Category Archives: OCDLA

Peace

Reflections on Skin Picking and Hair Pulling - OCD Center of Los Angeles

Reflections on
Skin Picking and Hair Pulling

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Peace is not something you wish for; it’s something you make, something you do, something you are.

~ Robert Fulghum

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Peace

It’s quite natural to crave a feeling of peace. This is true whether you are experiencing a significant mental health issue, coping with a personal crisis such as a divorce or the death of loved one, or just trying to effectively manage the vicissitudes of every day life.

If you suffer with Skin Picking Disorder or Trichotillomania, peace is likely something you have been “wishing” for throughout your struggle. Of course, it would be wonderful if a feeling of peace would descend upon us just by wishing for it. But in reality, peace requires action. If you are committed to finding peace, you must wholeheartedly agree to do the work involved in attaining it.

In many ways, peace is a function of conscious acceptance in that it requires us to choose to accept reality as it is, rather than as we would like it to be. Of course, this may not be easy – sometimes the urge to pick or pull may be so powerful that it feels almost impossible to peacefully accept. Some with Skin Picking Disorder or Trichotillomania describe their urges as being like a loud sound that simply can’t be ignored – as if someone has turned the volume of the urge up so high that it is the only thing they can pay attention to.

In order to move through and past this extremely distracting urge, the first thing you must do is to fully accept its existence. If you spend your time attempting to control or avoid your picking and pulling urges, all you are doing is spending time engaging with something you cannot control.

Once you have accepted the presence of your loud and annoying urges to pick or pull, you can choose to engage in other activities. When you do this, you will notice the volume of your urges decreases because they are no longer front and center. They will still be there, but they will not be all-consuming. By choosing the action of doing something other than engaging with the urge, you take an enormous step forward in your recovery.

Choosing to act differently in response to your urges may at first feel quite difficult. But keep in mind that peace is not just wishing or hoping – peace is “something you do”. It is something that requires repeated practice. And with effort and commitment, it eventually becomes “something you are”.

__________________________

1) In what ways are you accepting, or not accepting, of your unwanted urges to pick or pull?

2) What actions might you take to further develop a peaceful, accepting relationship with your urges?

3) What are some activities that you find peaceful, and how can you implement them in your daily life?

__________________________

Weekly Tip: This week, try to be mindful of your thoughts, feelings, and actions at those times when you are able to accept and move through an urge without giving in to it. Notice if there is a sense of peace after you accept an urge rather than trying to control it. Practice this approach in order to develop a consistent, new pattern of responding to your urges with acceptance, action…and peace.

__________________________

For a free subscription to “Reflections”, please click here.

The OCD Center of Los Angeles is a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of OCD, Skin Picking Disorder, Trichotillomania, and related conditions. We offer the following services:

  • Individual Therapy
  • Low-Fee Group Therapy
  • Online Therapy
  • Phone Therapy
  • Home Visits
  • Intensive Outpatient Program
We treat adults, adolescents, and children, and offer services six days a week, including evenings and Saturdays. For more information, please contact one of our client coordinators at (310) 824-5200 (ext. 4), or click here to email us.
__________________________

OCD Center of Los Angeles
http://ocdla.com

(310) 824-5200

Written by
Kelley Franke, MA
and Tom Corboy, MFT

© 2016 OCD Center of Los Angeles

We will never share, rent or sell your personal information to third parties.

OCD Center of Los Angeles: 11620 Wilshire Blvd. #890, Los Angeles, California 90025, United States

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Habits

habits-wordle1

__________________________

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

~ Warren Buffett

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Habits

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
http://ocdla.com

(310) 824-5200

Written by
Kelley Franke, BA and Tom Corboy, MFT

© 2016 OCD Center of Los Angeles

How Long Does it Take to Break a Habit?

image.jpegYes Trich is more than a ‘bad habit’. However, it is an unwanted behavior that I believe can be unlearned or changed.

My goal is to break this ‘habit’. I have been working at this since beginning this blog 2 years ago. Yes, I tried to stop pulling before that, but my mindset changed. I was willing to do everything I could, including changing my mindset.

Before a bad habit or unwanted behavior can be changed or stopped, I believe you need to change your thinking. Your thinking rules everything you do. This is why cognitive therapy is effective. The fist step of changing your thinking is to accept that you have a real disorder that causes you to pull your hair. It is not a lack of will power or discipline that keeps you in the cycle of hair pulling and self-loathing that often directly follows pulling. Click here for more information about Commitment and Acceptance Therapy.

Once you have changed your thinking, you can focus more on the unwanted behavior (hair pulling or any behavior). Cognitive Behavioral Therapy follows this approach (CBT).

According to The OCD Center of Los Angeles:

“The most effective treatment for Trichotillomania is a combination of various types of Cognitive-Behavioral Therapy (CBT). Perhaps the most important of these is called Habit Reversal Training (HRT). HRT is based on the principle that hair pulling is a conditioned response to specific situations and events, and that the individual with Trichotillomania is frequently unaware of these triggers. HRT challenges Trichotillomania in a two-fold process. First, the individual with Trichotillomania learns how to become more consciously aware of situations and events that trigger hair-pulling episodes. Second, the individual learns to utilize alternative behaviors in response to these situations and events.

Other Cognitive-Behavior Therapy techniques can be used as adjuncts to HRT in the treatment of Trichotillomania. Among these are Stimulus Control techniques and Cognitive Restructuring. Stimulus Control techniques involve utilizing specific physical items as “habit blockers” to restrict the ability to pull hair, while Cognitive Restructuring helps an individual with Trichotillomania learn to think differently in response to the urge to pull their hair.
Skin Picking and Hair Pulling – Reflections

One of the most effective CBT developments for the treatment of Trichotillomania is Mindfulness Based Cognitive Behavioral Therapy. The primary goal of Mindfulness-Based CBT is to learn to non-judgmentally accept uncomfortable psychological experiences. From a mindfulness perspective, much of our psychological distress is the result of trying to control and eliminate the discomfort of unwanted thoughts, feelings, sensations, and urges. In other words, our discomfort is not the problem – our attempt to control and eliminate our discomfort is the problem. For those with Trichotillomania, the ultimate goal of mindfulness is to develop the ability to more willingly experience their uncomfortable thoughts, feelings, sensations, and urges, without pulling their hair. To learn more about Mindfulness Based CBT for the treatment of Trichotillomania, click here.

Here’s how long it takes to break a habit, according to science
*You’re gonna need more than will power.
SIGNE DEAN 24 SEP 2015

From daily tooth-brushing to the 11am coffee, we all have dozens of habits that get us through our daily routine. Some are great – weekly gym visits are often encouraged – others not so much, like smoking a pack a day, or dialling the number of the pizza place way too often. Because we recognise our habits as useful or detrimental behaviours, we often strive to shape them accordingly.

There’s no shortage of apps out there designed to help you form a habit, and many of those are built on the assumption that all you need is 21 days. This number comes from a widely popular 1960 book called Psycho-Cybernetics by Maxwell Maltz, a plastic surgeon who noticed his patients seemed to take about 21 days to get used to their new faces.
However, according to a 2009 study, the time it takes to form a habit really isn’t that clear-cut. Researchers from University College London examined the new habits of 96 people over the space of 12 weeks, and found that the average time it takes for a new habit to stick is actually 66 days; furthermore, individual times varied from 18 to a whopping 254 days.

The take-away message here is that if you want to develop a new behaviour, it will take at least two months, and you shouldn’t despair if three weeks doesn’t do the trick – for most people that’s simply not enough. Stick with it for longer, and you’ll end up with a habit you can keep without thinking.

But what about trying to break an unwanted habit?

It turns out the two – habit forming and breaking – can be quite closely linked. As psychologist Timothy Pychyl explains to Alison Nastasi at Hopes and Fears, they’re two sides of the same coin: “Breaking a habit really means establishing a new habit, a new pre-potent response. The old habit or pattern of responding is still there (a pattern of neuron responses in the brain), but it is less dominant (less potent).”

From daily tooth-brushing to the 11am coffee, we all have dozens of habits that get us through our daily routine. Some are great – weekly gym visits are often encouraged – others not so much, like smoking a pack a day, or dialling the number of the pizza place way too often. Because we recognise our habits as useful or detrimental behaviours, we often strive to shape them accordingly.

There’s no shortage of apps out there designed to help you form a habit, and many of those are built on the assumption that all you need is 21 days. This number comes from a widely popular 1960 book called Psycho-Cybernetics by Maxwell Maltz, a plastic surgeon who noticed his patients seemed to take about 21 days to get used to their new faces.
However, according to a 2009 study, the time it takes to form a habit really isn’t that clear-cut. Researchers from University College London examined the new habits of 96 people over the space of 12 weeks, and found that the average time it takes for a new habit to stick is actually 66 days; furthermore, individual times varied from 18 to a whopping 254 days.

The take-away message here is that if you want to develop a new behaviour, it will take at least two months, and you shouldn’t despair if three weeks doesn’t do the trick – for most people that’s simply not enough. Stick with it for longer, and you’ll end up with a habit you can keep without thinking.

But what about trying to break an unwanted habit?

It turns out the two – habit forming and breaking – can be quite closely linked. As psychologist Timothy Pychyl explains to Alison Nastasi at Hopes and Fears, they’re two sides of the same coin: “Breaking a habit really means establishing a new habit, a new pre-potent response. The old habit or pattern of responding is still there (a pattern of neuron responses in the brain), but it is less dominant (less potent).”

“It’s much easier to start doing something new than to stop doing something habitual without a replacement behaviour,” says neuroscientist Elliot Berkman. “That’s one reason why smoking cessation aids such as nicotine gum or inhalers tend to be more effective than the nicotine patch.”

Experts agree that there’s no typical time frame for breaking a habit, and the right recipe is going to be a mix of personality, motivation, circumstances, and the habit in question. “People who want to kick their habit for reasons that are aligned with their personal values will change their behaviour faster than people who are doing it for external reasons such as pressure from others,” says Berkman.

According to psychology professor Susan Krauss Whitbourne, sometimes a habit can be broken quickly: “In extreme cases, the habit can be broken instantly, such as if you happen to become violently ill when you inhale cigarette smoke or nearly get hit by a bus when texting and walking.” But in most cases it’s going to take longer than that, and you should probably allow for at least two months.

To successfully break a habit, you need to think of your strongest motivation, which will drive you along. Think of a ‘replacement behaviour’ for the habit, but make sure it’s a positive one – replacing smoking with snacking is a common trap, for example. And be patient. The longer you’ve had a habit, the longer it will take to get rid of it.

“Longtime habits are literally entrenched at the neural level, so they are powerful determinants of behavior,” explains Berkman. “The good news is that people are nearly always capable of doing something else when they’re made aware of the habit and are sufficiently motivated to change.”

So stay strong, you can do it.

 

 

 

Struggles

Reflections on Skin Picking and Hair Pulling - OCD Center of Los Angeles

Reflections on
Skin Picking and Hair Pulling

__________________________

Suffering usually relates to wanting things to be different from the way they are.

~ Allan Lokos

__________________________

Suffering

Everybody suffers. But much of our psychological suffering occurs as a result of our beliefs about how we think life “should”be, or how we would ideally like it to be. Often, it is our over-attachment to these beliefs that turns normal, everyday pain and discomfort into true suffering.

If you have Skin Picking Disorder or Trichotillomania, you may suffer needlessly as a result of this type of over-attachment to certain beliefs. An unwanted blemish or hair (or event or feeling) is not as you wish it would be, which leads to distress, which in turn leads to a picking or pulling episode. This not only worsens the physical consequences of these conditions, but leads to more psychological suffering in the form of hours (or days) of self-loathing during which you spend a great deal of time negatively evaluating yourself and your behavior.

Common negative thoughts might include “I should have been able to overcome the urge to pick or pull”, or “I look so ugly”, or “I am inadequate” or “I am hopeless”. Over time, and with much repetition, these types of thoughts become internalized into an overall negative belief system you have about yourself, which only increases your suffering.

The long-term goal of recovery is to develop more psychological flexibility by making room for all of the imperfections of real life, thus lessening the emotional suffering you experience. Life will never be 100% free of pain and suffering.  In fact, life is full of unavoidable pain, such as the pain we experience with serious illness or injury, or the death of a loved one. However, much of our psychological pain is self-created by thoughts and beliefs that are unhelpful, and which ultimately lead to picking and pulling setbacks.

If you do not measure up to what you think is acceptable, you may ultimately inhibit and prolong your recovery. Alternatively, by accepting all of life, including your imperfections, you will reduce your suffering, and move further down the road of recovery.

__________________________

1) How often do you get stuck in the trap of judging yourself and your picking and pulling behavior, and not allowing room for imperfection?

2) What specific thoughts do you have after a setback that might increase your suffering?

3) What thoughts might be more helpful in promoting your long-term recovery?

__________________________

Weekly Tip: When you experience negative self-talk, notice how this increases your suffering, and choose instead to fully accept yourself, including your imperfections.

__________________________

For a free subscription to “Reflections”, please click here.

The OCD Center of Los Angeles is a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of OCD, Skin Picking Disorder, Trichotillomania, and related conditions. We offer the following services:

  • Individual Therapy
  • Low-Fee Group Therapy
  • Online Therapy
  • Phone Therapy
  • Home Visits
  • Intensive Outpatient Program
We treat adults, adolescents, and children, and offer services six days a week, including evenings and Saturdays. For more information, please contact one of our client coordinators at (310) 824-5200 (ext. 4), or click here to email us.
__________________________

OCD Center of Los Angeles
http://ocdla.com

(310) 824-5200

Written by
Kelley Franke, BA and Tom Corboy, MFT

© 2016 OCD Center of Los Angeles

We will never share, rent or sell your personal information to third parties.

OCD Center of Los Angeles: 11620 Wilshire Blvd. #890, Los Angeles, California, 90025, United States

Unsubscribe From This List / Unsubscribe From ALL LISTS

NamasteLight