Breaking the cycle of BFRBs (Body-Focused Repetitive Behaviors) is not just about willpower—it’s about learning how to work with your nervous system, your environment, and your emotions. For individuals living with behaviors like hair-pulling (trichotillomania), skin-picking (excoriation), or nail-biting, the urge to engage in these actions often comes automatically, especially during stress, boredom, or emotional overwhelm. But with the right tools, change is possible—starting with awareness and compassion.

What Are BFRBs?

What exactly are Body-Focused Repetitive Behaviors? BFRBs are compulsive, self-grooming behaviors that can cause physical damage and emotional distress. They’re often triggered by stress, anxiety, perfectionism, or even sensory needs—and can feel impossible to resist without structured support.

Common BFRBs Include:

• Trichotillomania: Repeated hair pulling from the scalp, brows, or lashes.
• Excoriation Disorder: Chronic skin picking, often leading to sores or scarring.
• Onychophagia: Chronic nail-biting.
• Dermatophagia: Biting or chewing the skin, often around fingers.
• Cheek or lip biting: Repetitive biting of the inside of the mouth.

2 Tools to Help Break the BFRB Cycle

1 – Try Habit Reversal Training (HRT)

When it comes to addressing BFRBs, it can feel tricky or overwhelming. Unlike behaviors that require you to procure something, you typically have everything you need to engage in a BFRB, because you have access to your body at all times. It becomes less about “abstaining”, and more about being able to realize when behaviors are happening and replacing them with different behaviors. Habit Reversal Training has been beneficial for those who see us for BFRB therapy in Woodland Hills.

• You cannot just will yourself to stop BFRBs, you need to replace them with something else. We recommend Habit Reversal Training when dealing with something as intrusive as BFRBs. HRT is a behavioral therapy that helps increase awareness of your triggers and teaches you to replace the behavior with a “competing response”. In our Woodland Hills BFRB therapy sessions, we help to guide an understanding of when behaviors happen, why they happen, and how to recognize the signs before or during to avoid or stop a behavior.
• Taking note of your habits is how you begin to address them. Start by tracking when and where your urges happen—after school, during work meetings, while watching TV, etc. This step may force you to note or confront feelings of shame that you may experience in relation to your BFRB, or in how you handle stressors. Because of that, it may feel like a difficult undertaking. Prepare yourself to uncover habits that are unpleasant, or notice patterns that are disappointing. Remember that just because you identify something, that doesn’t mean that you have to immediately cut it out of your life. For example, you may be able to keep your dream job while adjusting how you handle some triggers that arise while you’re on the clock. Or you may be able to maintain a friendship with someone who matters to you if setting some boundaries for yourself will help your relationship to work better. Don’t avoid the truth because you’re thinking what the next possible step might be. Be as open and honest as you can; try to take note objectively.
• Use a competing behavior. A competing behavior is anything that makes the BFRB harder to complete, like clenching fists, squeezing a stress ball, or folding your hands in your lap. You may also opt to wear gloves to limit the effectiveness of your fingers/nails, or take up an activity like knitting to keep your hands busy. Some competing behaviors will require certain tools; you might keep a squeeze ball in your desk at work, or needlepoint next to the couch at home. You may carry something in your bag with you, tuck away equipment in your vehicle, or some other solution so that you have help on hand when you need it. It is good to practice clenching your fists or folding or sitting on your hands for when you are on your own, but ideally you can use a variety of tactics depending on the situation you’re in at the time.
• HRT is an ongoing process, not a one-time solution. Practicing HRT consistently helps retrain your brain to respond differently over time. It can take a while to build new habits; just like it may have taken a while for your BFRBs to fully manifest, it might take some time to replace those behaviors. You may have to revisit your competing behaviors as time goes on, and adjust your cues for when to employ them. 

2 – Use Grounding and Mindfulness Techniques

In order to help improve your mental and emotional environment, you can take steps throughout your days that help you to ground in the present and be mindful.  As a BFRB counselor in Woodland Hills, I know that the physical output of the behavior isn’t the entire issue. It is often a symptom of an internal, mental struggle – it is a manifestation of discomfort, loneliness, anxiety, boredom, or dissociation. 

• Grounding and mindfulness can help you attach or reconnect to your body and/or emotions. BFRBs often occur when you’re disconnected from your body or emotions. Mindfulness brings you back to the present. It is true that your mental health can have a huge impact on your behavior and your behavior can have a huge impact on your mental health. This means that mindfulness can help you to stave off or avoid BFRBs, and that participating in BFRBs can lead to a decrease in your sense of mental wellness. When you are able to connect to your body, you are not only cognizant of impulses to pick, or scratch, or any other BFRB, but you can feel anxiety and distress building in the body as a cue to take a pause before you get to the point of enacting a BFRB. It can be uncomfortable to adjust to connecting to your emotions; where you might have avoided feeling your feelings before, you will now be experiencing them. Give yourself grace to struggle, and lean on others for comfort and support.
• Use all five senses to ground yourself in the present. Try the 5-4-3-2-1 technique: Name 5 things you see, 4 you can touch, 3 you hear, 2 you smell, and 1 you taste. You may choose to cycle through the things you can sense a few times as a way to truly focus in, naming the same 5, 4, 3, 2, and 1 things through each cycle while trying to take slow, deep breaths, and relaxing your body. When you are able to connect with your senses, you are better equipped to be aware of your body and its movements. Being present can help you to recognize anxiety earlier, or to avoid subconscious behaviors that can arise when you are avoiding emotional distress by dissociating or by doing a Body-Focused Repetitive Behavior. Often, it is rumination about the past or worry about the future that can disconnect us from our bodies. Because you cannot predict or control what will happen, nor can you change what has already occurred, these stressors can spiral without any solution. Being able to remind yourself of where you truly are can help you to take note of what is going on. You may have unmet needs (like affection, support, hunger, fatigue; they can be emotional and mental and physical needs).
• Make grounding and mindfulness techniques part of your daily routine where you can. Yes, these techniques can be helpful when you are in a stressful situation. But they also have many benefits as you move through your daily life. If you are able to stay present and manage your anxiety levels more often, your overall stress levels will decrease. This means that you have more capacity to handle triggers and mishaps, as your nervous system isn’t in a state of stress all the time. Determine what techniques work best for you, such as utilizing your senses, or connecting to your breath. Use technology to your advantage. For example, before bed or during stressful moments, you can practice deep breathing or listen to guided meditations focused on calming the nervous system.

Key Takeaways

• Body-Focused Repetitive Behaviors are more than bad habits—they’re complex coping mechanisms that deserve compassion and support.
• Strategies like Habit Reversal Training and mindfulness can help interrupt the cycle and build new responses.
• Change takes time, and progress can be slow—but every small win matters.
• Those who attend in-person or online BFRB therapy experience an improvement in symptoms and behaviors over time, provided they do careful and consistent work.
• BFRB improvements don’t happen all at once, but can be made over time. There will be trial and error and missteps involved, but it can be done.

How Therapy Can Help

Therapy—especially approaches like CBT, HRT, or ACT (Acceptance and Commitment Therapy)—can help individuals understand the emotional roots of their BFRBs and develop healthier coping strategies. With support, structure, and self-compassion, it’s possible to manage urges and reclaim a sense of peace and control.

BFRB Treatment in Woodland Hills 

Bodily Focused Repetitive Behaviors (BFRBs)—such as nail-biting, hair-pulling, or skin-picking—are often misunderstood and unfairly judged. Unlike physical health conditions that elicit immediate empathy, BFRBs can be dismissed or minimized, despite the deep emotional toll they take. But your pain is real, and you deserve support.

At Embracing You Therapy, we are committed to reducing the stigma around BFRBs and offering specialized care. Our therapist, trained in treating BFRBs and OCD-related disorders, understands the unique nature of these struggles. Using evidence-based approaches, we help you regain a sense of control, rebuild your confidence, and start living the life you deserve—without shame or limitation.

Contact us today for your complimentary 20-minute phone consultation with our Client Care Coordinator.