Available from 10:00am - 6:00pm
- new York, USA
- Support@thoughtshifttherapy.com
- 914-215-5409
You’re not “just picking” or “just pulling.” Body-Focused Repetitive Behaviors (BFRBs)—like skin picking (excoriation), hair pulling (trichotillomania), and nail biting—are real, distressing conditions that often come with feelings of shame, secrecy, and the exhausting effort to stop… and then start again.
You’ve probably tried willpower, distraction, covering things up, even punishing yourself for the behavior. But BFRBs aren’t about weakness or lack of discipline—they’re about a cycle your nervous system has gotten stuck in, often in response to stress, boredom, or anxiety.
Body-focused repetitive behaviors (BFRBs) are self- grooming behaviors in which individuals pull, pick, scrape, or bite their own hair, skin, or nails, resulting in damage to the body.
For these behaviors to be considered a disorder, they typically occur often enough to:
Cause noticeable emotional distress or interfere with daily life—such as work, school, or relationships
Result in physical harm or injury to the body
Contribute to feelings of confusion, isolation, and low mood or depression
We use Habit Reversal Training (HRT)—a behavioral therapy that helps increase awareness of the urge and teaches new, more helpful responses. It’s part of a larger framework called CBT for BFRBs, which may also include mindfulness, emotional regulation strategies, and identifying what’s underneath the behavior.
Because it focuses on changing patterns, not fighting urges. HRT works by helping you catch the behavior in the moment and gives your body and brain a new, healthier way to respond. It’s practical, empowering, and rooted in research—and over time, it helps break the cycle.
HRT teaches us that change doesn’t come from willpower alone—it comes from awareness, practice, and compassion. Through this therapy, you learn to notice the moments leading up to the behavior, understand what your body and mind are trying to communicate, and choose a new way to respond.
It’s not about forcing yourself to stop—it’s about building a toolkit that helps you feel more in control, less reactive, and more connected to your needs. Over time, HRT helps you rewrite the script, so your urges don’t have the final say.
At Thought Shift Therapy, we treat BFRBs using Habit Reversal Training (HRT)—a research-backed, compassionate approach that helps you gain awareness of your patterns and build new ones that work with your brain, not against it. We’ll work together to:
Identify triggers: both emotional and environmental
Build “competing responses” (behaviors that replace the urge)
Rewire the urge-reward loop
Address the deeper emotions that might be fueling the cycle
