Relapse Prevention Strategies for Skin Picking Disorder

Skin picking disorder is a chronic condition that lasts a lifetime, which means it never goes away completely. However, it is possible to live without picking, and many people do so successfully. People in recovery from skin picking disorder learn to manage the urges and behaviors similar to the way people with asthma learn to manage their condition. It takes awareness, perseverance, and resilience but even then relapse can happen.

Relapse & Lapse: A New Language

The concept of relapse is most associated with addiction. The word itself connotes dread, fear, or failure. The dictionary definition does not inspire confidence either “suffer a deterioration after a period of improvement.” Contrast the definition of “lapse” which is to “pass gradually into an inferior state or condition.” How would you like refer to a setback?

In recovery, language means a lot because it conveys attitude and meaning. When someone forgets to take their maintenance medication and has an acute asthma exacerbation, they are not described as someone who relapsed. People who exercise regularly and have a setback in their schedule aren't accused of a relapse. Therefore, when making lifestyle changes involved with managing skin picking disorder, we are not talking about relapse either. Change is hard. Sometimes life gets hard and setbacks experienced. Lapses happen.

Tips for Lapse Prevention

Accept that lapses will happen. If you expect to experience a setback at some point, you can have realistic expectations about your recovery and plan accordingly. Identify triggers and high-risk situations. Part of managing a chronic condition is recognizing what sets it off. People who have asthma attacks when they are around animals tend to stay away from animals. Figure out what your triggers are for picking and either stay away or create ways to deal with them when they arise.

• Be prepared. In therapy, you likely learned ways to keep your hands busy or developed competing responses to take the place of picking. If your fidget spinner is your go-to tool, make sure you have it with you all the time. Some people use grounding tools like aromatherapy to manage stress, so if you do, make sure you have it with you at all times.
• Preventative care. Take care of YOU! Live a balanced lifestyle with a healthy diet and regular exercise. Maintain low-stress levels and engage in self-care before you need it.
• Lifestyle management. Establish routines, create stimulus controls and competing responses.
• Use habit apps. Devices like Keen from HabitAware help you stay aware of hand movements that lead to picking and alerts you.
• Social Support. Social support is a huge benefit, and when you enlist the help of your supportive others, they can help you recognize signs or triggers before you are aware. For example, maybe your best friend notices you are a little more anxious than usual. Let your friend know how to alert you so you can take proactive action.
• Be someone’s people. People in recovery who help others in recovery experience significant benefits from being someone else’s supportive other. It keeps you focused on modeling good behavior and coping skills as well as improving self-esteem.

Deal with a Lapse

Be gentle with you. Life happens, and sometimes setbacks occur too. Resist the urge to scold, berate, condemn, or otherwise beat yourself up. Stop the negative self-talk as soon as you notice it and replace it with positive self-talk. 

• Process. Discuss with your therapist or a supportive other what happened. The key to processing is not to dwell on the lapse, but to determine what the trigger may have been or what you may have needed to prevent the lapse. Think of this as the learning part of the experience.
• Adjust. Once you identify the trigger, come up with what you’ll need to deal with it next time. Act immediately, because the longer you wait, the harder it will be to overcome it.
• Celebrate your victories. For example, maybe you interrupted your picking behaviors and stopped it before you injured yourself. Even though you had a setback, find something that went good, that you did right, or anything positive that resulted.
• Keep on! Add what you need to routine and keep working on your recovery. You deserve it!

Actively Engage

Changing language is not cause for complacency. Trading the negativity associated with the word relapse and accepting that lapses will happen does not open the door for relaxing into apathy. Positive recovery experiences require active engagement to maintain. Take steps to care for yourself and when lapses occur, learn, adapt, and keep on recovering.