Body-Focused Repetitive Behaviors

Information & Approach

According to the TCL Foundation, Body-Focused Repetitive Behavior (BFRB) is a term for a group of related disorders including, but not limited to, hair pulling, skin picking, and nail biting. These behaviors are not habits or tics; rather, they are complex disorders that cause people to repeatedly touch their hair and body in ways that can result in physical damage. 


Common BFRBs Include:

Hair-Pulling Disorder (Trichotillomania) causes people to pull out the hair from their scalp, eyelashes, eyebrows, and other parts of the body resulting in noticeable bald patches. 5-20% of people who have hair pulling disorder also swallow the hair. 


Skin-Picking Disorder (Excoriation) causes people to repetitively touch, rub, scratch, pick at, or dig into their skin, resulting in skin discoloration, scarring, and even severe tissue damage and disfigurement. 


Nail-Biting Disorder (Onychophagia) causes people to bite their nails past the nail bed and chew on cuticles until they bleed, leading to soreness and infection.


Other BFRBs include frequently chewing on the inside of the cheeks and biting the lips until they bleed.


I am trained in and offer a variety of evidence-based treatments for individuals struggling with Body-Focused Repetitive Behaviors (BFRB). These include Cognitive Behavioral Therapy (CBT), ComB Model, and Habit Reversal Training. I work with all ages impacted by BFRBs to help them overcome grief and loss, associated with the BFRB, thorough exploring the roots of the behavior, understanding the scope of the impact, and developing strategies to reduce or eliminate the BFRB.