Hello all! For those of you who haven’t seem my Instagram feed (@lotustherapyatx) I wanted to share a the content of a video I posted earlier this month:

When I posted on my story asking for questions, someone asked, “Why do people tend to pick or pull repeatedly at the same spots on their skin or hair?”

I felt the vulnerability in that question. I wanted to answer it in a way that would bring self-compassion to a very painful behavior.

Many pickers and pullers frustrated by the phenomenon that after they have picked, no matter if they try to let that spot heal, their hand goes right back to mess with it. Or try to grow back their hair and are the exact hairs the hands search for, baby hairs.

In order to better understand this dynamic, we can look to the animal kingdom. Animals, when they come into our communities as domestic, zoo, or research animals, only then do they sometimes engage in repetitive body-focused behaviors, just like humans do, in some of the same circumstances.

You can think about a bird who is over-plucking its feathers, or if you have a dog or cat that licks at spots over and over again (without a dermatological origin), and you can think about whether it might be because the animal is stressed.

Let’s take a dog or a cat who is getting at this spot. Once they get at that spot, they are going to go right back to it, and a dog who is over-grooming will even have to wear a cone. That’s because once we have something that is open, inflamed, it is different, or in the case of hair-pulling, those little hairs that grow back feel different, and those changes are triggers themselves for picking and pulling.

Which means that it is very hard for us not to go back to those spots over and over, and they can be very hard to heal. If we think about a cone for a dog, if we want to heal our spots, we can consciously create barriers to picking or pulling. If we have something like a finger cap, that can create a natural barrier to create awareness when the hand goes to the hair or face.

That’s just one piece of the puzzle. Once you are aware of that tendency it doesn’t mean that you are not going to want to pick or pull. There are a couple more cognitive and emotional ways to work on leaving those spots alone.

Cognitively, in our minds, when we want to pick at a spot, there’s a sense of it’s wrong, it’s bad, something that needs to go, it doesn’t belong here. We can work on training ourselves to think about those things differently. For example, when I have a spot that I am really trying to let heal, I will think of it as a scab that is here to heal me, and it’s the right thing. With hair-pulling, it could be, these little hairs, they have to be little because they’re growing back, and they are doing just the right thing.

So just bringing a new framework to these thoughts can make a big difference. One thing to know is that once we start this process it can lead to some grief. Once we see our scabs or our baby hairs as ways we are trying to heal, it can really bring our awareness to the pain of the fact that our coping mechanism involves picking and pulling at our bodies in ways that hurt us.

What I found was that when I started to change my way of thinking, it led to a lot of sadness, and I had to sit with that sadness, but it also made me think about my scabs differently, as things I needed to care for. Again that doesn’t mean that you won’t pick or pull again, and then if you pick or pull anyway it can be even more painful emotionally. So that’s where it comes back to self-compassion, like “OK, I tried to leave it alone, but even though I knew it was part of healing it still felt wrong, so I did it anyways. But that’s OK, I’ll keep trying.” I found that it did take a number of tries, and making some space for that grief, before I was able to let go of my reliance on skin-picking.

Other ways to focus on letting things heal, especially with skin-picking, you can do a ritual afterwards, to take care of the wound, with Neosporin and another kind of barrier, band-aids, or to wash and style the hair after pulling. This brings a different energy in, to stop the shame cycle after picking.

And then, we have to attend to the environmental or psychosocial triggers that may have been leading us to pick or pull in the first place. We can look back at animal behaviors here, because we’ve studied it so much that it can be easier to identify triggers for animals, but these triggers are much the same for humans.

The main stressors that lead to over-grooming include isolation, that feeling of boredom, frustration, and being trapped in too small of a space, which for humans can be a lack of freedom, maybe a teenager whose parents are strict or an adult who feels trapped in a job or relationship. If we really want to work on leaving those spots alone, we have to tend to which of those 4 is really up for us, and how can we try to shift in those areas.

For animals, they have found that increasing the size of a pen, or adding a companion animal. Or if male horse is flank-biting and needs to get out aggressive energy, time in the field with another male horse can relieve that tension and end the behavior.

So, for humans, what are the stressors that are leading us to that spot, and what can I change? So if you are a teenager and you feel like you don’t have enough freedom, is it time to sit down with your parents to talk about having a voice in the rules and punishments, earning trust to get more freedom, asserting yourself in that way.

If isolation is a big problem, and you feel like you can’t be your true self with people, and feel socially disconnected, group therapy can be very helpful to look at some of those barriers to being close to people.

With frustration, that has to come out of the body, so, can you punch a boxing bag, or do some work with clay, or express yourself, if the person you are angry with tends to shut down, than talk about it with someone else, at least get it out of your body.

So, when I think about this idea of going back and back and back to picking or pulling spots, it can be so painful to be working on healing something and have to go all the way back to scratch to start over. I just want to re-emphasize compassion, compassion, compassion. Life is hard, and your skin-picking or hair-pulling is really a response to the stresses in your life, and it is an attempt to cope.

There can be better ways to cope, so if you think about addressing those four categories, can you find new ways to cope in your life. Often times that does involve finding a good therapist because some of these issues do go way beyond the surface and need some caring attention from a professional. And there are some things that you can do on your own, starting with forgiving yourself for going back and back and back to that spot until you can leave it alone.