Body-Focused Repetitive Behaviors (BFRBs) like hair pulling or skin picking can be confusing and upsetting.
With skilled, caring support, change is possible—and you don’t have to face it alone.
What Are BFRBs?
Body-Focused Repetitive Behaviors (BFRBs) are repeated actions, such as picking skin or pulling hair, that can harm the body or cause distress. Many people try to stop these behaviors over and over without success. A behavior is considered a BFRB when it causes distress, interferes with daily life, and isn’t better explained by another condition.
Common BFRBs include:
- Hair pulling (trichotillomania)
- Skin picking (excoriation disorder)
- Nail biting or picking
- Biting lips, cheeks, or tongue
- Nose picking
- Eating hair or skin
What BFRBs Are Not
BFRBs are often misunderstood. Here’s what they are not:
Not Obsessive Compulsive Disorder (OCD)
Though they are related to OCD, BFRBs are distinct. They may look like compulsions, but they don’t include obsessive thoughts or fears of harm. They often bring brief comfort or satisfaction instead of relief from intrusive thoughts or intense anxiety.
Not a Tic Disorder
Tics are sudden and involuntary. BFRBs tend to be more deliberate or habitual and may bring relief or pleasure.
Not Self-Harm
Self-harm involves trying to cause pain or injury. People with BFRBs don’t want to hurt themselves—they’re often trying to manage stress, boredom, or other feelings.
Not Rare
Around 3% of people worldwide live with a BFRB. However, these conditions are often overlooked.
Not Just a “Bad Habit”
BFRBs are complex conditions that often need professional help. Willpower alone is rarely enough.
Not Always Caused by Anxiety
Anxiety and stress can play a role, but BFRBs also happen when someone feels bored, tired, or overstimulated.
Not Untreatable
While there’s no single “cure,” many people learn to manage BFRBs and lead satisfying lives. Therapy and support can build awareness, reduce harm, and improve coping.
Frequently Asked Questions
1. How do I know if my behavior is a BFRB?
If a repeated action—like hair pulling, skin picking, or nail biting—causes distress or physical harm, it may be a BFRB. Our clinicians can help you understand and take next steps.
2. Who do you treat for BFRBs?
We work with children, teens, and adults who experience BFRBs. Families can also receive coaching and support to help at home.
3. What treatments help with BFRBs?
We use proven, research-based methods like Comprehensive Behavioral Treatment (COMB) for BFRBs and Habit Reversal Training to reduce harm and manage urges.
4. How much does treatment cost?
The Concord Center is a self-pay practice. Many clients receive partial reimbursement from out-of-network insurance, and sliding-scale options are available.
5. Can therapy be virtual?
Yes. Many clients choose secure telehealth sessions for convenience or privacy.
6. Can family members be involved?
Yes. Family involvement often helps recovery, especially for children and teens. We offer parent coaching and family sessions when helpful.
Next Steps
If you or someone you love struggles with a BFRB, you’re not alone. At The Concord Center, our clinicians offer compassionate, evidence-based care for individuals and families ready to make change.
Complete an inquiry form for individual services, and we’ll follow up to connect you with a clinician who’s a good fit.