Body-Focused Repetitive Behaviors (BFRBs)

Repetitive behaviors like skin picking, hair pulling, or nail biting that can feel hard to control.

What This Can Look Like

BFRBs often include:

  • Hair pulling (trichotillomania)
  • Skin picking (excoriation disorder)
  • Nail biting (onychophagia)

These behaviors can be triggered by stress, boredom, urges, or intense emotions, and may lead to shame, concealment, or physical damage.

How the Cycle Maintains Itself

BFRBs often provide brief relief, soothing, or “reset” feelings, which reinforces the behavior. Over time, urges can become more frequent or automatic.

Nail biting

How CBT Helps

CBT for BFRBs focuses on understanding triggers and building new responses. Evidence-based approaches include:

  • Habit reversal training (HRT)
  • Comprehensive Behavioral therapy (ComB)
  • Skills for awareness, urge management, and behavior change

As an adjunct to treatment, KY CARDS is a supporter of Habitaware, the company who developed the Keen bracelet for BFRB treatment. Keen is particularly effective in helping individuals who struggle with BFRB by tracking patterns and facilitating awareness of skin picking, nail biting, and hair pulling.

To learn more about how Keen can assist you in your BFRB treatment, click here.

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Treatment at KY Cards:

What to Expect

Treatment is structured and tailored. The goal is not willpower. The goal is building tools and routines that reduce urges and support long-term change.