Close this search box.

Body-Focused Repetitive Behaviors (BFRBs)

Body-focused repetitive behaviors, include a range of repetitive actions or movements that an individual performs, frequently without a clear purpose.

What is Body-Focused Repetitive Behaviors (BFRBs)?

Body-focused repetitive behaviors (BFRBs)  include a range of repetitive actions or movements that an individual performs, frequently without a clear purpose. These behaviors become a notable aspect of various mental health disorders, such as obsessive-compulsive disorder (OCD) and certain tic disorders.

In the context of OCD, body-repetitive behaviors manifest as compulsions, which are ritualistic actions performed in response to obsessive thoughts. These behaviors aim to alleviate anxiety or prevent a feared event, even though they may not be connected logically to the feared outcome. Examples include excessive hand washing, checking, or counting rituals. The repetitive nature of these behaviors provides temporary relief but perpetuates the cycle of obsession and compulsion.

Tic disorders, on the other hand, involve involuntary, sudden, and rapid movements or vocalizations known as tics. While not all tics fall into the category of body-repetitive behaviors, certain complex motor tics, involving repeated movements of specific body parts, can be considered as such. These behaviors often begin in childhood and vary in severity, with some individuals able to suppress tics temporarily, leading to heightened tension and subsequent release when the tic is finally expressed. Despite their temporary soothing effects, individuals engaging in BFRBs frequently grapple with shame, guilt, and a sense of loss of control.

Some of the most common BFRBs include:

  • Dermatillomania (Skin Picking)
  • Dermatophagia (Skin Eating)
  • Morsicatio Buccarum (Cheek Biting)
  • Onychotillomania (Nail Biting)
  • Trichophagia (Hair Eating)
  • Trichotillomania (Hair Pulling)
  • Cheek Biting (Morsicatio Buccarum)

Treatment for Body-Focused Repetitive Behaviors (BFRBs)

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a highly effective and evidence-based approach for treating Body-Focused Repetitive Behaviors (BFRBs). At Light On Anxiety, our specialized therapists are trained in using CBT techniques tailored specifically for BFRBs such as trichotillomania (hair-pulling disorder), dermatillomania (skin-picking disorder), and onychophagia (nail-biting).

Through CBT, clients learn to:

  1. Identify triggers and patterns associated with their BFRBs.
  2. Develop alternative coping strategies, and implement behavioral interventions to reduce or eliminate the problematic behaviors.

Techniques such as habit reversal training (HRT) and stimulus control help clients gain awareness of their BFRBs and develop healthier responses. With compassionate support and guidance, our therapists empower clients to regain control over their behaviors, improve their self-esteem, and lead fulfilling lives free from the constraints of BFRBs.


Medication can be a helpful adjunct to therapy in the treatment of Body-Focused Repetitive Behaviors (BFRBs), particularly for individuals with severe symptoms or co-occurring conditions such as anxiety or depression. At Light On Anxiety, our team of psychiatric providers works closely with clients to assess their unique needs and develop personalized medication regimens.

Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are commonly prescribed to reduce anxiety and mood symptoms associated with BFRBs. Additionally, N-acetylcysteine (NAC) has shown promise in some studies for reducing hair-pulling and skin-picking behaviors.

Our approach to medication management prioritizes safety, efficacy, and collaboration with clients to ensure they receive the most appropriate treatment for their symptoms.

Integrating CBT + Medication

At Light On Anxiety, we offer integrated treatment plans that combine evidence-based therapy with medication management to address both the psychological and physiological aspects of BFRBs.

Our therapists and psychiatric providers collaborate closely to tailor treatment plans to each individual’s needs and preferences:

  • CBT helps clients develop coping strategies and address underlying triggers for their BFRBs.
  • Medication can provide additional support by reducing anxiety and mood symptoms and enhancing the effectiveness of therapy.

Our approach involves a careful integration of CBT and medication, depending on patient preferences and clinical needs, to address both the biological and psychological aspects of Body-focused repetitive behaviors (BFRBs).

  1. Collaborative Treatment Planning: Our experienced team works collaboratively to create an individualized treatment plan that assists you in meeting your treatment goals as effectively and rapidly as possible.  
  2. Patient Empowerment: We believe in empowering you with comprehensive information about Body-focused repetitive behaviors (BFRBs) treatment options, allowing you to make informed decisions about your treatment journey. 
  3. Monitoring Progress: Regular monitoring and adjustments to your treatment plan are made based on your response and progress. This ensures you are obtaining maximum benefits from the time and energy you are putting into the Body-focused repetitive behaviors (BFRBs) treatment process.  
  4. Ongoing Support:  We offer ongoing support and adjustments to your treatment plan as needed, ensuring a comprehensive and personalized approach to your path to healing.

Your Unique Path to Freedom From Body-Focused Repetitive Behaviors (BFRBs) 

Our goal is to create a treatment plan that aligns with your needs and preferences, recognizing that each individual’s journey is unique.

What are the symptoms of Body-Focused Repetitive Behaviors (BFRBs)?

The symptoms of BFRBs include various behaviors, each with its own unique characteristics:

Persistent engagement in repetitive behaviors related to the body, such as pulling hair, picking skin, or biting nails.
Difficulty controlling the urge to perform these behaviors, even when there’s a desire to stop or reduce them.
The behaviors can lead to noticeable physical damage, such as bald patches from hair pulling, skin lesions from skin picking, or damaged nails from nail biting.
BFRBs are often associated with emotional distress, including feelings of shame, guilt, or embarrassment due to the inability to control the behaviors.
Significant interference with daily activities, work, or social functioning due to the time spent engaging in these behaviors or the consequences of the behaviors.
Unsuccessful attempts to stop or reduce the behaviors, despite awareness of the negative consequences.
Excessive preoccupation with the body parts involved in the behaviors, leading to significant distress.

FAQs about Body-Focused Repetitive Behaviors (BFRBs)

Body-focused repetitive behaviors (BFRBs), encompassing actions like hair-pulling, skin-picking, or nail-biting, have multifaceted causes involving genetic, neurological, environmental, and psychological factors. Genetic predisposition plays a role, particularly when there is a family history of these behaviors. Neurological differences, especially in areas related to impulse control and emotional regulation, may contribute to the development of BFRBs. Stress, anxiety, or trauma can act as triggers, as individuals may engage in these behaviors as coping mechanisms. Learned behavior, perfectionism, sensory stimulation, and body image issues further contribute to the complexity of BFRBs.

Some BFRB examples include: hair-pulling, skin-picking, nail-biting, cheek or lip biting, thumb-sucking, knuckle-cracking, skin chewing, etc.

Triggers for body-focused repetitive behaviors (BFRBs) can vary among individuals and are often linked to emotional states or situations. Stress, anxiety, boredom, or feelings of tension are common triggers that prompt individuals to engage in repetitive actions like hair-pulling, skin-picking, or nail-biting. Emotional distress or even positive emotions may lead to the activation of these behaviors, as they may serve as a coping mechanism or a way to regulate emotions.

More About Treatment for Anxiety

What is CBT & ERP for OCD?

Light On Anxiety CEO Dr Debra Kissen describes how CBT & ERP helps clients move past OCD and other anxiety disorders.

Learn more about how we can create a custom individual treatment plan to fit your goals.

Success Stories

Get Anxiety Fighting Tips
to your Inbox!