BFRB Pittsburgh

BFRBs, or body-focused repetitive behaviors, describe a group of disorders in which a person performs repeated behaviors such as hair-pulling, skin-picking, cheek-biting, or nail-biting in such a way, and with such frequency, that the behavior results in damage or disfigurement to their body. The result of such behaviors leads to significant personal distress including shame, guilt, embarrassment, and emotional distress.

Social and interpersonal interactions may be severely affected and can include problems with peers, family, and friends. Academic and vocational aspects of life can also be affected; the BFRB sufferer may not wish to attend school or work or seek out these important life activities.

BFRBs are not uncommon. Estimates are that they affect about 2-3% of the general population. This translates to about 8 million child and adult sufferers, or about 1 in 50 persons. It is likely that most people know someone who is suffering with a BFRB. Both males and females are affected. Onset in early childhood may be related to thumb-sucking and self-soothing and often spontaneously remits. The more common onset in adolescence occurs more often in females and usually has a more chronic, lifetime course.

BFRBs belong to a set of disorders described as Obsessive Compulsive and Related Disorders. BFRBs are not OCD, and OCD is not a BFRB. However, approximately 25% of those affected with either one of these disorders may also have the other. The cause of BFRBs is unknown, although a genetic component is strongly suspected as these disorders tend to be experienced by other family members and are more common between identical twin sets, but not necessarily so.

Anxiety is commonly associated with BFRBs, although not seen in every case. It is now understood that several factors may be related to body-focused repetitive behaviors. Some of these factors have to do with the patient’s sensory needs, their mood or affect around the time of the BFRB, particular cognitions or thoughts that the person may be having, positions or movements of the person’s body, and places or environments in which the BFRB is performed.

BFRBs may occur along with other disorders such as OCD, Major Depression, General Anxiety Disorder, Body Dysmorphic Disorder (BDD), Tourette’s Disorder, eating disorders, alcohol and other substance abuse disorders. Although skin-picking is common in Substance Abuse Disorder, this may not reflect a true BFRB but may be related to skin sensations associated with the drug of abuse.

Treatment of BFRBs is comprehensive and involves Cognitive Behavioral Therapy (CBT) including behavioral modification, lifestyle changes, and self-accommodation. No medications have been conclusively shown to be successful in treating BFRBs to date. Peer support can be an important part of achieving and maintaining recovery from BFRBs.

BFRB Pittsburgh is a non-profit therapist-led peer support group dedicated to the support and education of those suffering from BFRBs. The group is the first of its kind in PA, and I facilitate the meetings which are held monthly in Wexford, PA, just north of Pittsburgh. For more information please call: 724.799.8300.


TLC Foundation for BFRBs (

International Obsessive Compulsive Foundation (

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