Going Cold Turkey: If It Was Easy, Everyone Would Do It

You’ve probably seen the “challenges” to stop picking around the internet. You might have even tried a couple yourself. A few days in and the urge to pull is overwhelming! Why can’t you just stop? That’s the million-dollar question, isn’t it? 

Just about everyone has picked at a scab or bitten their nails just a bit too much. But when skin picking becomes repetitive and affects your well-being, it’s more than just a “bad habit”. Skin picking (also known as dermatillomania) is an obsessive-compulsive related disorder characterized by pathological skin picking resulting in damage to the skin. It is driven by powerful compulsions that can be difficult to control. It takes more than a challenge to turn them off.

Just why someone picks isn’t well understood and there is no one single treatment for it. So, the idea of going cold turkey might be really appealing. After all, there are probably some people who have done it. But does it work? Can going cold turkey really stop your picking once and for all? Or is it better to take it slow and steady in treatment? The experiences of people who have tried cold turkey tell a tale of just how hard it can be.

Going Cold Turkey – What Does That Even Mean?

You’re probably most familiar with the term “cold turkey” as it relates to smoking cessation or quitting alcohol. In fact, cold turkey is a broad term that essentially means you are trying to break a habit by sheer willpower alone. When you go cold turkey, you’re essentially saying that you are all in, zero deviation, and you are going to dig deep and just gut it out until the habit is broken.  

Going cold turkey is appealing to many people and one of the most popular choices for breaking a habit. It’s also the method with the highest failure rate. Still, there’s no shortage of people who will tell you they stopped doing X and never looked back. Can it happen? Sure? Does it usually? No. 

For the vast majority of people, going cold turkey with skin picking – or any habit – is akin to winning the lottery. Lots of people play but very few can say they’ve hit that jackpot.  

Skin picking, while not a “habit”, shares many qualities of a habit. It’s no coincidence that Habit Reversal Training (HRT) is one of the primary interventions used to treat skin picking. So, it’s not surprising that people might try to go cold turkey in an attempt to stop picking. 

What is their experience? Does it help?

Talking Cold Turkey

In the beginning, the idea of going cold turkey can be encouraging, even exciting. There is a sense of “I am strong.” “I can do this!!” That in itself can be quite motivating. There is hope! 

Many people who pick express that they often start each day with the intention of going cold turkey but find it much harder to abstain than they expected. Some describe it as almost “debilitating”. They start off in a good place, highly motivated, but the urge to pick can be intense. They often find they’ve picked even a tiny spot sometimes not even realizing it. The result is often feelings of failure and disappointment. And, the daily starting over. “This time is the last time” is a common sentiment that describes the process. Some people report that they are able to stop for some period of time, but the general consensus seems to be that they find themselves picking again despite their best efforts. Going cold turkey seems to become a cycle that while well-intentioned, doesn’t usually eliminate the picking behavior for most.

Still, people try and hold on to hope that this time will be different. And some do report success in reducing picking. Others employ strategies like timers, journals, and other tools to try and abstain from picking. 

What’s clear from the real-life experiences that people share is that cold turkey is hard and there are a lot of stops and starts. 

So, if it’s so popular, why doesn’t cold turkey work very well?

• Low success rate. It’s estimated that less than 5% of people who try it are successful. 
• Going cold turkey is super hard.  You have to be prepared to be really uncomfortable – some would say miserable – for an extended period of time. 
• Slip ups and restarting is common. Each successive attempt becomes harder because you will not forget how miserable you were the last time. 
• Going cold turkey can be risky. When you take away something your body and mind are used to (in this case skin picking), there’s a reaction. Take the picking away may increase feelings of anxiety or depression. 
• There’s no plan. You just do it…and hope it works out. It’s kind of like tightrope walking without a net. 

It’s been suggested that a big part of why cold turkey doesn’t work well for skin picking is that when you stop picking, it creates an internal tension or pressure. You’re doing well, all your energy is going into not picking, and then BAM! Something happens that’s out of your control and takes all your energy and attention. Your motivation is zapped and as we as humans often do, we revert to our security blanket, our coping strategies, which soothe us when we’re stressed out or anxious or whatever that trigger is for you. That feeling of being out of control returns and the pressure builds. Picking is a way to relieve that pressure. 

Now you know, life has a way of throwing a monkey wrench into the mix at the most unexpected moments. Skin picking is thought to be driven by a compulsion to pick (pressure) so when you’re faced with pressure whether it’s from within or from life being life, you’re going to gravitate to what you know works to alleviate pressure. And the harder you resist, the harder it becomes to resist. It’s a complicated cycle and, for most people, cold turkey is no match for that kind of pressure. 

Not being able to stop is not a matter of willpower, commitment or anything of the sort. Skin picking is a complex disorder and requires a more targeted intervention to stop.

Getting Help

There are a number of therapies and approaches to treating skin picking that can help. Therapies such as HRT and cognitive behavioral therapies can help you reduce picking and learn better ways of coping. Unlike going cold turkey, you don’t have to go it alone. You can find supportive care and a supportive community to help. In support, there is hope. 

References

1. Scott, S. (2017, July 12). Is quitting cold Turkey the right choice? Retrieved from https://www.developgoodhabits.com/quitting-cold-turkey/

2. Anyone try to just… quit cold Turkey? (n.d.). Retrieved from https://www.reddit.com/r/Dermatillomania/comments/t6zspw/anyone_try_to_just_quit_cold_turkey/

3. KIM ON SKIN. (2020, April 21). This is why stopping your compulsive skin picking doesn't work! [Video]. Retrieved from https://www.youtube.com/watch?v=kAPTZZtA2ts