today, for the first time in my life, i realise that the old oft-quoted, and oft joked-about, line ‘the first step is admitting you have a problem’ is relevant to me. because i am addicted to skin-picking. you can relate it to anxiety, you can relate it to OCD, you can relate it to impulse control disorders - and all of these things are accurate - but at the end of the day i am addicted to the process. to the cycle. and, to my embarrassment, i knew a long time ago that i ‘had a problem’ but, instead of that being a reason to quit, it became an excuse to keep doing it. ‘i can’t stop because it’s a real thing and it’s not my fault’. today my therapist asked me to frame skin-picking as an addiction, to take everything else - all the reasoning behind it - out of the equation, and to think only about the behaviour itself. when you break it down, i am addicted to it.
now, i experience two distinct behaviours when it comes to picking. i pick my face in a focused way - i.e. i actively look in the mirror to find imperfections and then i target them. i pick the skin on my fingers in an automatic way - i.e. sometimes i don’t even realise i’m doing it. i’m going to discuss them both independently of each other, because the mechanisms behind them are different, and many people find that they experience only one - so i’ll split them up to make it easier to jump to the section that applies to you.
when i pick my face, i don’t necessarily ~plan~ it, but i’ll go into the bathroom and automatically head straight for the mirror. i can be, like, seconds away from peeing myself, but if i glance in the mirror and see something squeeze-worthy, that literally takes over as priority in my mind. the thought process (for want of a better word - i’m never really conscious of any thoughts) behind my scanning is that i want all the imperfections in my face to be cleaned out. if i see a blackhead, for example, i am unable to do a single other thing - try as i might - until i have gotten it out. this is because my anxiety spikes at this point. and, although i recognise it to be damaging, giving in to the impulse and then carrying out the behaviour is what will make me feel calm again. once i am aware of the ‘imperfection’ i physically enter into an uncontrollably anxious state which will not go away until i ‘solve the issue’. of course, i’m not solving it, i’m making it worse and beginning the cycle again.
what therapy is teaching me, when it comes to fixing behaviours that involve anxiety, is that in order to do so, we must be able to be ok with feeling anxious. nothing will magic the anxiety away. yes, i can target that, and i can work on stopping it at the root - but until i achieve that, the anxiety will still be there. what we have to learn to do, therefore, is to control our behaviours in response to the anxiety. if i notice a blackhead and i do not touch it, i will become horrifically anxious - but, and this is important, anxiety cannot grow exponentially. this means that a person cannot just get more & more anxious indefinitely. it isn’t possible. the body/brain cannot withstand that and therefore the anxiety will ALWAYS eventually decrease. this is fact. so, we have to learn to be ok with feeling like that for a while. it isn’t pleasant, but it *will* go away. and, you know what that means? the next time it happens, the anxiety spikes less, and decreases faster. the same is true for the time after that, and the time after that, and the time after that. is that easy? of course not.
the way for me to fix my face is to not do it. cold turkey. while it may seem like i’m trivialising it to compare it with, for example, alcohol addiction, it is in fact the same mechanism that controls both. it is not enough for me to limit myself, or try to regulate it, or to ‘allow myself’ to just do it a bit. if i start, i cannot stop. if i start, i make my skin worse, which gives me more to pick at. if i want to stop, i have to just completely stop.
my therapist suggested a facial every couple of months. this not only acts as a method to treat myself for sticking to it, but also means that any imperfections that do exist can be dealt with by professionals in a clinical setting.
my hands are a whole different situation. i pick my hands constantly. very often this is without even realising i’m doing it. i don’t realise until i look down and there’s literal chunks of skin all over whatever i’m wearing (sexy). or i feel something wet and realise my fingers are bleeding. or, worse, i don’t feel it and then just look down and realise that the last 4 things i touched have blood smeared on them. i do it when i’m nervous (which is almost all the time), i do it when i’m bored, i do it when i stop momentarily at traffic lights, i do it whenever my hands aren’t doing something else. it’s endless. what this means is that, unlike with my face, this is more considered of a ~habit~. it’s just automatic, i do it without thinking - which means that in many ways it’s harder to control. you cannot think your way out of it because you don’t realise you’re doing it. the only way to break a habit is to prevent yourself from doing it.
for me, this used to take the form of those big long nails. they look great, and they technically do stop me from doing it, but i can’t actually function with them on so all they do is make me feel more anxious. (if you’re cool with long nails then i cannot recommend them enough, they are great at stopping you from being able to get at your skin with any actual force/grip). as a last resort, i put plasters/band-aids on all my fingers. that’s obviously also not ideal but sometimes you can literally feel the infections starting and you don’t have a choice. the problem with barrier methods is that they *will* cause some level of frustration and anxiety, but when it comes to breaking a habit, being physically unable to engage in the behaviour can be literally the only way to fix it long-term. there are days that go by when i don’t pick my face/fingers, but that doesn’t mean i’m ~cured~, and it is the ongoing & continuous lack of engaging in the behaviour that is the key to eventually breaking the habit.
here’s the T - science says that, in theory, you can learn a habit, or break one, in 28 days. that’s how long you gotta do/not do something for to make it habitual. so, as of today, the new double-edged plan is cotton gloves* and hand lotion. gloves for every minute i’m at home. if i need to take ‘em off to type something or use my phone or make food or shower, so be it, but every second that i can have them on, then that’s what i’m going to do. when i’m out the house and not wanting to channel MJ circa 1985, i’m going to have my hands so permanently lubed up with hand lotion that i’ll leave trails on everything like a big anxious slug.
i also upgraded my fidget cube** to a multi-sided one. it does help, but i find it hard to actively get it out my bag to make myself stop and i’m often resentful of being told to stop by others. despite the mechanisms behind the initial behaviour may be different, being forced to stop when i’m in the middle of a ‘good bit’ with my fingers results in the same anxiety as i experience when i can’t pick my face. i’m trying to make sure i have my cube with me all the time. it really does work wonders when i *do* get into it, it’s just the initial breaking free from being locked into the behaviour that is easier said than done.
so, dear pals, here’s what you must understand - about both of these different mechanisms. there isn’t a pill you can take to stop yourself from doing it. nothing will just stop this from happening. your disorder *is* a behaviour. it is not a thought, or a feeling, or a mood. regardless of the reasons behind it, and although you can tackle the root causes, ultimately the only means by which you can stop the cycle is by stopping the behaviour that’s causing it to continue. i never said it would be easy did i? unfortunately, this is our reality. this disorder manifests itself as a behaviour that - contrary to how it feels - we *are* in control of, and therefore the only way we can stop skin-picking impacting our lives, is to stop picking our skin. we must change the behaviour.
as always, my email (firstname.lastname@example.org) is always open and i’ll never not be ready & willing to discuss this with anyone who needs advice or just a good old moan.
good luck my friends.
*the cotton gloves i bought are from boots, and cost £2.59. you can find them here. i wouldn't recommend latex/nitrile etc gloves as they will be much more suffocating to your hands over long periods of wear, and the more uncomfortable you are, the more likely you are to give up. there are definitely cheaper ones to be found online, but i just wanted them asap.
**the fidget cube i use was a birthday present, but is almost identical to this one. again, there are cheaper options available, but might have a slower delivery time etc.