Body-focused repetitive behaviors (BFRBs), like hair pulling, skin picking, and nail biting, can take up a lot of space in a family's life. Not just in bathrooms and bedrooms, but in conversations, emotions, and worries about the future. Parents want to help, kids want relief, and everyone is exhausted by the cycle of noticing, reminding, trying harder, and feeling discouraged.
When a young child pulls their hair, picks their skin, or bites their nails to the point of injury, it's natural for the adults in their lives to want to focus on stopping the behavior. Parents want to prevent their child from experiencing harm, and clinicians want to help the child gain control and relieve their parents of worry. But with body-focused repetitive behaviors (BFRBs), especially in young children, control is rarely the place to start.
When the causes of body-focused repetitive behaviors (BFRBs), such as hair pulling (trichotillomania), skin picking (excoriation disorder), or nail biting, are discussed, the question often arises: Are these behaviors caused by trauma? It's a fair question. The assumption makes intuitive sense. Many behaviors that cause physical harm or distress are linked to emotional pain or traumatic experiences. However, the science paints a more nuanced picture.
