My Approach to Working with People with Body Focused Repetitive Behaviours.
I’m so glad you’re here.
Even if we don’t go on to work together, my hope is that just by reading this far will have helped you feel slightly less alone.
So, you’ve probably been battling with your urge to pick or pull for quite awhile now. No doubt you’ve tried to find some support, perhaps in the form of therapy or counselling but, for whatever reason, it’s not been all that you’d hoped for. Perhaps you’ve been judged or experienced a lack of understanding and knowledge or even been in the uncomfortable position of having to be the one educate others about what it is that you’re dealing with. Help has been hard to find.
That’s probably made you feel very alone and quite vulnerable.
Where We Are Now.
Body focused repetitive behaviors are generally not well understood and not a lot of research has been done into them.
The DSM-5 (Diagnostic and Statistical Manual) lists them as ‘obsessive-compulsive and related disorders’ but this is seldom helpful when sufferers ask for help. Theorists have associated them with a wide variety of causes including grooming behaviors that have gone too far, self-harming behavior and, least helpful of all, simply as unwelcome habits able to be unlearned.
Because there is little formal training specific to working with people battling body focused repetitive behaviors, there’s a lack of deep understanding within the helping community of its origins and complexity. In the absence of deeper understanding, treatment often aims at controlling the behavior, at a symptomatic level, without addressing the underlying factors that are the root cause. Factors that contribute to, and reinforce, the cycle of behavior are largely left without closer examination. So, the teaching of cognitive skills, through the talking therapies, has become the preferred default approach and, although this is certainly useful, there is deeper work to be done.
What I see.
Your body focused repetitive behavior, your skin picking, nail biting, hair and eyelash pulling, is not just a habit and is also not something that you are always consciously aware of doing. It has a function and is a strategy that you use to help yourself to stay emotionally safe in the world.
I think of it as a signalling system, your own elegant and very personal way of letting yourself know that ‘Something’s not right!’, that something’s out of balance. Just like an infant will begin to fret and cry if hungry, wet or frightened, you’re signalling to yourself that something needs to be attended to. It’s also a response to that ‘Something’s not right!’ feeling. Engaging in your BFRB is the method you’ve been using to make it feel alright again and to survive. If you feel satisfaction and pleasure, it’s because you’re meeting a need.
Afterwards though, an uncomfortable feeling starts creeping in. It might be shame, frustration or physical discomfort from the damage you’ve caused. This probably sets you right back to feeling that ‘Something’s not right!’ feeling but now complete with the inescapable urge to put things right again and so you begin the cycle once more.
Does it help to think about it this way…?
You’ve quite naturally been trying to help yourself come into balance but the method you’ve had to use is causing you physical and emotional harm. That’s what we need to work on - where it comes from, what keeps it going and how you can meet that need in a more appropriate way.
My Approach.
I don’t see you as someone that needs to be fixed. I see you as someone who needs to be understood, cared for and accepted for the amazing human that you are.
I respect you for wanting to take the first steps. I appreciate your courage and I hope that you will allow me to walk that road with you, sometimes as a guide but always as a trusted companion.
I hope that in our work together you’ll see that you are so much more than the scars that you carry.
How I Work, the Nuts and Bolts...
I work specifically with individuals who are affected by body focused repetitive behaviors and this is what you might expect if you get in touch with me:
First of all, I’m quite friendly. I’ll suggest that we have an initial conversation of about an hour in length at a time that suits us both to get to know one another. There’s no fee for this as we’re just testing the water. It’s often the case that individuals find even this initial conversation starts to help them feel better. Here you can ask all of the questions that you need to and I’ll do my utmost to respond thoughtfully. I will also ask you some questions so that I have a very general idea of who you are and what you’d like to focus on.
If, as we talk, I feel that what I offer might be of help to you and that it would be appropriate for us to begin working together then (if you feel the same way) I’ll outline the next steps that we might take and let you know my fees and availability.
If you decide to go forward and work with me then we’ll meet online on Zoom for an hour at a time and we’ll agree a schedule that suits.
If you’d like to get in touch, please click here.
Training
Advanced Practitioner Diploma in Integrative Psychotherapy (APDIP), through the London School for Clinical Communication and Psychotherapy (currently training towards full NCIP, BACP and BPC registration as an Integrative Psychotherapist)
Eye Movement Desensitisation and Reprocessing (EMDR) and Psychological Trauma through LSCCH
ICF Accredited Diploma in Transformative Coaching, through Animas Centre for Coaching.
ICF Accredited Certificate in Group Coaching and Facilitation, through Animas Centre for Coaching
Polyvagal Theory for Embodied Trauma Recovery, with Dr Ariel Schwartz PhD, through PESI continuing Education
Certificate in Traumatic Stress Studies, through the Trauma Research Foundation
CCTP Trauma Treatment Certificate, with Dr Janina Fisher PhD through PESI Continuing Education
Contemporary Practices in the Treatment of Body Focused Repetitive Behaviours (BFRBs) with Dr Marla W. Diebler PsyD, ABPP (The Center for Emotional Health of Greater Philadelphia and Dr Renae M. Reinardy PsyD (Lakeside Center for Behavioural Change)
Clinical Training in the Treatment of Body Focused Repetitive Behaviours through the TLC’s Virtual Professional Training Institute (VPTI) led by Dr. Charles Mansueto, Dr. Fred Penzel, and Ruth Golomb, M.Ed., LCPC.
The Identification and Treatment of Body focused Repetitive Behaviours Certificate through the Department for Clinical Neuropsychology University of Hamburg Metacognitive Training.
Certificate in Acceptance and Commitment Therapy through Cardiff University
A Personal note.
I’m deeply imperfect, very human, kind of scrappy and a bit of a nerd.
I hate having my photo taken, love gravel cycling and I’m rubbish at parties.
I’m unconventional but have a reverence for continued professional development and a massive respect for scientific thinking.
I’m also extremely stubborn and resourceful and I’ve had to stitch together the training that I needed to do this work from so many different and interesting places.
I’m enthusiastically Integrative and cross-disciplinary in my approach because I feel profoundly that that’s what will serve you best.
