04.30.2004
8:46 a.m.
I'm not a freak! Well...
Warning: Some people may find this entry gross. Read with caution.
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About a month ago, I went with my husband to the $10 haircut place to get his hair cut. While he was getting it cut, I was reading a magazine. All of a sudden, I flipped the page, and started reading this article called "I Can't Stop Picking My Face."
I nearly screamed, "Holy crap! That's ME! I'm not a freak! Other people do it, too! There's even a NAME for it!!!"
It's a psychological condition called psychogenic excoriation. (Yeah, like I needed ANOTHER thing to add to my list of "issues"... Oh well.)
If you don't feel like clicking the link, here are some highlights:
"What is skin picking?
Pathologic skin picking is repetitive, ritualistic, or impulsive picking of normal skin, leading to tissue damage, personal distress, and impaired functioning. The behavior has been described for more than 100 years but remains poorly understood, under-diagnosed, and under-treated.
Most people pick at their hands or face to a limited extent, and picking does not by itself suggest a psychiatric disorder. Pathology exists in the focus, duration, and extent of the behavior, as well as reasons for picking, associated emotions, and resulting problems. Persons with pathologic skin picking report irresistible, intrusive, and/or senseless thoughts of picking or impulses to pick, accompanied by marked distress."
My husband can tell you that if I'm stopped WHILE I'm "working on something," I get mad.
"Tweezers, razor blades, knives. . .
Persons who engage in pathologic skin picking typically spend substantial time picking. Most often they pick the face, but any body part�lips, arms, hands, or legs�may be the focus. They may pick at blemishes, pimples, scars, or healthy skin. Some use their hands and fingernails to pick, and others use pins, tweezers, razor blades, or knives. Picking may worsen in the evening."
I find myself doing it all day, every day. Pimples or dry spots on my face, fingernails, cuticles, anything that's available. I'll be picking at say, a blemish on my face while I'm at work, realize what I'm doing, get embarrassed and ashamed, and stop. Then I find myself doing it again a few minutes later. It's a totally unconscious thing for me. Sometimes quite a few minutes pass before I even realize I'm doing it.
"Reasons for picking.
Many patients pick to relieve discomfort or tension. Others pick to improve their appearance, as in BDD [body dysmorphic disorder], or to remove perceived dirt or contaminants, as in obsessive-compulsive disorder (OCD). Still others say they pick as a habit, with minimal awareness. Itching or uneven skin may also cause the behavior. We have found that a patient may pick for several of these reasons. Most report:
-tension before picking
-satisfaction during picking
-guilt, shame, and dysphoria after picking."
The article in Marie Claire said that there are two main reasons that people pick. One is to relieve tension, and the other is to induce a sense of euphoria. For some, it acts as a sedative, and for others, as a stimulant.
I'm completely in the sedative category. When I'm picking at something, it's like I go into a trance. I'm not worried about anything, or thinking about anything... There is only whatever I'm working on. It's like...a Zen thing, almost.
Of course, there is also my tendency toward self-destruction. I don't think people would consider it "normal" to pick at the skin around your fingernails to see if you can peel it to your first knuckle, or all the way around the digit, and feeling of a sense of accomplishment that is directly related to how much damage you do. Or picking at something until it bleeds, and then picking at it some more. Even picking at my fingernails or cuticles while I'm driving, knowing that I might actually get into an accident while I'm doing it, and not caring, because "I just have to get this one thing!"
There are apparently a few ways to help people with this disorder. The first is to prescribe SSRIs or MAOIs. I'm on an SSRI already, so that's set. Some picking relates to anxiety, so doctors feel that if you get the anxiety under control, the picking will lessen.
The second method is habit reversal therapy.
"In a case series, three patients were successfully treated with habit reversal and cognitive-behavioral techniques, consisting of:
-awareness training (using a skin-picking diary)
-competing response techniques (such as making a fist or squeezing a ball)
-emotion regulation skills
-psychoeducation
-cognitive restructuring (such as using Socratic questioning to produce rational alternatives) in situations that elicit the urge to pick."
Jeez...if I had to use a skin-picking diary, all I'd be doing is writing in there. All other work would have to cease. I do have a stress-ball squeezy thing I got from State Farm, though. Maybe I'll put that on my desk and play with it today, to see if it helps at all.
I'd really like to stop doing this behavior. It makes my face scar, and my fingernails and fingers will never look PRETTY if I don't stop picking at them and making them scab and bleed. I want to stop. I've just been doing it for SO many years now (about...12 years?) that I'm not sure if I can actually stop.
Apparently this is one of the most difficult disorders to completely cure. About 98% better is the most that can be expected. Even that would be a step in the right direction. Even that would help me feel like less of a freak.
I guess all I can do is actively try to make an effort, and see what happens.
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Ooh! It's like therapy in a little white box. *grin* Thanks for letting me babble.
HAPPY FRIDAY!!!
Food I'm craving: doughnuts
Song in my head: the chicken dance song
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