Hypnotism can be a powerful aide in helping YOU with BFRB's. Hypnotism greatly amplifies therapeutic interventions.
Researchers, Nunn and Azrin found that a single 2-hour session of habit-reversal therapy resulted in an average 90% reduction in the frequency of the habit, improving with practise to an average of 97% after one month. However, only 10% of subjects reported that the habit never reappeared (1977: 28–29). Despite the fact there were modest setbacks, the average reduction was still 99.5% overall after six months. Two studies on habit reversal by Azrin & Nunn from the 1980s are listed by Chambless et al. (1998) as fitting the standards for "probably efficacious" treatment specified for Empirically Supported Treatments (ESTs). In In other words, researchers still consider their approach to be one of the most effective methods for breaking bad habits that are supported by research in the psychotherapy sector.
The following largely uses Scientific Research Language
Counter-conditioning or desensitisation is used as a change mechanism to counter the unwanted behaviour. Azrin and Nunn published a straightforward self-help book titled Habit Control in a Day (1977) that provided a straightforward explanation of the technique.
Body-focused repetitive behaviours (BFRBs) are a group of disorders characterised by repetitive, self-directed behaviors that damage the body. These behaviours include hair-pulling (trichotillomania), skin-picking (excoriation disorder), nail-biting (onychophagia), and cheek biting, among others. BFRBs are classified under the broader category of obsessive-compulsive and related disorders (OCRDs) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).
Research indicates that BFRBs typically emerge in late childhood or early adolescence and can persist into adulthood. The exact prevalence of BFRBs is not fully established, but estimates suggest that about 1-4% of the population is affected by trichotillomania, while excoriation disorder affects approximately 1-5%. BFRBs can cause significant distress and functional impairment, often leading to physical harm, scarring, and social embarrassment.
The etiology of BFRBs is multifactorial, involving a combination of genetic, neurobiological, and environmental factors. Studies have shown that individuals with BFRBs often exhibit abnormalities in brain regions related to habit formation, impulse control, and emotional regulation. For instance, structural and functional MRI studies have implicated the striatum, anterior cingulate cortex, and prefrontal cortex in the pathophysiology of these disorders.
Moreover, BFRBs are associated with psychiatric comorbidities, including anxiety, depression, and obsessive-compulsive disorder (OCD). Individuals with BFRBs often experience heightened stress and anxiety, which can exacerbate their repetitive behaviours. Interestingly, research suggests that BFRBs may serve as a coping mechanism for managing negative emotions, though this relief is typically short-lived and followed by feelings of guilt or shame.
Treatment for BFRBs often involves a combination of behavioral therapies and pharmacological interventions. Cognitive-behavioural therapy (CBT), particularly Habit Reversal Training (HRT), is considered the gold standard in treatment. HRT focuses on increasing awareness of the behaviour, identifying triggers, and implementing competing responses to prevent the behaviour. Other therapeutic approaches, such as Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT), have also shown promise in treating BFRBs.
Pharmacological treatments are less well-established, though selective serotonin reuptake inhibitors (SSRIs) and N-acetylcysteine (NAC), an antioxidant, have been explored with mixed results. NAC, in particular, has shown some efficacy in reducing hair-pulling and skin-picking behaviors in small clinical trials, likely due to its glutamatergic modulation.
Despite advances in understanding and treating BFRBs, many individuals remain untreated or undiagnosed due to stigma and a lack of awareness among healthcare providers. Increased research and awareness are crucial for improving diagnosis, treatment, and support for individuals with BFRBs, as these behaviours can significantly impact quality of life and overall mental health. The complexity of BFRBs requires a nuanced and multidisciplinary approach, integrating psychological, pharmacological, and social support strategies to manage and mitigate these challenging behaviours.