BFRB Awareness Campaign, Times Square, NYC

It is estimated that about 3% of the population has a body focussed repetitive behavior (BFRB). Body Focused Repetitive Behaviour “is an umbrella term for any chronic behavior that causes a person to consistently cause physical damage to oneself unintentionally through a compulsive act in order to relieve anxiety.” The key difference between BFRB and other compulsive behaviours that cause harm to the body is that BFRBs are characterised by direct body-to-body contact. It is collectively grouped among Obsessive Compulsive and Related Disorders in the Diagnostic and Statistical Manual 5 (DSM5). These behaviours can manifest in a variety of ways, with the overarching similarity between the different disorders being the regulatory effect experienced by the person engaging in this behaviour, on overwhelming emotions or cognitive thought patterns such as stress or anxiety. There a number of different BFRBs, namely:

• Trichotillomania (compulsive hair pulling)
• Excoriation Disorder / Dermatillomania (compulsive skin picking
• Onychophagia (compulsive nail biting)
• Trichotemnomania (compulsive hair cutting)
• Dermatophagia (compulsive skin biting)
• Rhinotillexomania (compulsive nose picking)

There are other named BFRBs closely related to these main disorders listed above, but the most common of the BFRBs is dermatillomania and trichotillomania.

Widely Experienced, Little Known

Although a relatively common disorder, it often goes undiagnosed, largely due to the lack of awareness that these behaviors are in fact clinical disorders, and due to the intense shame and guilt that often goes hand in hand with the disorder. As a result people who have these conditions suffer alone, ashamed, and in silence. The greatest travesty of this is that the loneliness and isolation can be prevented if there was greater awareness and acceptance of these disorders. This is the work and the mission of organisations like The TLC Foundation for Body Focused Repetitive Behaviors. Previously known as The Trichotillomania Learning Center (TLC), much of their research and awareness when they first started was centred around trichotillomania, one of the BFRBs. However as their reach grew they started to provide resources and information about other BFRBs as well. They had always been aware of the under-representation of the other BFRBs and when the time was right and they had the resources to do so, the rebirth of TLC gave way to a new home, the TLC Foundation for BFRBs. 

Sharing knowledge. Supporting recovery. Finding a cure

This is the mission of the TLC Foundation. Much of the strides we have made in understanding BFRBs and developing treatment methods to address them has been due to the efforts of TLC to raise awareness among sufferers and health professionals alike. They also provide training resources for therapists to better equip them to deal with BFRBs more effectively. Their most recent awareness campaign, probably their most extravagent is shown in the video above. They have been flighting an advert for the TLC Foundation to raise awareness about hair pulling and skin picking in New York Times Square between April and July 2016. Their reasoning is that if 3% of the population have a BFRB and 50,000 people cross Time Square Daily, this ad campaign has the potential to reach at least 1500 people with a BFRB each day - plus countless others who know someone with one of these disorders, with this compelling message of solidarity and hope.