Understanding how Body-Focused Repetitive Behaviors affect the people we love—and how support can make all the difference.

The impact of BFRBs on relationships is often more complicated than it seems. Whether it’s hair pulling (trichotillomania), skin picking (excoriation disorder), or nail biting, Body-Focused Repetitive Behaviors (BFRBs) can affect not only the individual experiencing them—but also their romantic partners, family, and close friends. As a BFRB counselor in Woodland Hills, I know that these behaviors are often misunderstood, leading to frustration, shame, or conflict in relationships.

What happens when BFRBs affect your relationships?

BFRBs can trigger emotional and relational challenges. If left unaddressed, they may create distance, miscommunication, or even conflict—especially when the behavior is misunderstood as “just a habit” or something the person should be able to “just stop.”

Here are a few ways BFRBs can show up in relationships:

• Romantic Relationships: One partner may feel confused, helpless, or even rejected if they don’t understand the behavior. The individual with BFRBs may feel ashamed or try to hide it.
• Friendships: Friends may offer well-meaning but unhelpful advice (“just stop picking”), leading to disconnect.
• Family Dynamics: Parents or siblings may become overly involved, critical, or distant depending on their understanding of the behavior.
• Internal Impact: The person with BFRBs may feel isolated, embarrassed, or unlovable—leading to withdrawal or self-silencing.

3 Tools to Navigate the Impact of BFRBs on Relationships

1 – Educate and Normalize

Those who see us for BFRB Therapy in Woodland Hills find that being able to educate those around them not only helps them to create strategies that benefit from support, but stymie feelings of isolation and rejection. The key to tackling most challenges is to feel empowered and supported, so this is where education and normalization can be game changers.

• Knowledge is a power that can be shared. So many mental health struggles come with their own stigmas attached, and Body-Focused Repetitive Behaviors are no different. Education can go a long way toward helping to understand what a BFRB is. BFRBs are not just bad habits—they are mental health conditions often tied to anxiety, perfectionism, or sensory needs. Partners and loved ones should learn about the condition together. Being empowered with this knowledge and understanding reduces blame and fosters compassion. This will also enable those around you to have a better understanding of how to communicate with you about what they are experiencing when it comes to your BFRBs. You may find that certain people among your close ties are more receptive than others; you may want to start with them when you begin working on how you educate and communicate. By the time you get to those who may not be as open to re-educating themselves, you will be well-practiced, and also have the confidence of knowing that it is possible for the people in your life to learn and grow.
• Don’t forget to re-educate yourself as needed. …And show yourself grace and compassion. You likely know that you are not the only person to struggle with BFRBs, but there may be times when you struggle to show yourself compassion and care. If you are taking the time to educate the people around you, and they are putting in the work as well to learn and ask questions, that is excellent. But that is not the end of your task. Do not neglect your own needs and curiosities in your endeavor to teach and normalize. As with anything in life, we have to start with ourselves if we want to experience growth and change. This growth mindset will also make it easier for you to receive feedback from the people around you about how the relationship is working for them, or the changes they may notice and experience as you try different methods of dealing with your BFRBs.

2 – Practice Open, Non-Judgmental Communication

Within relationships, taking an active role can look different depending on what each of you is dealing with. It is always helpful for the person with a BFRB to explain and help educate, but there is a lot the other person can do, as well. If you’re supporting someone with a BFRB, ask open-ended questions.

• Come from a place of curiosity; leave room for things not to be “perfect”. It is amazing how being careful with the way you choose to phrase a question or comment can impact the way the other person feels and answers. When you are able to ask a question that doesn’t assume there is a straightforward, fix-all answer, you give space and permission for the person suffering. “Is there anything that feels helpful when you’re having the urge?” Firstly, asking if there is anything conveys that you are aware that there might not be a tidy solution. Without that pressure, this question also allows the person with the BFRB to advocate for themself, and also takes the onus off the other person to be the “problem solver”. Most people seeking support want to be helped, not dictated to. This is true in any situation, whether it’s BFRBs, pressure at work, difficulty juggling the demands of running their household, or any other stressor. 
• Assume you will help, don’t assume how you will help. How many times in your life has someone said, “Let me know if I can help,” or, “Do you want some help?” When you put it that way, the person you are offering to is obligated to ask for help, anyway; it changes from being an offer to being a suggestion that they can ask. Consider asking the following: “How can I best support you without making you feel watched or pressured?” This allows you to volunteer to help without taking over the process. Avoid commenting on appearance or trying to “fix” it—focus on connection. Most of the time, a supportive environment and compassion from a loved one is going to be the thing that helps to calm a nervous system, or empower the person with the BFRB. You might get a response like, “Can you just sit with me for a while until I feel a little better?

3 – Set Boundaries & Respect Autonomy

For those who spend time with someone who struggles to manage their BFRBs, it can be difficult to determine how best to support them. It can feel like something that is your business, because it is a given that BFRBs impact behavior. It can also feel like something that isn’t your business, because you’re not the person who has the behaviors. It’s okay to ask for clarity around how BFRBs may impact shared living spaces or routines—but it’s also important to avoid micromanaging. 

• The best coping method is one that works. Empower the individual with the BFRB to lead the conversation on coping strategies. You may have an idea about what you think might work best; in fact, so may the other person. Ultimately, it may not be “up to” either of you, as what might seem most convenient or practical might not be most effective. It may not be about “not trying hard enough”, or not trying something “the right way”. It might just be that that tactic is not effective. Giving space for the best solution is essential to figuring out what that solution is. We practice these strategies in our Woodland Hills BFRB therapy sessions, and having room and permission for trial and error helps make genuine strides and experience more beneficial change.
• The person with the BFRB is ultimately the one who can learn to deal with them. Of course, you want your loved one to reduce and eliminate the ways their BFRB interferes with their life, their happiness, and your life together. It can be tricky to navigate supporting someone for whom you care deeply. As with any struggle experienced by a loved one, there is often an impulse to take responsibility for the other person’s BFRB. It comes from a place of wanting to “fix the problem” for them. BFRB intervention can manifest as calling it out, expressing frustration or disappointment when a BFRB occurs, or trying to physically suppress behaviors. Trying to exert control over the other person isn’t going to help them actually make the changes they need to make in order to replace their BFRBs with more positive habits.

Key Takeaways

• BFRBs can affect romantic, family, and social dynamics—but understanding helps bridge the gap.
• Compassionate communication and mutual education are key to maintaining strong relationships.
• Support should be empowering, not controlling. You are a team member, not the team manager, when you are supporting someone who deal with BFRBs.
• BFRBs are not a habit to break, they are a mental health disorder best treated with in-person or online BFRB therapy.

Therapy can help individuals and couples navigate BFRBs with compassion and clarity. Whether you’re the one living with a BFRB or the partner of someone who is, therapy provides a safe space to understand emotional triggers, build trust, and strengthen the relationship dynamic.

BFRB Treatment in Woodland Hills 

Bodily Focused Repetitive Behaviors (BFRBs)—such as hair-pulling, skin-picking, and nail-biting—are often misunderstood and unfairly judged. While physical health issues like broken bones or cancer often receive compassion, those struggling with BFRBs may face shame, silence, or dismissal, despite the very real mental and emotional toll they take.

At Embracing You Therapy, we’re committed to changing that narrative. Our therapist, who specializes in treating BFRBs and OCD-related disorders, offers evidence-based care rooted in understanding and respect. With the right support, tools, and guidance, you can regain control, rebuild your confidence, and move toward a life where your goals and dreams aren’t held back by BFRBs.

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