BRFB Brave: Embracing Self-Compassion and Acceptance with Skin Picking Disorder

Living with dermatillomania, a body-focused repetitive behavior (BFRB) commonly referred to as “skin picking disorder”, can be challenging. People living with skin picking disorder often feel isolated, ashamed, and frustrated as they battle the urge to pick at their skin, which can lead to visible lesions and scarring, emotional distress, and impaired functioning.

When we think about managing skin picking, what usually comes to mind first is treatment and learning to resist the urge to pick and, yes, that is an important part of the process. However, there’s also an emotional, internal side of skin picking. One of the most powerful tools in managing skin picking is not about the picking itself but rather an internal mindset shift - embracing self-compassion and acceptance.

Developing a deep sense of self-compassion and acceptance is key to building this inner strength. Self-compassion and acceptance can transform the way you experience skin picking and contribute to a greater sense of well-being. 

The Role of Self-Compassion

Self-compassion is broadly defined as treating yourself with kindness, understanding, and empathy, especially in moments of failure or struggle. For people with skin picking disorder, having self-compassion is critical because it helps to counteract those feelings of shame and self-judgment that often accompany the condition. Instead of harshly criticizing yourself for picking, self-compassion allows you to acknowledge your struggles in a gentle and caring way. 

Dr. Kristin Neff, a leading researcher in the field of self-compassion, identifies three core components of self-compassion:

1. Self-kindness vs. Self-judgment: Being warm and understanding toward yourself rather than critical and judgmental.
2. Common humanity vs. Isolation: Recognizing that suffering is a part of the shared human experience.
3. Mindfulness vs Overidentification: Observing your thoughts and feelings without becoming overwhelmed by them.

Self-kindness and compassion are particularly relevant to skin picking because they can help break the cycle of self-blame and encourage healing and resilience.

5 Practical Strategies to Embrace Self-Compassion

Self-compassion may seem like a small thing but it’s a powerful quality that can have significant impacts on one’s emotional well-being. And there are things you can do to enhance your self-compassion. 

1. Practice mindfulness: Mindfulness is the practice of staying present and fully engaging with your current experience without judgment. When you notice the urge to pull or feelings of frustration, take a moment to pause and observe these feelings without reacting to them. Acknowledge your emotions as they are, without labeling them as “good” or “bad.” This non-judgmental awareness is the first step in cultivating self-compassion.
2. Use Compassionate Self-Talk: Pay attention to the way you speak to yourself, especially when you encounter challenges or setbacks. Replace harsh, critical thoughts with kinder, more supportive ones. Instead of thinking, "I can’t believe I did this again, I’m so weak," try reframing the thought to something more compassionate, like, "I had a difficult moment, but I’m working on it. I choose to give myself grace." This shift in self-talk can dramatically improve how you feel about yourself.
3. Create Self-Compassionate or Self-soothing Rituals: Develop a daily ritual that reinforces self-compassion. This could be as simple as placing your hand over your heart and taking a few deep breaths while repeating a compassionate mantra, such as, “May I be kind to myself today.” You can also use fidget toys or stress balls to keep your hands busy, offering a physical outlet that doesn’t involve harming your skin. Consistent practice can help you internalize these feelings of self-compassion, making them a natural part of your response to challenges.
4. Celebrate small wins: Breaking the cycle of skin-picking can take time, and progress is often gradual. Celebrate even the smallest victories, such as going a day without picking or using a healthy coping strategy. These small successes build resilience and reinforce your commitment to self-care.
5. Seek support: Having genuine support and acceptance from friends and family can make the journey to recovery feel less isolating. Whether it’s sharing your experience with a trusted friend or joining an online community for people with BFRBs, seeking support can reduce the isolation you may feel. When you realize that others struggle with similar issues, it becomes easier to extend the same compassion toward yourself that you would offer a friend.

Acceptance: Embracing the Journey

Along with self-compassion comes the need for acceptance. Acceptance is an often misunderstood concept. Acceptance does not mean resignation or giving up on improving. Rather, it is about acknowledging where you are in your skin picking journey without attaching guilt or shame to the process. Acceptance allows you to create space for change by reducing the emotional burden of self-judgment.

3 Tips for Encouraging Acceptance

Just like you can learn self-compassion, you can foster acceptance too. 

1. Accept imperfection: While the exact cause is unknown, skin picking disorder is thought to arise in part from a desire to "perfect" the skin by picking at perceived imperfections. Recognizing that imperfections are a natural part of being human can reduce the impulse to pick. Practice looking at your skin with a neutral or compassionate gaze, rather than focusing on perceived flaws.
2. Adopt a holistic approach to healing: Recovery from skin picking is rarely a straight line. Some days will be better than others, and that’s okay. Accept that there will be ups and downs and focus on the bigger picture. This mindset will allow you to stay grounded, even when setbacks occur.
3. Forgive yourself for lapses: You may have days when you slip into old habits. The fact is, relapses can happen. Instead of dwelling on the lapse, remind yourself that healing is a journey. Forgiving yourself for not being perfect is a powerful act of self-compassion.

Putting It All Together

Cultivating self-compassion and acceptance helps build emotional resilience, which in turn fosters a more positive self-image and may help to reduce symptoms over time. When you view yourself with kindness and patience, you create an environment for healing that goes beyond your skin picking. By practicing self-compassion, you sow the seeds of self-confidence and resilience, even in the face of ongoing challenges.

References 

1. Anderson, S., & Clarke, V. (2019). Disgust, shame and the psychosocial impact of skin picking: Evidence from an online support forum. Journal of Health Psychology, 24(13), 1773–1784. https://doi.org/10.1177/1359105317700254

2. Ortiz, A., Goold, A., Zhang, J.W. (2023). Self-Compassion, Personal Improvement, and Motivation. In: Finlay-Jones, A., Bluth, K., Neff, K. (eds) Handbook of Self-Compassion. Mindfulness in Behavioral Health. Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-031-22348-8_12