In the previous blog post, I covered four stressors that have been found to be triggers common both to humans and animals who engage in body-focused repetitive behaviors: frustration, boredom, the experience of being trapped in too small of a space or of feeling trapped, and isolation. I explored the role frustration has as a particular trigger for picking and pulling, and how psychodynamic therapy can help people develop ways to express and assert themselves, two elements of adaptive emotional regulation.

Another common trigger for picking and pulling is boredom. The term boredom encompasses both a physiological experience - feeling under-stimulated - and an emotional one - feeling uninterested, uninspired, perhaps a little depressed.

To look more closely at the ways boredom can lead to BFRBs, it is helpful to think first about boredom in the animal kingdom.

Animals in the wild don't develop BFRBs. It is only under the care of humans as pets or zoo or research animals that a bird will develop a problem with feather-plucking, a dog will lick off patches of her fur, or a horse will repetitively gulp in air, a behavior called cribbing.

When lions pace restlessly in their cages at the zoo, it is easy to see how a lack of stimulation can be damaging and difficult to cope with.

It was owners’ annoyance with behaviors like cribbing that attracted the attention of animal behaviorists. Looking for solutions to cribbing, for example, specialists found that if horses were given more space to graze, they can stop the cribbing behaviors altogether (Natterson-Horowitz & Bowers, 2012).

It makes sense that domestic animals would get bored. Their bodies and nervous systems are built to react to decades-old survival instincts to hunt down their food and protect their groups from danger. When the process of eating shifts from hunting, killing and consuming an animal to eating kibble from a bowl, boredom is an understandable result.

In the same way, our human bodies are often restless. Our lives tend to be covenience-based and focused around screens of some kind, whether at work or for entertainment. Exercise is a choice, sometimes a fraught one, rather than a part of daily living. All of these factors add to the boredom element of picking and pulling.

This dynamic is one element underlying the boredom that triggers picking and pulling episodes. Often, people pull while sitting on the couch, unwinding, and watching TV. It may be that the mind is engaged and the mood is good, but the body may still be feeling under-stimulated. Given that people with BFRBs tend to have sensitive nervous systems, restlessness often settles into their hands.

Luckily, as with restless animals, there are ways to change the environment to give the nervous system more of what it needs. These kinds of practical changes are encompassed within the range of behavioral therapy techniques. Another way to think about the goal when addressing boredom and restlessness is to develop the skill of identifying and meeting underlying needs.

In the case of restlessness while unwinding, having sensory objects to choose from at places where hands tend to get restless, like in a basket by the couch, can be a game-changer The idea of choosing to give the hands what they need at those times shifts away from the dictate to play with fiddle toys instead of picking or pulling. The psychodynamic therapy approach has set the stage for growth with self-kindness instead of by force of will.

Adding more home cooking into the mix can be one way to shift back to expending energy in a productive and creative way. Creative endeavors like beading and ceramics can be similarly helpful.

Other versions of boredom embody different needs and will lead to different solutions. Picking or pulling that happens while driving is often related to the anxiety of being trapped in a car with the stressors of the road. When I moved to a new house with a longer commute, I found that I had to time my drives away from rush hour, give myself plenty of time to get to work, and listen to books on tape in order to adjust to the new stressors without my hands getting restless.

Another way to think about animals’ struggles with BFRBs is as overgrooming behaviors. While licking and plucking and biting are elements of the healthy grooming process, when the these behaviors go beyond the grooming function t they become problematic.

Healthy grooming is another category of behavioral ways to address BFRBs. When biting the cuticles is the go-to behavior, nail care and manicures can provide a different kind of sensory input. Hair care can feel comforting and increase confidence. Choices around cuts and color can provide a different way to think about hair. These choices can lead from a shift in focus on criticism of the appearance to enjoyment of self-expression. While skin care can often have a negative repetitive element, bringing balance to a skin-care regime can be comforting.

Sensory stimulation, shifts to the environment, and healthy grooming behaviors. It can be fun and rewarding to figure out how to give the body more of what it needs when boredom rears its head!

References:

Natterson-Horowitz, B. & Bowers, K. (2012). Zoobiquity. NY, NY: Vintage Books.