For Partners

If you suspect your partner is picking at his/ her skin, it can be frustrating as a loving companion to sit back and watch. Often, I receive e-mails from partners who are upset for various reasons due to a partner’s picking which also includes questions on how to communicate with him/ her. The following includes practices I have used in my personal life and continue to promote due to their effectiveness in creating an open conversation about skin picking in a relationship.

 

1. “I see my partner skin picking and even trying to hide it from me. What do I do?”

103590651010038483629_7979501822000498788_oThere are many ways to approach your partner without distressing her. Due to the sensitivity of compulsive skin picking and on how many levels it may be affecting her, you must allow her to feel in control of the conversation. In the past, she may have been bullied, rejected by professionals, scolded by parents, or mistreated by past partners.

Try talking to her when she’s in a better mood, asking her if it’s okay to sit down without electronic distractions (computer, tv, cell phone) because you are concerned about her. Once you have her full attention, you can bring up that you’ve noticed that she’s been picking at her skin and ask her what her opinion on it is. It is important to tell her that you don’t judge her and understand that there are people who struggle with picking at their skin, which doesn’t make them any less of a person. From there, she will hopefully open up to you and discuss her feelings on the situation. Assure her it’s something she doesn’t have to be ashamed or embarrassed about and you accept her 100%.

Don’t belittle your partner, tell her that it’s making her skin worse, tell her to “just stop”, or slap her hand. All will result in her trusting you less and she will further isolate herself, feel less loved/ accepted, and it will shut down communication.

 

2. “He doesn’t want to talk about his picking. He just pushes me away and I don’t know how to talk to him about it.”

While the above question addresses how to go about communicating with him, he may not feel comfortable talking about it for various reasons; he may be in denial, feel like no one could possibly understand, not be aware that there are others with this condition, or is afraid of being rejected (to name a few). It may take small steps for him to open up to full disclosure about his struggle.

You must respect that he does not want the conversation to continue. However, you can leave him with a few thoughts that may make him more apt to discussing it in the future:

  • Tell him you love him no matter what and are there for him
  • Tell him that you care for him and do not judge him
  • Educate him about the resources available for support and treatment
  • Reach out by letting him know you’re willing to listen whenever he’s ready
  • Provide him with online resources for if he would rather talk to who have this condition to feel more comfortable with

Don’t continually push your partner into talking to you about this private matter- he may have never even voiced it to anyone before. By attempting to force him to open up he may feel that you don’t have his best interest in mind, that you’re only concerned about how the behavior makes you feel, that you don’t recognize how it affects him emotionally, or that his relationship to you is on the rocks. Never give an ultimatum of “picking or me” or “talk about it or I’ll leave” because that furthers the feelings of being misunderstood, pressured, and rejected.

 

3. “How do I get her to stop?”

The truth of the matter is that you can’t, for the long term, if she has Excoriation Disorder. When you see her picking, there are many things you can do (there are many things she can do, if interested)… but you shouldn’t until you have spoken to her. She may not be in a place of wanting to stop picking or she could be feeling hopeless about her situation so checking in with her to see what you can do is best.

Ask her if she would like you to touch her hand when she’s picking subconsciously while so that she is made aware that she’s doing it. If she’s in the washroom for too long, ask her if it’s okay to knock on the door to remind her that she’s been in there for “x” number of minutes. Building respect with someone who has issues surrounding skin picking is key to gaining trust from the sufferer, but recognizing her lead is important in empowering her to feel better about herself in general.

Don’t yell at her, intimidate her, withhold affection as a punishment if she picks, or tell her that she’s “strange”, “a freak”, or “different”. She needs a partner who can accept her for who she is, as she is, without judgment or feeling like she’s an expendable partner for her condition.

 

4. “That sounds fine, but I don’t want to enable the behavior. How do I get him help or convince him that he needs it?”

The tricky part about Body-Focused Repetitive Behaviors is that help is not always readily available. While psychologists are great at helping clients with a multitude of mental health afflictions, BFRBs are not high on that list due to a lack of information, minimal research, and a lack of adequate training that can help a professional practice evidence- based approaches specifically for these disorders. If he cannot stop picking and has tried various methods to stop, he probably knows that he needs outside sources to supplement his efforts in stopping or reducing the behavior but may not be optimistic that it will help.

The choice is his whether to seek out psychological counseling for his picking. In order to effectively treat Excoriation Disorder, other parts of a sufferer’s life needs to be examined; for this reason, going to a professional who is not BFRB- trained could still be beneficial in treating certain aspects that may have caused him to begin picking or even help him with how to cope with the disorder.

There are no treatment programs for family members to abide by, regarding the fear of being an enabler. When a disorder that has so little in supports, research, understanding, and treatment providers is affecting someone the best thing you can do is respect his wishes and support his overall well-being.

 

If you are a partner who has a question, please leave it in the comments section below. Depending on the frequency of the question asked the article may be revised to reflect this new information. Check out BFRB specialist Dr. Fred Penzel‘s article for significant others.