As a child, from the age of about ten, my brother ( three years older than me) never called me by my name, but always referred to me as ‘Scabby’ or ‘The Scab’. When, at age and eleven, I joined him at secondary school (Watford Grammar School for Boys, Hertfordshire, UK, just in case anyone’s remotely interested) he ensured all his friends knew this name for too, with all too predictable results.
Sadly, my highly emotionally immature mother (click here to read my article on emotionally immature parents) would, too, refer to me by this not entirely flattering appellation. Or just laugh when my brother used the term.
The reason (apart from their flagrant and wholly gratuitous ignorance) was that I compulsively picked at my skin. I have since discovered that this is a recognised disorder with various medical names, including:
– body-focused repetitive behaviour (BFRB)
– skin picking disorder (SPD)
– excoriation disorder
The disorder is also related to obsessive compulsive disotder (OCD) and involves picking, scratching and digging under the skin with one’s finger nails.
What Causes It?
Research suggests that the disorder is a dysfunctional response to stress used (consciously or subconsciously) in an attempt to alleviate high levels of mental distress and turmoil.
It is also theorised that it can operate as an expression of repressed rage and/or other repressed feelings.
In nearly half of all cases the onset of the disorder occurs before the age of ten years. It is linked to childhood abuse and trauma and is often accompanied by depression, anxiety and obsessive thoughts.
Genes are also thought to play some part in the disorder.
In severe cases, individuals can spend hours a day picking at their skin and the harm inflicted can be so severe that skin grafts are required.
Also, as can well be imagined, heavy scarring can result (as it has in my case).
Link To Suicide:
Particularly worryingly, about 11% of those who suffer from the disorder will attempt suicide.
Shame and Guilt:
To compound the problem, those who suffer from the disorder often feel ashamed of their compulsion and, accordingly, do not want others to know. Because of this, they often select areas of skin to pick which are not normally on show to the public (eg see picture above).
More research is needed to ascertain effective treatments but two of the most promising at the moment are cognitive behavioural therapy and habit reversal training.
David Hosier BSc Hons; MSc; PGDE(FAHE).