How Do I Get My Child to Stop Pulling or Picking?
(watch the video here: https://youtu.be/DH8qYh0H_v8 )
Those of us who treat Body Focused Repetitive Behaviors like trichotillomania or dermatillomania hear this question often from concerned parents. I will try to give some support in this video, and let me specify that this is geared toward kids who are teenagers and older. I think the advice is a bit different for younger kids, especially those age 5 and below. I work mainly with teens and adults with chronic hair pulling and skin picking, and I can tell you that even those who are adults have concerned parents who may feel at a loss for what to do. So let’s talk about some things that help, and some that are not so helpful.
I ask clients early in therapy what their goals are for treatment. If the client is a minor, we may start off with mom and/or dad in the room. Treating a BFRB for a teen is a family issue, and enlisting family members in treatment can help ensure success in many cases – at least that’s always my hope.
So here are some common questions that parents (and sometimes their kids) ask when going into therapy for a BFRB:
“Can you make my child stop picking or pulling?”
In talking about treatment goals with one family where a teen had trichotillomania, one mom said to me “I want you to make him want to stop.” Right away, we were in trouble. Sometimes through the course of therapy a person can become motivated to make positive changes, but there is no guarantee. It helps if there is already some motivation on the part of the person being treated, or at least a willingness to give it a try. Worst case scenario – we teach the tools needed to help stop picking or pulling, we offer lots of educational material and support resources, and we hope that when the child is ready, they will have what they need to be successful. That is still beneficial for all involved, in my opinion. But no therapist has a magic formula to make anyone want to stop a Body Focused Repetitive Behavior. We do have knowledge, training, experience, and lots of tools. But recovery requires a lot from the person who picks or pulls. There is homework, like keeping track of the behavior and maybe changing daily habits or the environment.
“Why does my child pull (or pick)?”
There are a wide variety of reasons people of any age engage in chronic skin picking or hair pulling. Some contributing factors can be anxiety, impulse control, attention deficit disorder, obsessive compulsive disorder, genetic predisposition, and sensory input issues like the Highly Sensitive Person personality trait. In some cases, there is nothing we can point to as a cause. This can be frustrating for parents – if your child is exposed to strep, and they get strep, chances are there is a standard treatment and they get better. BFRBs aren’t like that. They take time, patience, some detective work, commitment, and a flexible, open approach. We do spend some time looking at “why,” because there may be important guideposts there. For example, if the person who picks has a problem with anxiety, we not only provide tools to stop the BFRB, but we treat the anxiety. In many cases, where the “why” is less clear, we spend more time looking at the “how” – the sensory and environmental contributors to picking or pulling.
“How can I help?”
Talk to your child. Whether they are 14 or 35, they can tell you how they experience the urge to pick or pull. Listen to them. Ask them how you can help them – do they want to be reminded if you see them pulling? Do they want to join a support group, or see a therapist who is trained in treating BFBRs? Let them know you are a safe person to talk to. Read what you can about these behaviors.
I have to talk for a moment about what does not help. Unfortunately, these stories are not unusual. Seeing your child struggle with a BFRB is incredibly stressful for parents. You wonder if it is your fault, if other kids will make fun of them, or if the behavior will ever end. With teens especially, some have trich or dermatillomania and they are actually not bothered at all. But it is upsetting for parents all the same. The bottom line here is not to take that frustration out on your child. It breaks my heart when parents become so frustrated that they end up screaming at their child, telling them they will never quit, and basically taking out their anger at the behavior on the person. It happens more often than I would have believed when I started working with people with BFRBs. I have never once seen this work in helping to motivate someone to change. More often, it destroys their hope and their faith in themselves, whether they are 15 or 50. If you are feeling so upset that you are taking your anger out on your child, please consider talking to someone to help come to grips with your feelings. If you have a toddler who is learning to walk, you don’t yell at them or call them a failure every time they fall. You know they will get there, you show them compassion, you help maximize their chances of succeeding. That same approach is recommended with someone who picks or pulls.
“Can you recommend some resources?”
I have seen some absolutely awful advice on the internet, so if possible try to stick with people and websites where they actually have extensive knowledge and a track record of helping people. The gold standard in my opinion is the Trichotillomania Learning Center, and I will put a link to their website below. They have a wealth of information on both trichotillomania and dermatillomania, as well as lesser discussed BFRBs like thumb sucking and nail biting. Facebook has some great resources as well, such as the Canadian BFRB Support Network. I would be very wary of websites promising an instant cure, or that make you pay just to get a glimpse of their “advice.” Those of us who actually work with BFRBs tend to write, make videos, and talk to groups for free, just to help get the word out. The Trichotillomania Learning Center also has lists of support groups and qualified therapists in your area.
So, whatever their age, listen to your child, be someone safe to talk to, offer help and resources, and reach out for help yourself if your frustration reaches the boiling point. Your child is still your child, even with dermatillomania or trichotillomania. People with BFRBs can feel very isolated. Don’t let this behavior drive a wedge between you and your child. Join their team. Keep the dialogue going – your supportive presence can go a long way in your child’s recovery.
Resources in the video description box here: https://youtu.be/DH8qYh0H_v8