What help should a person with skin picking disorder get?

Generally speaking, when it comes to anxiety, you do NOT want to avoid the things that make you anxious. All this does is strengthen the anxiety. What is most helpful with anxiety management is facing the anxiety head-on, doing the things that make you uncomfortable. Safety is a big priority though, so please do not forget that. 

 

OCD can show up in the form of skin picking, hair pulling, etc. Do you know what your triggers are to picking your skin, what makes you want to do it or what triggers you to engage in that behavior? 

 

Do you think it would be beneficial for you to seek out the support of a therapist to help you? It is hard to provide a clear and direct answer within this forum since I cannot ask you questions and get more information.

 

Below is the DSM 5 definition of OCD from BeyondOCD.org;

Clinical Definition of OCDThe DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) provides clinicians with official definitions of and criteria for diagnosing mental disorders and dysfunctions.  Although not all experts agree on the definitions and criteria outlined in the DSM-5, it is considered the “gold standard” by most mental health professionals in the United States.DSM-5 Diagnostic Criteria for Obsessive-Compulsive Disorder (300.3)A.    Presence of obsessions, compulsions, or both:Obsessions are defined by (1) and (2):1. Recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).Compulsions are defined by (1) and (2):1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation; however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are excessive.Note: Young children may not be able to articulate the aims of these behaviors or mental acts.B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.D. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; preoccupation with appearance, as in body dysmorphic disorder; difficulty discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania [hair-pulling disorder]; skin picking, as in excoriation [skin-picking] disorder; stereotypies, as in stereotypic movement disorder; ritualized eating behavior, as in eating disorders; preoccupation with substances or gambling, as in substance-related and addictive disorders; preoccupation with having an illness, as in illness anxiety disorder; sexual urges or fantasies, as in paraphilic disorders; impulses, as in disruptive, impulse-control, and conduct disorders; guilty ruminations, as in major depressive disorder; thought insertion or delusional preoccupations, as in schizophrenia spectrum and other psychotic disorders; or repetitive patterns of behavior, as in autism spectrum disorder).Specify if:With good or fair insight: The individual recognizes that obsessive-compulsive disorder beliefs are definitely or probably not true or that they may or may not be true.With poor insight:  The individual thinks obsessive-compulsive disorder beliefs are probably true.With absent insight/delusional beliefs: The individual is completely convinced that obsessive-compulsive disorder beliefs are true.Specify if:Tic-related: The individual has a current or past history of a tic disorder.Reprint permission pending from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (Copyright 2013). American Psychiatric Association.I am going to define Exposure Response Prevention therapy below. This definition is taken from IOCDF.org. This is the gold standard treatment and care for anxiety disorders. You can also go to this website to see if any therapists near you specialize in OCD.What is Exposure and Response Prevention?You may have heard of Cognitive Behavior Therapy (CBT) before. CBT refers to a group of similar types of therapies used by mental health therapists for treating psychological disorders, with the most important type of CBT for OCD being Exposure and Response Prevention (ERP).Exposure in ERP refers to exposing yourself to the thoughts, images, objects, and situations that make you anxious and/or start your obsessions. While the Response Prevention part of ERP refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been “triggered.” All of this is done under the guidance of a therapist at the beginning — though you will eventually learn to do your ERP exercises to help manage your symptoms.That said, this strategy of purposefully exposing yourself to things that make you anxious may not sound quite right to you. If you have OCD, you have probably tried to confront your obsessions and anxiety many times only to see your anxiety skyrocket. With ERP, the difference is that when you choose to confront your anxiety and obsessions you must also commit to not give in and engage in the compulsive behavior. When you don’t do the compulsive behaviors, over time you will feel a drop in your anxiety level. This natural drop in anxiety that happens when you stay “exposed” and “prevent” the compulsive “response” is called habituation.Another Way to Think About ERP:Think of your anxiety as an alarm system. If an alarm goes off, what does it mean? The alarm is there to get your attention. If an intruder is trying to break into your house, the alarm goes off, wakes you up, gets you to act. To do something. To protect yourself and your family. But, what if the alarm system went off when a bird landed on the roof instead? Your body would respond to that alarm the same way it would if there were an actual threat such as an intruder.OCD takes over your body’s alarm system, a system that should be there to protect you. But instead of only warning you of real danger, that alarm system begins to respond to any trigger (no matter how small) as an absolute, terrifying, catastrophic threat.When your anxiety “goes off” like an alarm system, it communicates information that you are in danger, rather than “pay attention, you might be in danger.”Unfortunately, with OCD, your brain tells you that you are in danger a lot, even in situations where you “know” that there is a very small likelihood that something bad might happen. This is one of the cruelest parts of this disorder.Now consider that your compulsive behaviors are your attempts to keep yourself safe when that alarm goes off. But, what does that mean you are telling your brain when you engage in these behaviors? You are reinforcing the brain’s idea that you must be in danger. A bird on the roof is the same as a real intruder breaking into your home.In other words, your compulsive behavior fuels that part of your brain that gives out these many unwarranted alarm signals. The bottom line is that to reduce your anxiety and your obsessions, you have to decide to stop the compulsive behaviors.However, starting Exposure and Response Prevention therapy can be a difficult decision to make. It may feel like you are choosing to put yourself in danger. It is important to know that Exposure and Response Prevention changes your OCD and changes your brain. You begin to challenge and bring your alarm system (your anxiety) more in line with what is happening to you.How is ERP different from traditional talk therapy (psychotherapy)?Traditional talk therapy (or psychotherapy) tries to improve a psychological condition by helping the patient gain “insight” into their problems. Talk therapy can be a very valuable treatment for some disorders, but it is not effective at treating the active symptoms of OCD.While talk therapy may be of benefit at some point in an OCD patient’s recovery, it is important to try ERP or medication first, as these are the types of treatment that have been shown through extensive research to be the most effective for treating OCD.