I have never stopped picking at my skin, not even for a full day in the past… at least 15 years now. I’m okay with this fact because of the lack of resources in my area to treat this condition, so I had to accept that this would be a part of me forever to varying degrees and learn that I am still a person worthy of self-love despite my everlasting battle with Dermatillomania. Last night was a prime example for me of just how entrenching this disorder can become, seemingly erasing everything I’ve learned about myself, my needs and triggers, during this journey of “balance”.
I am a long ways from the days and nights I would spend up to 8 hours hunched over on the bathroom cabinet sink (see how the paint wore away) just picking while trapped in my racing thoughts. My eyes served as a body scanner as I would start at my face with my fingers roaming down my body until I reached my ankles- then, rinse and repeat the cycle. Despite learning of my specific patterns that led up to a night such as last, being curled up on the floor of my cubicle of a bathroom for two and a half hours, I must not have been listening to earlier signals that my body- or mind- were warning me just a few hours before.
Cognitive Behavioral Therapy (CBT) is a method that is practiced by many mental health professionals to treat this condition, whether or not they fully comprehend the dynamic and multi- faceted nature of this disorder. My experiences with “Dr. A”, who I speak ill of in FOREVER MARKED: A Dermatillomania Diary consisted of her executing CBT straight out of a workbook without quite understanding *ME*. Although my suicidal self could have certainly done without being called whiny and selfish, among the string of other demeaning terms, I did learn more about myself through her feeble attempts of ridding me of my picking compulsion.
I was asked to keep a daily log that included a few simple questions so I could record and analyze my specific behavioral patterns while finding ways to intercept at certain trigger points. Although I have added a few more to the list for further self-investigation, these are the helpful questions that you need to ask yourself every time you engage in the behavior:
(a) What were you doing before you engaged in the behavior?
(b) List the areas you picked or pulled at, in order
(b) What time did you start to pick/ pull and for how long?
(c) What were you thinking about when it happened?
(d) How were you feeling at the time?
(e) How were you feeling during the behavior?
(f) What instruments did you use? (hands, tweezers, etc)
(g) How did you feel afterward?
Make sure to record them immediately after the event while the scenario is still fresh! If you are unable to answer all questions the first few tries, don’t worry, because they will be on the forefront of your thoughts so you know what to be mindful of in future interactions. Not only is the rigorous recording also supposed to deter you from picking (or pulling if you have Trichotillomania) so that you don’t have to take the time for the critical self-reflection of journaling, it helps to establish what the best course of action is for your treatment plan. Unfortunately, “Dr. A” only led me through this portion of the treatment before dropping me as a patient like a hot potato, passing blame onto me for my picking not getting better, instead of helping me work through my new found awareness.
I learned that I am a consistent night picker, which makes sense because the body slows down at night and inhibitions are at their highest. Whatever your “drug of choice” is, everyone is more prone to fall into old patterns when they are sick, tired, in pain, and even hungry. While the list of emotional triggers is much longer, the physical provocations are proof that everyone in the world is, in fact, big babies. When babies are in need of emotional or physical attention their first reaction is to cry because that’s all they know and that it oftentimes comes with them getting what they need from a parent. Since we have once felt positive and relieving emotions after engaging in our BFRB, the reward resulted in our anxiety levels being met through these self-soothing coping mechanisms. After turning into a compulsive and life-altering disorder, our picking or pulling has become our silent cry that soothes us when our body or minds become uncomfortable.
So what happened to me last night? I used the washroom at midnight and enacted my usual refusal to stay up all hours of the night unlike the schedule in my previous life for the very reason of not being trapped in the bathroom, being left alone with my disorder. Somehow, getting ready for bed when I normally do still didn’t prevent me from losing time and losing myself last night. Maybe it was a result of me coming down with the cold that my fiance just finished having (my throat started hurting today), a reaction to no longer taking the pain medication for my back that was bloating me up without enough of a positive effect, or I was simply trying to cope with how I can’t find damn-well decently priced and alright- looking boutonnieres for our wedding in 68 days!
Whatever your drug, compulsion, addiction, disorder, or habit is, don’t let a slip-up dictate where your recovery is going. Luckily I am far past the self-degradation that so many others engage in (naturally) after having a relapse. Tonight I plan on relaxing and come bedtime when the battle ensues like every night of my life, I’ll be freshened up with a shower and relaxed enough to transition to bed. If it doesn’t produce desired results, then I’ll take it day by day until I’m back to my usual “managed” self.