Chains of habit are too light to be felt until they are too heavy to be broken.

~ Warren Buffett



We all have habits. In fact, many habits, such as putting on your seatbelt or brushing your teeth, are beneficial. But those suffering with Skin Picking Disorder and Trichotillomania have habits that are anything but beneficial.

All habits – good or bad – include three components:

  • A cue, which triggers the habitual behavior to start.
  • The behavior itself, such as picking or pulling.
  • A reward, which “reinforces” the behavior, thus leading you to repeat it in the future.

This is called a “habit loop” and it is a crucial principle in understanding these conditions.

Habit Reversal Training (HRT) is one of the most important strategies used in changing your behavior and breaking habit loops. The first step in HRT, as discussed here in previous installments, is building awareness of your picking and pulling. Once a trigger is identified, it can act as a warning sign that you are about to engage in a destructive behavior.

Using HRT, you learn to instead use a competing response to the trigger, rather than picking or pulling. This competing response should ideally be something that actively engages your hands, and which can be done easily in most situations. The immediate goal is to make picking or pulling more difficult, or even burdensome. Some examples of competing responses include squeezing a stress ball, knitting, writing, or painting. Basically, anything that keeps your hands away from your skin and hair!

By introducing this alternative behavior as a replacement for your habitual behavior, you interrupt the reinforcement, start the process of breaking the habit loop, and begin developing a new, non-damaging habit in its place. Additionally, some people use habit blockers such as gloves, to act as a further impediment to their picking and pulling.

It may take some time to find what works for you, and some things might work better than others depending on the given situation. As a result, you may at first find it difficult to consistently implement HRT, and may grow frustrated with yourself. But with repeated practice, you can learn to replace a destructive habit with one that is neutral or even positive. While HRT is seldom a solution in itself, it is a critical component of a long-term process of challenging these destructive, habitual behaviors.


1) Create a list of the situations that often trigger you to pick or pull.

2) Create a list of different competing responses you might use this week when you feel the urge to pick or pull. (Hint: The TLC Foundation for BFRBs website at www.bfrb.org sells many inexpensive “fidgets” that can keep your hands busy.)

3) Keep a log of which competing responses work and don’t work for you this week, and try to come up with alternatives for those times that the competing behavior you try is not helpful.


Weekly Tip: Remember that when you first start using competing responses, you might feel frustrated because you are using it so often, or because HRT is simply not working in that moment. This is a normal reaction, and it is important to keep trying new ways to break the habit loop. You might find that you will have to try several replacement behaviors, or to repeat the replacement behaviors numerous times before you start to experience success in breaking your habit loop.


OCD Center of Los Angeles

(310) 824-5200

Written by
Kelley Franke, BA and Tom Corboy, MFT

© 2016 OCD Center of Los Angeles


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