The emotional toll of BFRBs (Body-Focused Repetitive Behaviors) often goes far beyond the physical symptoms. For many individuals, behaviors like skin picking, hair pulling, or nail biting are not simply “bad habits”—they’re deeply connected to mental health struggles such as anxiety, depression, and OCD. When emotional pain goes unspoken, it often finds expression through the body. BFRBs can be misunderstood and stigmatized, especially when people are afraid to share their experiences, but there are many sufferers.

What’s the Link Between BFRBs and Mental Health?

BFRBs are repetitive behaviors performed in response to internal emotional discomfort. These behaviors can provide short-term relief—but often lead to long-term distress, guilt, or shame. Many people with BFRBs experience them alongside other mental health conditions, creating a cycle that’s difficult to break without support. As BFRBs become entrenched habits, shame about behaviors (and their side effects) can lead to isolation, and the unresolved emotions that aren’t being properly managed are still there.

Common Emotional and Mental Health Connections:

• Anxiety: BFRBs may offer temporary relief from tension or worry.
• Depression: Feelings of shame or low self-worth can increase urges and isolation.
• Obsessive-Compulsive Disorder (OCD): Some BFRBs have obsessive or compulsive elements.
• Perfectionism & Self-Criticism: Many individuals with BFRBs struggle with being “too hard” on themselves.
• Stress & Emotional Overwhelm: BFRBs can become coping mechanisms when other tools feel out of reach.

3 Tools to Support Emotional Healing and Behavior Change

1 – Increase Emotional Awareness

Through mindfulness and paying attention to your emotions, you can identify what you are feeling and begin the process of observing what happens and when. The goal is to make an observation without also making a judgment about yourself, though that takes time and practice.

• Before a BFRB urge hits, ask: “What am I feeling right now?” You may notice that you are stressed out, lonely, bored, anxious, frustrated, or any other feeling. You may also find that you struggle to identify or name what you are experiencing, which may be part of the reason you end up doing a BFRB when that feeling arises. Being able to track when stress is rising, or take note of what emotional state is impacting you, can help you to circumvent a behavior sooner, when it is easier to pause. It can also enable you to recognize which specific emotions are the most triggering, and consider other ways that you might soothe yourself. For example, if you are angry, you might want to move your body and burn off energy. If you are bored, you may need to participate in a hobby. Knowing which emotion is which can help you choose the best response to it.
• Utilize a practical tool to help you. Try journaling or using an emotion chart to identify patterns (e.g., stress before exams, loneliness at night). Sometimes it takes a visual to see patterns. Sometimes it takes letting a stream of consciousness happen to get to what is going on underneath the surface. Being able to look at a whole picture and see what events or circumstances seem to surround your need to engage in a BFRB can help you determine where to begin in addressing it.
• Understand the value of having emotional awareness. Awareness is the first step to replacing the behavior with a healthier form of emotional release. Combined with an understanding of BFRBs, you can use your emotional awareness to develop other coping skills and mechanisms. In our Woodland Hills BFRB therapy sessions, a lot of work goes into learning how to see the knowledge you obtain from being emotionally aware as a powerful tool. Sometimes, in this society, it feels like there are too many emotions about too many things, and being aware of them can be scary. It can be tempting to try to “shut down” and try to avoid it, but that isn’t going to make any situation better or more manageable.

2 – Create a Coping Kit for Triggers

As a BFRB counselor in Woodland Hills, I often hear how hard it can be to stop behaviors, especially without something to replace them with. The key is to work on your emotional regulation skills, and to have tactile aids as you do.

• Build a small “BFRB survival kit”. A kit that includes fidget tools, putty, textured fabrics, or grounding scents can help you to regulate your emotions and avoid certain behaviors. If you have a habit of picking at your skin, wearing gloves can help you to stop by limiting your ability to use your nails. You can also hold items to keep your hands busy. You may choose to use small games to stave off boredom while also keeping yourself occupied; let yourself have fun with the kit and experiment with different items. If you find that something isn’t working well for you, you can trade it for something else. Your kit might evolve over time, as you learn and grow and change.
• Don’t hesitate to make use of it! Use it when you feel overwhelmed, bored, anxious, or emotionally dysregulated. You don’t have to wait until you’re about to engage in a behavior to pull out your survival kit; in fact, utilizing it at the first feeling of stress or boredom can help to stymie the impulse before it is overwhelming. Circumstances sometimes mean that you can’t access your tool kit right away, and that’s okay, too! There is no perfect way to navigate, all you can do is be consistent and focus on making progress.
• Make sure your coping kit is full of positive BFRB replacements. The goal is not to punish the behavior—but to meet your needs with compassion and creativity. A grounding scent that helps you feel calm is much more effective than something that makes you feel guilty or ashamed. If you enjoy coloring, use a coloring book to occupy your mind! If you enjoy building, find something you can assemble and reassemble while you process your emotions. How many different items can you add to your “survival kit”? You might prefer to have a main kit at home, and a couple small items at work and in your car or in your bag. There is no perfect use of tools, but you can give yourself a good chance at replacing behaviors in a positive way by covering all your bases.

3 – Challenge the Shame Cycle

Because most people who have BFRBs try to hide their symptoms and behaviors, the idea of opening up about their experiences can be very overwhelming. Those who see us for BFRB therapy in Woodland Hills benefit from overcoming this cycle through unpacking their past and sharing their experiences.

• Reframe your BFRB in your mind. BFRBs thrive in secrecy and shame. Remind yourself: “This behavior is a response to pain, not a failure.” Overcoming the shame of BFRBs isn’t a one-step process, but it is something you can work on through consistent efforts. Being able to talk to yourself about why you’re experiencing what you are experiencing with kindness and compassion can help you to address what the root issue is. It is much easier to solve a problem if you are able to accept that something is wrong and look honestly at what the reason might be. Shame naturally hinders that process.
• Don’t keep it to yourself. Talk about it—whether with a therapist, support group, or trusted friend. There are in-person and online support groups for people who struggle with body-focused repetitive behaviors, and these groups can help you to realize that you are not alone in your struggle. It may even help you to open up to your loved ones, as you will have practice talking about your BFRB. Keep in mind that in relationships, we share a lot of situations that the other person can’t relate to, but that doesn’t stop us. Why should talking about your BFRB be any different when it comes to leaning on a trusted loved one?
• You take better care of what you love. Self-compassion practices can help disrupt the belief that you’re “broken” and promote healing from within. It is far easier to show yourself kindness and understanding when you haven’t been putting yourself down or avoiding self-care. Speak to yourself with affirmations that acknowledge your struggle without assigning a moral value to what you do or what you’ve done in the past.

Key Takeaways

• BFRBs are closely tied to emotional distress and mental health challenges like anxiety, depression, and OCD.
• They often serve as coping tools in moments of overwhelm—they are not signs of weakness or lack of control.
• Healing requires both emotional support and practical strategies to meet those needs differently.
• Attending in-person or online BFRB therapy can help you to identify triggers, patterns, and behaviors in a safe and supportive environment.
• Identifying your emotions, discovering replacement behaviors, and exiting the loop of shame to behavior to shame again can help you to minimize the frequency and persistence of body-focused repetitive behaviors.

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, despite being part of the Obsessive Compulsive Disorder spectrum. While society readily offers empathy for physical health conditions like cancer or broken bones, mental health struggles like BFRBs are too often met with silence or stigma.

At Embracing You Therapy, we’re committed to changing that. Our therapist, who specializes in BFRBs and OCD-related disorders, provides evidence-based care rooted in compassion and understanding. You deserve to reclaim your confidence, pursue your goals, and live without shame. BFRBs don’t have to define your life—and we’re here to help you take that first step forward.

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