I remember when I first realized that pulling out my eyelashes felt good. I was 9 years old. I started pulling on my eyelashes in order to make a little suction noise when my eyelid popped away from my eye. Just a child’s diversion, but it also felt achy and good. I started tugging on individual lashes until they came out. And soon, I had no eyelashes left.
Some of us with body-focused repetitive behaviors (BFRBs) associate a stressful event with the onset of the behavior. But for most of us, if there is any kind of triggering event, it is often very ordinary: making a wish on an eyelash or scratching a pesky mosquito bite. However benign the initial onset, picking and pulling can spiral into serious problems. Once the behavior becomes ingrained, it is very difficult to stop without intervention.
Here are three accounts by young people who remember the early adolescent years when they started picking or pulling and found they kept doing it.
Beth, age 21: “I know exactly how it started. I had just completed the fourth grade, and it was during my summer vacation. A popular girl from my school who lived in my neighborhood had started a ‘girls club.’ She was always doing something to be the center of attention and would often put on plays that she wrote, directed, and starred in. The girls club was in the basement of her house. She would charge kids in the neighborhood a quarter as admittance fee to see her so-called plays. One time when we arrived for her to open up the doors, we were all surprised to hear that the admittance wouldn't be the quarter we carried but instead she required that one eyelash be plucked by each girl and dropped in an envelope at the door. That sounds pretty weird, and I wonder now what she was up to, but all I knew was when I pulled out that lash something like a good-feeling electric shock went through my face in the most surprising way. Later I found that I could achieve feelings like that by pulling more lashes, and soon it became a regular thing with me. By the next school year I was missing all my eyelashes and there were spaces within my eyebrows. The feelings have changed over the years: That electric shock is gone, but in its place is some kind of special feeling that, to this day, I can't get in any other way.”
Brian, age 19: “All I know is that it began kind of slowly, around the time I was 13. All of my friends in the neighborhood spent a lot of time on ‘the hills’—the sloping wooded land behind our houses in Pittsburgh. We would spend endless hours playing soldiers, hide and seek, explorers or whatever our imagination came up with. The hills were loaded with thorny bushes, brambles, poison ivy and mosquitoes that would eat you alive. My mom always wanted me to wear long pants and good shoes when we played there. But kids being kids I’d be down there running around in shorts and flip-flops a good deal of the time. I'm not sure when, but at some point, I began to pick at the scabs, bug bites and abrasions that I always had on my skin, particularly on my lower legs. Soon they were such a bloody mess that some of the other kids began to tease me about it. So I took to wearing long pants, not only when playing on the hills, but all the time, just to cover up my legs. But I had developed this habit of picking at my legs wherever I found any scabs or bumps. My legs became a disaster—raw and bloody. I tried to hide it all from my parents, but my mom noticed the bloody spots on my sheets and pajamas. She and my dad confronted me one evening and made me show them my legs under the bright lights in the kitchen. They were alarmed by what they saw, and even more so when, through tears and sobs, I told them I didn't know why I did it, but that I couldn't stop.”
Zach, age 20: “You see these scars and bloody spots on my arms. Well, that’s just the tip of the iceberg. I never take my shirt off in public or wear shorts outside of my own room. I feel like a leper. Come to think of it, I kind of live the life of one. What separates me from other people my age is a body that looks like it’s been through the wars. Actually, you know as well as I do—I've done this all to myself. It wasn't really too bad at first, say when I was 11. That summer we were at a vacation cabin on a lake. It seemed like there were a million mosquitoes, especially at dusk, when my cousins and I were running around playing on the shore. They seemed to especially like biting me, and I was a mass of itching, red bumps. I couldn't help scratching at them until the skin was broken and they started to bleed. Within a few days, there were little crusts and scabs all over my arms and legs. I kind of liked picking them off, and I would bite and swallow them, enjoying the taste and the crunch when I bit down on them.”
“My parents caught on quick to what I was doing. They just let it slide until the vacation was over, but when they saw me continuing to do this back at home, they got more upset. I don't remember much about what they did to try and help me stop—maybe medicine and Band-Aids and that kind of thing, but one day they tried something new, and that's when things really got bad. At the dinner table one night I began to pick at the scabs on my arms. My father announced that this was disgusting behavior, very inappropriate in a nice house among family members, and that if I felt it necessary to pick, I was to go to the bathroom and stay in there as long as the picking went on. Well, when I got in the bathroom the picking went wild. I dug deeper, damaged more skin, and probably created more scarring in a week of this new program then I had in the whole month before. Mom told me later that they been watching TV and—hard to believe—but a TV doctor was advising parents about how to deal with their child's skin picking. That was his brilliant advice that they followed, and this was the impact on my family. Incidentally, my mom cried when she told me that.”
As a parent now, I empathize with both the kids who start picking or pulling and the parents who don't know how to help them. But help is available, and I encourage all families grappling with these issues to research body-focused repetitive behaviors (BFRBs) and find out how to limit their negative impacts.
Special thanks to my colleagues, Charles Mansueto, Ph.D., Ruth Golomb, LCPC and Sherrie Vavrichek, LCSW-C of the Behavior Therapy Center of Greater Washington, Silver Spring, MD, for sharing these stories collected from patients at their clinic.
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