simultaneously.
Six tips on how you can best support the loved one in your life with a BFRB
1. Encourage them to communicate with you
Having someone to talk to is incredibly valuable for anyone struggling with their mental health. Forcing a person into a conversation is never going to have a positive outcome, but you can gently let them know that you are ready to listen whenever they are ready to share their thoughts or feelings.
When you are listening, don’t be tempted to jump in with solutions, or to try to console them saying “you’ll be fine” and “it’s not that bad” - these statements might be misinterpreted as belittling their experiences or emotions. Instead, let the speaker guide the conversation, and make it clear that their struggle is valid and you are sympathetic to their pain.
2. Don’t attach negative emotion to their behaviours
If you’re a parent, never punish or get angry when your child engages in pulling or picking. Similarly, resist any temptation to comment on any physical signs of their behaviour in a negative way. Doing this will exacerbate the feelings of shame and embarrassment that the sufferer is already experiencing, resulting in the cycle becoming more deeply ingrained.
Instead, when you notice that the person has been engaging in the behaviours, say something neutral like “I notice that you’ve pulled your hair today; do you want to talk about how you are feeling?”.
3. Try to find out what their triggers are
If you learn which scenarios or situations trigger your loved one’s BFRB, you can help them to avoid that trigger. For example, if they often engage in the behaviour in the evening, you could agree to call them in the evening, or watch TV together instead. If they pull or pick in front of a mirror, put the mirrors in the house away. Finding out their trigger could be the first step to tackling an underlying cause of their behaviour
4. Help them find distractions and calming behaviours
Every BFRB sufferer finds different techniques and activities helpful as sources of distraction. It can be quite a mission to figure out which one is right for which person!
You can help on this mission by offering some suggestions of things that your loved one might want to try - from fiddle toys to colouring books, jigsaws, music or nail polish - and remind them to use these tricks when they feel the urge to pick or pull.
5. Point them towards sources of support
When someone is stuck in a BFRB cycle, they might lack the self-awareness or headspace to properly explore the support on offer to them. Although you should never take on the burden of ‘managing’ their recovery, you could help them get started by guiding them towards a reputable local psychologist, or by emailing them links to recommended BFRB blogs and websites.
You could also suggest that your friend or relative tries out a recovery-aid tool.
6. Celebrate their progress
When someone is struggling with a BFRB, it can often feel like a big cloud is hanging over their life. You can be the ray of sunshine that breaks through that cloud!
Encourage the person to keep a record of how often they are pulling or picking; when they reach a milestone or streak, celebrate together with an activity you both enjoy. This praise and moral support will help to motivate them to break the cycle of their BFRB, and will also positively impact their self-esteem.
Ultimately, you know the person best, and you probably have a good idea of how they might react to each of the above suggestions. However, don’t let any preconceived ideas put you off giving each one a try. And always remember, the most helpful thing you can do this BFRB Awareness week is to offer non-judgemental, unwavering love and positive affirmations.