Understanding and Treating BFRBs
If you’re living in Fort Lauderdale or somewhere nearby in South Florida and find yourself pulling your hair, picking at your skin, biting your nails or lips, or picking at your cuticles in a way you can’t stop — you may be dealing with a body-focused repetitive behavior (BFRB). While these behaviours may seem harmless at first, they often cause distress, scarring, hair-loss or social embarrassment and significantly impact quality of life.
At Still Minds Psychology, we specialise in evidence-based treatments for BFRBs and related disorders. Below we’ll walk through what BFRBs are, how they differ from similar conditions like OCD, and what treatment can look like — especially for clients in Fort Lauderdale, Plantation, Davie, Hollywood, and the surrounding South Florida region.
What are BFRBs?
Body-focused repetitive behaviours (BFRBs) refer to a group of conditions in which individuals engage in repetitive self-grooming behaviours that cause physical damage, such as pulling out hair (known formally as trichotillomania), picking skin (excoriation disorder) and other related behaviours (lip-biting, nail-picking, cheek-biting).
These behaviours often:
Occur outside full conscious awareness (you may pick without realising).
Provide a short-term sense of relief, gratification or reduction in tension, but then are followed by guilt, shame, or damage.
Are driven not simply by “I’m worried I’ll get sick” (as in some forms of OCD) but by an urge, sensation, or need for relief.
Because of this, BFRBs can be easily mistaken for other conditions, so proper assessment is key.
How BFRBs Differ from OCD
While BFRBs are classified among the “obsessive-compulsive and related disorders,” they differ in how and why the behaviour happens. Some key differences:
With Obsessive‑Compulsive Disorder (OCD), there’s typically an intrusive obsession (eg: “If I don’t wash my hands 10 times the house will burn down”) and a compulsion performed to reduce that fear. BFRBs, instead, often involve an urge or sensory discomfort rather than a specific fear of harm.
BFRBs may happen automatically, when distracted or bored, with less full awareness. In contrast, OCD compulsions are more deliberate, rule-bound and anxiety-driven.- International OCD Foundation
The treatment approaches differ: while exposure and response prevention (ERP) is the gold standard for OCD, BFRBs often respond best to treatments like habit-reversal training (HRT), comprehensive behavioural (ComB) approaches, mindfulness and sensory-trigger management.
Because of these distinctions, getting the right diagnosis sets the stage for the right treatment — and faster relief.
Evidence-Based Treatment for BFRBs
At our practice in Fort Lauderdale, we offer specialised care for BFRBs. Here’s what effective treatment usually involves:
1. Assessment & Functional Analysis
We begin by exploring what happens before, during, and after the behaviour: triggers (sensations, thoughts, environments), behaviours (hair‐pulling, skin‐picking), and consequences (relief, scarring, shame). This helps to build a map of what maintains the behaviour for you.
2. Habit Reversal & Competing Responses
One core technique is habit-reversal training (HRT): you become aware of the behaviour, learn to notice the urge, and then apply a competing response (eg: clenching your fists, using a fidget tool) instead of picking/pulling.
3. Comprehensive Behavioural (ComB) Approach
Because each person’s BFRB is unique, a comprehensive treatment might also include:
Stimulus control (modifying the environment to reduce triggers)
Cognitive strategies (challenging thoughts like “My skin has to be smooth”)
Emotional regulation (learning to sit with tension instead of picking)
Sensory strategies (identifying the sensory urge and offering alternative inputs)
4. Maintenance & Relapse Prevention
Recognising that recovery is a process, we work on building long-term strategies: what to do when you’re stressed, bored, or hit a setback; how to rebuild confidence; how to care for the physical effects (scars, hair-loss) and reduce shame.
Why This Matters for Clients in South Florida
Living in the Fort Lauderdale / Plantation / Davie / Hollywood area comes with its own pace and stresses—busy commutes, workplace demands, family-life juggling, and the Florida climate. These all may influence triggers for BFRBs (e.g., sitting at a desk for long hours, feeling restless, evening fatigue).
Our local practice recognises:
The importance of structuring treatment to fit your lifestyle (e.g., after-hours sessions, tele-therapy for busy professionals).
Addressing the visible impacts (like hair thinning or skin scarring) that may affect your self-esteem in a community-oriented region.
Offering culturally-sensitive support attuned to South Florida’s diversity.
If you’ve been struggling with behaviours like skin-picking, hair-pulling, or other repetitive body-focused behaviours and you live in South Florida, you’re not alone — and effective help is available.
Taking the First Step
If you’re ready to explore treatment for your BFRB:
Schedule a consultation with our licensed therapist experienced in BFRBs and OCD-related disorders.
Remember: change takes time, but with the right support you can reduce these behaviours, ease the distress, and reclaim control.
Body-focused repetitive behaviours (BFRBs) such as skin-picking and hair-pulling affect more people than most assume, and they often come with shame and isolation. But evidence-based treatments — like habit-reversal training and comprehensive behavioural approaches — can help you regain control. If you’re in Fort Lauderdale, Plantation, Davie or Hollywood, and ready to break the cycle, reach out to Still Minds Psychology to begin your journey toward freedom from BFRBs. Learn more about services here.
