BFRB ( Body Focused Repetitive Behavior ) And Mindfulness

nail biting Body Focused Repetitive Behavior

Do you often feel the urge to bite your nails, pluck your hair or bite your lips, skin picking,? You could be suffering from a disorder known as Body Focused Repetitive Behavior (BFRB).

This is a cluster of several habitual behaviors which can take many different forms. Examples include biting, skin picking disorder, hair pulling disorder, teeth grinding, no speaking, nail biting, and cheek biting. Academic studies by institutions such as Marquette’s University indicate that adults with subclinical Body-Focused Repetitive Behavior Disorders are the most prevalent. A current study from the students of central Michigan university observes that BFRB’s is an umbrella stroke cover term for all chronic behaviors that cause physical damage to oneself. 

It is important to note that a significant number of people who suffer Body-Focused Repetitive Behavior Disorders often dismiss the occurrences as just bad habits. 

In this article, we have prepared the causes, symptoms, and possible treatment of BFRBs.

What Causes BFRB’s(Body Focused Repetitive Behavior)?

Body-focused repetitive behaviors such as obsessive-compulsive disorder, stereotypic movement disorder, mental disorders, chronic tic disorders, social isolation, nervous habits, unpleasant emotions, lip biting, etc may be caused by varying emotional variables. Depression and emotion regulation deficits are some of the major causes of the common BFRBs. 

In BFRB, people engage repeatedly in body activity, for instance biting their lips, chewing their cheeks, biting nails, picking their nose or skin, grinding teeth, and so on. These behaviors in people often lead to all sorts of negative effects on people with BFRBs including tissue damage, hair loss, dental damage on the mouth, feeling of tension, skin lesions, and other chronic skins conditions. Health technicians will normally diagnose this condition when a certain behavior starts causing damage to the body. BFRBs become noticeable mostly in adolescence, during the identity stage.

Types of BFRBs.

The occurrence of BFRBs can be broadly classified under the following categories. 


Trichotillomania is a body-focussed repetitive behavior where the victim experiences a constantly compelling, irresistible urge to keep pulling their hair. Most victims pull the hair from their heads while some can pull from other parts of the body such as eyelashes or eyebrows. This condition is more prevalent among young adults and teenagers. 

Trichotillomania is also referred to as trich, which is of course the short form of the main name. Other names for this condition include compulsive hair pulling or pulling disorder. Left untreated, trichotillomania can eventually lead to patches of noticeable baldness. 

Excoriation disorder

Excoriation disorder is a form of body-focused repetitive behavior (BFRB) that is characterized by repetitive picking at the skin, a severely irresistible urge to squeeze, scratch, rub or pinch the skin during anxious or stressful moments. The face area is normally the most affected and can lead to infections, scarring, or even physical disfigurements.

Excoriation disorder can cause serious disruption of one’s normal life as a result of skin lesions. Victims normally feel the urge to pick at minor skin stuff such as calluses or pimples. Of course, most people will ordinarily pick on such irregularities. But the difference is that excoriation disorder victims will do it repeatedly and often vigorously to the point of causing damage. Sometimes they can even pick on perfectly healthy skin. 

This condition seems to start occurring around the adolescent stage in life, at the onset of puberty. It could also affect children below the age of 10. Experts and government agencies estimate that about 1.4% of Americans suffer excoriation disorder and it’s more prevalent among women than men.  


This is a type of obsessive-compulsive and related disorder. It commonly begins during childhood meaning it can also affect school-going children. Onychophagia is then carried through to adulthood where it can intensify. It can lead to bleeding of the skin, pain, and even infections of the skin. Other signs include the feeling of tension, emotion dysregulation,  alarming damages to the cuticles and fingernails among others. 

Victims might experience other disturbing effects as well such as tension followed by a feeling of pleasure after they are done with biting. They are likely to feel ashamed, guilty or embarrassed as a result of the look of their nails due to the consistent damage. 

Chronic disorder

This involves quick and uncontrollable movements or vocal outbursts depending on varying emotions on body. These moments might last for reasonably short periods of time or even longer, depending on the intensity of the disorder. 


This is a compulsive disorder where one is compelled to use items such as scissors or a razor blade to cut their hair from the scalp. It results in shortening hair without damaging the scalp.

Just like many other types of body focused repetitive disorder, victims of trichotemnomania try as much as possible to keep the habit secret,  so they might often tend to do the pulling when alone. But of course, the results will always be visible to anyone who comes close to you. 

You will feel some intense tension before you get started on the pulling. After the pulling, you feel satisfied with some nice sense of pleasure. Many victims try as much as possible to resist the urge, but unfortunately, the urge is always so strong and of course, this is because it’s a compulsive disorder that is often impossible to control. 


Also known as compulsive skin biting, this habit disorder is dangerous as it involves biting huge chunks of flesh from one’s body. It can lead to chronic skin conditions including unsightly scars and even skin discoloration.

The TLC Foundation for Body-Focused Repetitive Behaviors observes that dermatophagia is largely classified by mental health experts as a  type of obsessive-compulsive and related disorder. 


Trichophagia is the irresistible urge to chew and swallow hair strands. This is one of the common compulsive behaviors that causes a pleasant feeling to the victim. Consequences include indigestion problems that might eventually require surgery. The prevalence of this condition is high among adolescents and children.

Some of the causing factors of trichophagia include social settings,  neurobiological factors, and genetic predisposition.  Experts have observed that 30% of trichotillomania victims are likely to suffer trichophagia.


Often confused with onychophagia, this is a condition where one exhibits nail picking tendencies. It leads to the destruction of the nail bed hence causing malformation of the nails.

What triggers BFRBs?

BFRBs can be triggered by adverse behavior patterns and life events such as temperament, environment, family stress, depression, and anxiety. It is believed that these triggers could have a genetic component. Some BFRBs could be direct indications of unresolved trauma or issues. 

Causes of BFRBs

The causation of BFRBs is not well known. But studies from institutions such as the Medical University of South Carolina show that some victims may have inherited the condition from their families

An interesting fact is that even primates, e.g. apes pull their hair, birds pull out their feathers, mice, cats, and dogs can ‘barber their fur or even bite their baldness.

Previous studies from the department of psychological and brain sciences at the University of Chicago clarify that BFRB’s are a mental health condition to a large extent.

How do I stop the occurrence of BFRBs?

  • First, you need to understand and think about the function of that behavior. Does it give you a feeling of enjoyment? Do you feel like it helps you to balance your feelings or deal with anxiety and stress?
  • Next is to modify the environment that causes the act of BFRB. You will see less repetitive and obsessive habitual behavior.
  • Whenever the urge comes, think of other alternative activities such as recording notes, reading, or even writing about the urge. This distraction will keep you busy and contribute to reducing the tendency of BFRBs.

Treatments for BFRBs

There are several effective treatment approaches to BFRB’s, mostly behavioral. The common and most effective behavioral treatment for BFRBs involves cognitive behavioral therapy, habit reversal therapy, and other innovative techniques such as dog-assisted therapy.

Some types of medication can provide relief by reducing physical injuries caused by BFRBs. Clomipramine, for example, is one of the treatment for trichotillomania together with N-acetylcysteine. Studies from the department of psychiatry and behavioral sciences at the University of Chicago indicate that understanding the patients’ unique biochemistry, neurobiology, habit reversal training, analysis of body,  impact of emotions, and the role of emotion regulation is key to treatment. 

Another great approach to healing entails joining a support group and participating in social alongside therapies. After all, a burden shared is a burden lightened.

Final Thoughts

Studies including one by the Oxford University Press states that it is possible to tame and eventually control BFRBs. Utilize these quick tips to arrest the situation. 

  • Track your progress with an app. There are several applications online for this
  • Be mindful of your thoughts and try as much as possible to shut down or distract any negative thoughts that may trigger BFRBs.
  • Practice calming techniques for the nervous system e.g. acupressure. This can reduce the prevalence of BFRB’s to a great extent.
  • Research more about your disorder and apply the positive bits in your routine life.

Do you have any questions or experiences concerning BFRB’s? Please feel free to share in the comments section. Share these tips as well with your friends or anyone that you know might be suffering from body-focused repetitive behavior.

Remember you can control and eventually get rid of your disorder or any association with BFRBs.