What are Body-Focused Repetitive Behaviours (BFRBs)?
Body-Focused Repetitive Behaviours (BFRBs) are a group of complex mental health disorders that are characterised by the uncontrollable urge to pull, pick, scratch, cut, or bite one’s own hair, skin, or nails.
People with BFRBs often experience high levels of emotional distress as a result of these behaviours which can severely impact everyday life, causing avoidance and disruption at work, school and social situations. The behaviours can also lead to damage to the body, such as thinning hair or bald patches, skin lesions, scarring, and infection.
Despite affecting an estimated 4 million people in the UK and Ireland alone, these conditions are still incredibly stigmatised and misunderstood, resulting in many people with BFRBs living in secrecy and shame. In fact, only 50% of people with BFRBs seek help from a healthcare or therapeutic provider. Our main objective is to lessen the shame surrounding BFRBs, by providing providing a warm and welcoming community that thrives on acceptance.
Types of BFRBs
Excoriation Disorder / Dermatillomania / Skin Picking Disorder is the repetitive urge to pick or scratch at the skin. Common areas include the face, lips, arms, back, and legs. The behaviour can lead to cuts, lesions, scarring, and in severe cases, infection.
Dermatophagia / Skin Eating Disorder is the repetitive biting or chewing of the skin, most commonly around the fingers. This can lead to bleeding, skin discolouration, scarring, and thickening of the skin that has been repeatedly bitten. It is common in people with Skin Picking Disorder.
Morsicatio Buccarum / Cheek Biting Disorder is characterised by irritation or injury to the the lining of the inside of the cheek, caused by repetitive chewing, biting or nibbling.
Morsicatio Labiorum / Lip Biting Disorder is the chewing, biting, or nibbling of the lips, causing damage to the skin.
Morsicatio Linguarum / Tongue Biting Disorder is the chewing or biting of the tongue, leading to injury of the tongue.
Rhinotillexomania / Nose Picking Disorder is the compulsive picking of the nose. The picking of nasal mucus is a common behaviour, however, it can become a BFRB when the person is unable to stop the behaviour despite it causing distress and damage to the lining of the nose.
Trichotillomania / Hair Pulling Disorder is the repetitive urge to pull out hair from the body. Commonly, hair is pulled from the scalp, eyebrows, or eyelashes, but can also be pulled from elsewhere in the body such as the arms, legs, or pubic area.
Trichophagia / Hair Eating Disorder is the chewing, sucking, or swallowing of hairs. It is often associated with trichotillomania. In some cases, the ingested hair can cause blockages in the intestines (Rapunzel Syndrome), which is a medical emergency.
Trichotemnomania / Hair Cutting Disorder is the repetitive urge to cut or shave the hair using scissors or other tools. This hair cutting can lead to noticeably uneven hair, bald patches, and cuts or damage to the scalp.
Onychophagia / Nail Biting Disorder is the biting of the nails leading to damage to the nail bed and cuticles. It is the most common BFRB, affecting approximately 20% of the population.
Onychotillomania / Nail Picking Disorder is the repeated picking or tearing of the nails, damaging the nails, cuticles and nail bed. Many people with onychophagia also have onychotillomania.
Mucus Fishing Syndrome is the compulsive removing of eye mucus, leading to damage to the membrane of the eyes. It can cause excessive mucus production, which is worsened the more the person removes the mucus.
Do I have to be in the UK or Ireland to join support groups?No you don't, we have regular attendees from around the world, so you are welcome to join our support groups and events if the time is suitable for you! All of our support groups and events are in English.
I don't want to attend the support groups but would like to be part of the community, how would I do that?Our private Facebook group is available for people to find support outside of our support groups. Since it is private, your membership will not be shown on your Facebook profile. Everyone who joins has to complete screening questions and agree to the group rules so that we can keep it a safe space for our members. You are also welcome to post anonymously if you would like. You can find the link to the group at the bottom of this page!
How do I join your support groups?Currently, all of our support groups are talking place online. To get the link and password, you can join our mailing list or contact us via our contact form.
I want to attend you support groups but am not comfortable switching my camera on. Is that okay?Of course! There is no obligation to have your camera on during the support groups. There is also no pressure to talk if you would prefer just to listen.
What do I do if my question isn't answered here?If you have any other questions, you can contact us via the "contact us" button at the top of this page!
Can children attend your support groups?At the moment, all of our support groups are for people aged 18 and over. We are working on obtaining DBS certificates and children safeguarding training for our volunteers so that we can offer support groups for children in the near future. In the meantime, we run a support group for parents of children with BFRBs online, on the first Wednesday of each month from 8-9pm.
How do I donate to you?We appreciate all donations, big or small. To donate to our GoFundMe, you can click the "Donate" button at the top of this page. Some things your donations will go towards include: - Continuation of our support groups - Venue hire for in-person support groups and events - Running of this website and mailing lists - Volunteer training - And much more!
Can BFRBs be treated?There are a number of treatments on offer for BFRBs. Therapies that have been shown to help include Cognitive Behavioural Therapy, Habit Reversal Therapy, and ComB Therapy. Attending support groups can help to lessen the internalised shame caused by BFRBs - sometimes connection is the best medicine.
Are BFRBs just "bad habits"?BFRBs are complex mental health disorders and shouldn't be reduced to habit. They are listed in resepected diagnostic manuals used by medical professionals and therapeutic providers internationally, such as the DSM-V and the ICD-10. Unlike habits, BFRBs are incredibly difficult to "break".
What causes BFRBs?As research into these disorders is in the very early stages, we don't really know why these disorders exist. Some have suggested genetic causes, environmental factors, childhood trauma, hormones, differences in neurotransmitters such as dopamine, serotonin, or glutamate, or a combination of factors!
Are BFRBs a type of OCD?BFRBs are under the umbrella "Obsessive, Compulsive, and Related Disorders" but are not a subtype of OCD. However, BFRBs and OCD do share some similarities, such as repetitive compulsive behaviour.
Are BFRBs self-harm?Self-harm is done with the intention of harming the body, often in response to emotional pain. Whereas, when a person engages in their BFRB, physical damage is created as an unintentional result of their behavior. In fact, some people find BFRBs pleasurable, and many report that it serves a self-regulation or soothing purpose.
Are BFRBs rare?BFRBs are a lot more common than once thought. It is estimated that 1 in 20 people (5%) have a BFRB. That's almost 4 million people in the UK and Ireland alone! However, despite BFRBs being relatively common, they are still heavily stigmatised and misunderstood.
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