Overcoming the shame and stigma of Body-Focused Repetitive Behaviors (BFRBs) is a deeply personal and powerful journey. Many individuals who live with behaviors like hair-pulling, skin-picking, or nail-biting struggle not just with the behaviors themselves but with the emotional weight of hiding them—from others and sometimes even from themselves. On top of dealing with triggers and the resulting impulses and behaviors, the added pain of these emotions can take a devastating toll.

What Is the Shame and Stigma Around BFRBs?

BFRBs are often misunderstood. Because these behaviors are visible and hard to control, people living with them may feel judged, embarrassed, or “broken.” Unfortunately, stigma and misinformation can make it harder to reach out for support. As a BFRB counselor in Woodland Hills, I hear from people that they are struggling with isolation caused by shame about their mental health disorder.

Common Experiences of Shame and Misunderstanding

BFRBs impact our lives in many ways, and there are common themes among those who suffer from them. You may have dealt with any of these.

• Feeling embarrassed to show affected areas (bald spots, scabs, bitten nails), and working hard to hide any evidence.
• Hiding the behavior from family, friends, or partners, often through extensive effort and planning.
• Believing it’s “just a bad habit” instead of a mental health condition. This may be something you have heard or been told, or a conclusion you have come to on your own.
• Internalized guilt—thinking “why can’t I just stop?” when actively doing a specific behavior, or when thinking about your BFRB later on.
• Avoiding social situations or intimacy due to fear of being seen or judged; this coincides with feeling embarrassed and trying to hide the behavior.
• Lack of public awareness leading to mislabels like lazy, attention-seeking, or self-destructive. These labels increase stigma and decrease willingness to open up and seek support.

3 Tools for Moving Toward Self-Acceptance and Support

1 – Educate Yourself (and Others)

When you are able to better understand what BFRBs are and how they work, you are able to address your behaviors and obtain support from the people around you. Something we hear in our Woodland Hills BFRB therapy sessions is how frustrating and isolating it can feel to be misunderstood.

• Learn the facts. BFRBs are recognized mental health conditions, not flaws in character. Tackling your symptoms and behaviors is about making adjustments to your habits by obtaining support and guidance from a mental health professional, not simply willing yourself to make a change. You may discover that learning the facts about your mental health disorder gives you perspective and courage to tackle it. There are specific guidelines about what a BFRB is and what it is not.
• Find safe spaces for education and guidance. You cannot expect yourself to learn everything on your own, nor to know everything there is to know. Follow BFRB-informed therapists, advocates, and organizations (like TLC Foundation for BFRBs). Not only will these people make and share content that is less likely to be triggering, but you can also gain a deeper understanding of your BFRB while connecting with people who are also struggling.
• Share trusted resources with loved ones to help them better understand your experience. Letting other people in is a positive step! By ensuring that you are the arbiter of resources, you help to safeguard against your loved ones falling victim to misinformation. Being the person to share resources also enables you to know what they know; you can have open conversation and effective dialogue when you are on the same page. Be prepared for questions asked in good faith, and also to communicate and enforce boundaries regarding your comfort level in discussion. Curiosity is healthy, as are boundaries. Relationships built on mutual respect flourish with both in place.

2 – Talk About It with Safe People

It can be easy to retreat into yourself when you are struggling, and more so when you experience shame related to your mental health disorder. It is when we most need connection that we feel our most vulnerable, which can make it difficult to seek help.

• Opening up can be scary, but shame shrinks when met with compassion. Taking a brave step and reaching out for a helping hand might feel impossible, but the benefit of receiving kindness in return can be invaluable. It is hard to think bad thoughts about yourself when a loved one is treating you with kindness and care. Give yourself permission to be loved and accepted by the people who want to be there for you.
• You don’t have to talk to everyone you know right away. Start small—maybe with a friend, a support group, or a therapist. Try out talking about your BFRB with them, let them know how it impacts you. Talking about something you are struggling with out loud can be scary, but the more you do it, the easier it gets. Starting with a person or group that you feel fully safe with will help you to speak aloud and unburden yourself off the weight of keeping your pain to yourself.
• Let your people know that it is not up to them to “fix” your problem. Set your loved ones up to provide you with the support you need by communicating with them. Use language like: “This is something I’ve been dealing with quietly for a long time, and I want to feel less alone in it.” This clearly establishes that you are seeking a safe place to talk about your BFRB, and connection. The best support someone in your life can give you is simply to be there for you, to spend time with you and show you care. It is a valuable position, and not one to be overlooked or undermined due to stigma or fear.

3 – Practice Self-Compassion

Being hard on yourself about your body-focused repetitive behavior isn’t going to help you manage it any better. In fact, bullying yourself contributes to worsened mental health. It is when you treat yourself with kindness and care that you instill self-confidence to tackle your problems.

• Your BFRB does not define your worth. This can be hard to remember when you feel as though it is something you are constantly dealing with; you might begin to think that it is all of who you are. On the contrary, no matter how often you have to deal with it, it is only one piece of you. And even when you look at the piece of you that it is, having a BFRB doesn’t make you a bad person, it doesn’t make you harmful to others, it doesn’t indicate anything about your personality or character.
• Combat your negative thoughts by being intentional about positive thoughts. Try affirmations like: “I am not my behavior—I am a whole, worthy person learning how to heal.” These are popular with the people we see for BFRB Therapy in Woodland Hills, who use them both in times of duress and as a part of daily self care. Affirmations can take some practice to add to your routine at first. You may have to set an alarm on your phone to remind you to do them.
• When urges happen, meet them with curiosity, not criticism. Ask: “What do I need right now?” instead of “Why am I doing this again?” Chances are good that there is an unmet need to uncover, but even if you’re not entirely sure, the pause to consider will help you to take a step back from any negative path you might be on. Consider yourself someone who is studying your BFRB from a distance, to gather as much objective information as possible. What would you wonder about someone you were observing going through the same thing; are they stressed, tired, nervous, hungry, angry…? Curiosity is more flexible and more forgiving.

Key Takeaways

• BFRBs aren’t common, but you are not the only person who struggles with them. They are a documented mental health disorder, with experience-based treatment options.
• You can make improvements to your mental health through in-person or online BFRB therapy.
• Be patient with yourself as you explore your BFRB and as you deepen your education. It can be tempting to pursue knowing “everything”, but that doesn’t mean you have to rush the process or have a deadline. Your understanding will evolve as you do.
• BFRBs are treated using Cognitive Behavioral Therapy (CBT), which addresses the behavior pattern of picking, pulling, biting, etc. om relation to thoughts and feelings. Non-clinical support, such as that from family and friends, is important when addressing BFRBs.
• Sharing about your BFRB with a person or people you trust can help to stave off isolation.
• It is easier to feel shame when you keep something hidden or secret; letting your loved ones in and communicating with them will ward off feelings of shame that you may struggle with.
• BFRBs are addressed through behavior modification and practice. Give yourself time and grace as you discover what works best for you.

BFRB Treatment in Woodland Hills 

Bodily Focused Repetitive Behaviors (BFRBs)—a group of mental health conditions classified under Obsessive-Compulsive and Related Disorders—are often some of the most misunderstood and unfairly judged. While our society readily offers compassion for physical health challenges like cancer or a broken bone, mental health struggles such as nail-biting, hair-pulling, or skin-picking rarely receive the same empathy or support.

At Embracing You Therapy, we’re committed to changing that. Our therapist, who specializes in treating BFRBs and OCD-related conditions, understands the latest research and evidence-based approaches to help you reclaim your confidence and quality of life. You deserve to pursue your goals and dreams without BFRBs holding you back.

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