By Katie Waits

*TW ÔÇô Discussions of Body-Focused Repetitive Behaviours (BFRBs), dermatillomania, and trichotillomania*

ÔÇ£Can you all please turn your cameras on?ÔÇØ 

ThatÔÇÖs such a familiar request nowadays. Some days, IÔÇÖll be happy to switch my camera on in a seminar. Other times, I dread those words. It usually means an hour of fidgeting, sitting at an awkward distance from the camera, constantly tilting and repositioning my screen in a bid to hide my skin. 

The last few years of high school were among the most stressful, and this stress always showed up on my skin. The anxiety of exams, friends moving away, and university applications meant that my skin suffered and I hated it. IÔÇÖd stare in the mirror or look at photos of myself and feel horribly self-conscious.  It also didnÔÇÖt help that I picked at my skin. Whenever a new blemish appeared, IÔÇÖd pick at it. At the time, I didnÔÇÖt think it was an issue. I mean, everyone probably picks at their skin from time to time, right? I thought it was normal. 

That was until my hands began drifting to my face or my neck in class, while I was reading, or talking to my friends, without me even realising it. Afterwards, my skin would usually hurt. I still didnÔÇÖt think it was a big deal, even when people started noticing and pointing it out, telling me to stop. No matter how good their intentions mightÔÇÖve been, IÔÇÖd get extremely irritated whenever someone told me to move my hands away from my face. Spots and scratches would pain me longer than they should have and would take ages to heal properly. Dark pink patches and scars wouldnÔÇÖt disappear, becoming a permanent feature on my face, back, and neck. 

When I started university, it got worse. With the worry of all of the change, my skin was in terrible condition. Meeting new people and trying to make a good impression made me all too aware of my appearance. I remember walking to lectures, the JOMEC building being quite a walk away, with my bag rubbing against the painful patches on my shoulders. Back at home, I would stand in front of the bathroom mirror for ages, looking for problems to ÔÇÿfixÔÇÖ. Regardless of the skincare routine I kept, I just couldnÔÇÖt stop picking at my skin. At this point, I was fed up and extremely miserable. 

Desperately wanting some advice, I booked a doctorÔÇÖs appointment. I wish I hadnÔÇÖt bothered. With my mum sat next to me, I told the doctor about my dilemma, how my skin was always sore, how I couldnÔÇÖt stop touching it. In response, he told me it was just a habit that I needed to break, maybe I needed to buy a fidget spinner or something. ItÔÇÖs safe to say I was horrified. Of course, itÔÇÖs fine to use a fidget spinner if you need to. Fidget toys do work for some people. However, at the time, they were something kids played with in school, something funny, a meme. Plus, by dismissing it as a habit, I felt like I hadnÔÇÖt actually been listened to. I left the appointment dejected.

Looking back though, that is hardly surprising. Many people donÔÇÖt really know what Body-Focused Repetitive Behaviour is, and if they do know, it is not usually taken seriously. Body-Focused Repetitive Behaviours, also known as BFRBs, are a group of related impulse control behaviours that include but are not limited to: skin picking (dermatillomania); hair pulling (trichotillomania); and, nail biting. They are certainly not just a habit. Damaging, difficult to overcome, and painful ÔÇö they can greatly impact peopleÔÇÖs lives. Triggered by anything from boredom to stress, BFRBs can often take up a lot of time. Sufferers become fixated on what theyÔÇÖre doing and are not doing it to deliberately cause harm to themselves, and are certainly not doing it to annoy you. It has been suggested that as many as 1 in 20 people may be affected by BFRBs. Unfortunately, they are often misdiagnosed, undertreated, and terribly misunderstood. This lack of awareness has meant that people who experience BFRBs are frequently, and wrongly, seen as disgusting, unhygienic, unattractive, and embarrassing. 

Discovering that there are actual terms for my behaviour has made me recognise that IÔÇÖm not alone with this issue. IÔÇÖm not weird or gross, but that doesnÔÇÖt mean itÔÇÖs not challenging. I still continue to struggle with my skin-picking behaviour today, particularly when I have a bad breakout. Resisting the urge to scratch at my skin, even when it may look okay, is incredibly tough  ÔÇö  and I get angry with myself a lot for giving in to the impulses. Living through a pandemic with a BFRB, where youÔÇÖre advised daily against touching your face, has proven exhausting. ItÔÇÖs like having a constant argument with myself  ÔÇö knowing I shouldnÔÇÖt touch my face and constantly fighting against the impulse, but if I donÔÇÖt give in to the urge eventually, it will gnaw at me all day. 

If I walk past a mirror, I have to actively tell myself not to look for too long  ÔÇö IÔÇÖm still working on that. When I grow my nails long, I have to make sure theyÔÇÖre not too sharp. Yes, IÔÇÖve heard it all before, having long nails sounds counterproductive but strangely, as long as theyÔÇÖre filed, I find itÔÇÖs more difficult to pick. Also, eventually, I did buy a fidget cube. I donÔÇÖt use it much, mainly because the buttons that distract me best make a clicking sound that may bother people around me. However, itÔÇÖs there if I need it!

I have good days and bad days, good months and bad months, and IÔÇÖm beginning to learn that thatÔÇÖs okay! BFRBs are draining and tiring, but it doesnÔÇÖt mean that youÔÇÖre dirty or disgusting. There are ways to deal with them and if you struggle with BFRBs, or think you do, as clich├® as it may sound, youÔÇÖre not alone. IÔÇÖve written this piece because IÔÇÖve hardly encountered awareness for BFRBs. TheyÔÇÖre pretty much invisible, with such an unfair, ignorant stigma. Please be patient with and supportive of the people who exhibit these behaviours. Believe me, theyÔÇÖre trying their best. 

Interested in reading more from this series? How about our most recent articles in Invisible Illnesses:
ÔÇô┬áInvisible Illnesses V: Living With a Depressed Parent
ÔÇô┬áInvisible Illnesses IV: Coming to Terms with My Complex PTSD and What Comes with It
ÔÇô┬áInvisible Illnesses III: Learning More About My Mental Health Than I Learnt From My BSc

Instagram: @quenchfeatures
Write for us: email features@quenchmag.co.uk or join the Facebook group where our pitches are posted
Our Section: Features