Therapy for…

Body-Focused Repetitive Behaviors

Body Focused Repetitive Behaviors, or BFRBs, are a group of behaviors in which an individual compulsively causes damage to his or her own body. This may be through chronic skin picking, hair pulling, cheek biting, nail or cuticle picking/biting, or other similar actions. The person may be relieving anxiety, may be bored or tired, may have family members who pull or pick – there is no single reason people develop a BFRB. Similarly, there is no one single treatment that can erase this behavior. It is vital when choosing a therapist for help with a BFRB, that the therapist have training and experience in this area.

BFRBs are generally considered to be Impulse Control Disorders. In other words, the problem is chronic, the person has tried to stop or reduce the behavior without success, there is no other medical cause for the behavior, and it has caused significant distress for the person.

BFRBs affect family and friends, as well, who often feel confused and helpless. There is help available for conditions like dermatillomania and trichotillomania. It can be difficult to find a mental health practitioner who understands how to treat BFRBs, and the condition doesn’t always respond to traditional “talk therapy.”

How do you treat Body-Focused Repetitive Behaviors?

At Fletcher Therapy, you can expect an individualized approach to your assessment and treatment. Marriage and Family Therapist Tammy Fletcher has a special interest in working with Body-Focused Repetitive Behaviors. She practices Integrative Psychotherapy, which takes a holistic view of the client as a whole person. You will learn tried and true tools for changing unwanted behaviors, but you will also look at factors like exercise, stress, sleep, and nutrition.

Treating the habit only with behavioral therapy is not enough. Chances for success increase greatly when therapy addresses the person from a holistic standpoint.


Along with Habit Reversal Training (HRT), Acceptance and Commitment Therapy (ACT), Exposure and Response Prevention, and where needed, family therapy, Tammy offers an understanding and supportive space to reduce and eliminate these behaviors. 

On her YouTube channel, Tammy has produced numerous videos on BFRBs. Below are some of her videos, and she is currently working to develop educational materials for parents and family members.

If you would like to make an appointment with Tammy Fletcher, LMFT, give her a call, send an email to, or click here to make an appointment.

Helpful Links

The TLC Foundation for Body-Focused Repetitive Behaviorsthe place for comprehensive information on any Body-Focused Repetitive Behavior, news, research, events, support groups, trained therapists, and conferences.

Angela Hartlin is the author of Scars of Shame, and one of the best known advocates for people with dermatillomania and BFRBs in the world. Her site is – well worth checking out. – an online therapy program for people with trichotillomania. They offer a similar program for those seeking help with dermatillomania, at

PickaDerms is an active Yahoo Group with over 2,000 members. Request membership here.


Body-Focused Repetitive Behavior Frequently Asked Questions (FAQ)

Our entire BFRB playlist can be viewed here: