115: Chronic Skin Picking is an Addiction, Not OCD

This is why the typical treatments for OCD - CBT and habit reversal - just don't seem to work.

You've been falling through the cracks of ill-fitted treatment and blaming yourself for being a hopelessly broken human being.

It's not your fault.

You've just been misinformed and going about healing the wrong way.

If this resonates, then odds are you'll find hope and a path forward in this episode.

You'll learn:

🌟How a behaviour can become an addiction
🌟Where addiction comes from
🌟How you can heal the root cause + the three core components that facilitate this

Resources:

Intermittent Reinforcement - article
https://www.catharticspacecounseling.com/blog/stuck-in-a-toxic-cycle-this-psychological-pattern-might-be-why

In the Realm of the Hungry Ghosts by Gabor Mate - book
https://www.goodreads.com/en/book/show/617702.In_the_Realm_of_Hungry_Ghosts

Behavioral Addictions: Signs, Symptoms, and Treatment Options - article
https://americanaddictioncenters.org/behavioral-addictions

Introduction to Behavioral Addictions - study
https://pmc.ncbi.nlm.nih.gov/articles/PMC3164585/

The Difference Between an Addiction and a Compulsion - article
https://www.verywellmind.com/the-difference-between-an-addiction-and-a-compulsion-22240

💌Share your story - Book your FREE BFPA* Support Call with me

🌟Download your FREE Guide to Stop Skin Picking Using Somatics

📝FREE Holistic Skin Picking & Hair Pulling Assessment - Join the waitlist

🎯Join the 7-Day Skin Picking Recovery Challenge

🙋‍♀️Send me a message here

My name is Raffaela Marie. I'm a holistic BFRB coach who has healed from 15 years of chronic skin picking myself and dedicated my life to helping driven women do the same. Through my podcast, free resources, and programs, I teach strategies to overcome urges, build emotional safety, and expand into authenticity. My approach goes beyond quick fixes, focusing on root causes and long-term recovery.

Transcript

SPEAKER_00 0:00

Don't just take it from me, take it from Gabo Mate, a world-renowned addiction expert. This is what he said in his book In the Realm of the Hungry Ghosts. The addict might as well be an obsessive compulsive, with one essential difference. Unlike the addict, the person with OCD does not anticipate his compulsive activity with any pleasure. Far from craving it, as the addict does, he regards it as unpleasant and distressing. How do most of us feel when we engage in picking, pulling, or biting? While there is a lot of emotional distress there and physical distress, there is also a craving, a desire, there's a soothing feeling, there's a release, there is even potentially a bit of enjoyment in the behavior mixed in with all the messiness. For many people, chronic skin picking, hair pulling, and nail biting are not OCD. They are addictions. And this greatly impacts the approach we take in healing from them. And if this resonates with you, then this episode is a must listen. We're going to talk about how a behavior can become an addiction, where addiction comes from, and how we heal the root cause. It's this approach that allowed me to heal from 15 years of chronic skin picking. You are listening to episode 115 of Beyond Skin Picking and Hair Pulling, the place to be, if you want to learn how to address the root cause of why you pick, pull, or bite at your body. My name is Rafaela Marie. I'm your host. I've healed from 15 years of chronic skin picking through addressing the root cause and treating it like an addiction. And I've been helping other people like you to heal as I did for the past three years. And I share everything I know with you on this podcast. And I want to invite you to a really special opportunity. An opportunity to share with me your story so that you can feel deeply seen, heard, and understood the way you never have before. Not only that, but I will give you my insight and guidance into what you can do right now to start healing in a practical and tangible way. I've already had many of these calls over the past few weeks with people in this community, and it is just so incredible. Firstly, to be able to give you the support that you so deeply deserve, because I know how it is to feel lost and stuck with this behavior. But also to be able to meet you, my listeners, if you want to get access to this really incredible opportunity, you can go ahead and click on the link in the show notes. I really look forward to hearing your story. I first really need to get this off my chest because I actually already recorded this episode yesterday, but the audio didn't work. So I'm back here again the next morning doing it all again. And if you've been listening to this podcast long enough, you know this isn't the first time this has happened, but it has been a long time since I've made this kind of mistake. Regardless, I know the content of this episode is so powerful. And now I've already gotten to practice sharing it with you once. This time round, it's going to be even better. And where I want to start with you is the four C's of addiction. That is compulsion, craving, control, and consequences. If you resonate, and I'm going to explain what they are, but if you resonate with these four C's, then it is highly likely that what you're dealing with is an addiction and not OCD. Compulsion can be seen as the irresistible urge or desire to engage in a behavior or substance, but we're talking about behaviors right now, so we're going to focus on behavior. The craving feeling is like there's a vital need you're not feeling. It's that deep pull inside of your chest or your stomach that is so hard to say no to. It's like you're starving or dying of thirst, and you have a glass of water in front of you or a meal sitting in front of you. It's your body telling you, I need this. And it's almost painful to resist. Then there is control, or better understood in this context, the loss of control and the consequences. This is one I believe we can all relate to. You keep doing it despite the consequences. Now I want to reiterate, some of this might sound like OCD, but the difference is that people who engage in an OCD behavior get no sense of soothing from the behavior. There is no enjoyment at any point in the behavior. The most they might feel is a release, but there is no feel-good feeling. And this is why the recommended treatments, such as CBT cognitive behavioral therapy, or habit reversal, don't seem to work. While for some, it may truly be OCD. For many, it's actually an addiction. And you've been falling through the cracks of ill-fitting treatment and blaming yourself for being a hopelessly broken human being. It's not your fault. And in fact, your brain is working exactly as it should. What do I mean by that? Let's have a look at how behaviors become an addiction. Examples of behaviors that can become addictions are things like chronic skin picking, hair pulling, and nail biting, but there's also eating, gaming, porn, shopping. And what these behaviors do is they trigger the release of natural hormones in our bodies, in our body called reward hormones or dopamine and serotonin. These are feel-good feelings. This is why engaging the behavior feels good, why it's soothing, why it can be calming. And the thing about these behaviors are that they naturally trigger the release of these hormones. When you eat food, that is good for your survival. So your brain is going to reward you for eating food by giving you dopamine and serotonin. When you drink water when you're thirsty, that is good for your survival. So your brain is going to reward you with dopamine and serotonin. It's like the brain's way of giving us a treat. Almost like training a dog. The dog does something that you want, you give it a treat. We do something that our nervous system, our brain, knows is good for our survival, it gives us a treat of dopamine and serotonin. How does this tie into porn, shopping, gaming, chronic skim picking, hair pulling, nail biting? Because I understand food and water makes absolute sense. The first one I want to highlight is that these behaviors, chronic skimpicking, hair pulling, and nail biting, are actually self-grooming behaviors. We see them in all animals. And they are good for our survival. Can you imagine if we never felt the desire or the need to groom ourselves, we would be at much higher risk of infection, of disease. And so grooming ourselves, our mind is going to say, hey, that's good. I'm going to give you a treat, dopamine and serotonin, so that you continue to engage in these really healthy behaviors that are good for our survival. But then what about things like shopping, gaming, porn, scrolling on our phone? Those are very modern things. What does that, what do they have to do with our survival? This is where something called intermittent reinforcement comes in. And this is a primitive or primal part of our brain that searches for novelty. This comes from our hunter-gatherer stages when we were actually going out hunting and foraging for food, looking out for dangers, trying to problem solve. All of these things are really good for our survival. They're really good for our brain to do. And intermittent reinforcement gives us a sense of anticipation, of excitement. It it draws us forward. It's like if you're foraging in the woods. Basically, it stops you from getting bored. If you're not able to find what it is you're looking for, the mushroom or the berries or whatever it is that you're looking for, intermittent reinforcement keeps us searching, keeps us almost craving, looking for that thing. Because when we find the thing that we're looking for, it's really satisfying. And that is a reinforcement. It's the unexpected. It's also how social media keeps you locked in with content, is the content that you're receiving is not predictable. Yes, the algorithm feeds you what it knows you like, but not in any specific order that you can pick up. You'll get a few reels of something funny that is to your humor, and then maybe a reel of something really sad will come up. And then maybe an informative reel will come up. And you might get a few of those, and then it'll jump back to something really funny. And then occasionally it'll throw in something that you don't like at all. That is intermittent reinforcement. You can't anticipate what's coming towards you. And that's really satisfying for our brain. That's the same thing with gaming, shopping, porn. Gaming plays on that really, really well. And I don't think I need to explain why gaming works, but shopping, when you go shopping, you're not going out and buying the exact same thing every single time. You're going out foraging for the exact thing, the specific thing that you want. Someone who watches porn, they're probably not going to watch the same thing every single time. They're going to go out and search for something, that thing that they want. And of course, there is a lot more underneath these behaviors than just this, but intermittent reinforcement is a really big driver behind why we engage in behavi in certain behaviors. It's also a really big driver in a behavior turning into an addiction. Now, here is the question. We all have a brain that gives us a treat when we engage in behaviors that are good for us. In this sense, our brains are not that different from each other. So what's the difference between someone who can groom themselves and it remains a healthy, normal, functional behavior, and someone who ends up over-grooming and that behavior turns into an addiction. There were a series of studies published in the 1970s called Rat Park. Maybe you've heard of it. And basically what they did was they took rats and they put them alone in small cages and they gave them water, which was just regular water, and then they gave them water laced with morphine. Rats who were alone in small cages tended to opt for the morphine water. Then you have Rat Park. And in Rat Park, they had emotional, physical, and mental stimulation. They had friends, they had toys, they had space to roam and play and exercise. And they also had the option of either regular water or water laced with morphine. The rats in Rat Park opted for regular water. They had the choice to take drugs. They chose regular water. While the rats who were alone in a small cage opted for the morphine water. Interestingly, the rats who had already been consuming morphine water, so probably already were developing an addiction towards that drug, when they were taken out of isolation and placed into rat park, they began drinking the regular water. They chose to drink the regular water. This has given us a great insight into one of the factors that greatly contributes to addiction, and that's our environment. And when we apply this to humans, we don't just apply it to the present moment, we apply it to the experiences we've had throughout our whole life, especially in childhood. When we are emotionally, physically, and mentally fulfilled, when we are connected, when we are not in a state of neglect, we will not seek out addiction because addiction is there to essentially help us to soothe the neg the neglect that we're experiencing on an emotional, physical, mental level. This is why one of Garb Mate's absolute most famous quotes is the question is not why the addiction, but why the pain. And so we, if we look at your life and look at your childhood, if you've had a really rough upbringing, it might be really easy for you to relate to this and see, oh yeah, that makes sense. It was a really rough time growing up. There was, there was a lot of pain that I experienced that I have not yet processed. And so, of course, your brain has to find a way to cope with that. And it has these really great hormones that make us feel okay, dopamine and serotonin. And we already have behaviors that naturally trigger those hormones. And so we are naturally going to, your brain is naturally going to do this. It's going to find a way to help you feel okay when you are living in an environment that doesn't support that itself. And so we will latch onto a behavior that we subconsciously learn we can use to give us that treat whenever we need some soothing, some calming, whenever we need to escape, whenever things just get too much or feel too much, or the pain gets too big. This is a way that we can just feel okay and get a break, even if it's for a brief moment. Now, if you're thinking, yeah, but my childhood was pretty great. My parents love me. My life is pretty great right now. I don't know why I should be struggling. Every human being has a need to feel seen, heard, and understood. Because when we feel seen, heard, and understood, we feel safe. And when we feel safe, we feel loved. And so I wonder if there are any situations where you didn't feel seen, where you didn't feel heard, where you felt misunderstood. And you were left alone with that. You didn't feel like you had someone you could talk to about that. You didn't have someone that you felt would actually listen or understand. And also ask yourself, how were your parents with regulating and managing their own emotions? Were they able to talk about them, share them with you? Were they able to help you work through the difficult emotions that came up for you? Or were they more about just pushing through, just getting on with life, just using some willpower, just get over it? Did they bottle up all their emotions and keep everything to themselves and never really showed how they felt? Or were there big explosions sometimes and then everything got swept under the rug? You don't need to blame your parents to see where they were struggling themselves. And if they struggled with their own emotions, they couldn't have helped you with yours, which would have created either big moments or many small moments of not feeling seen or understood or heard, not feeling connected, not feeling safe to be yourself, to be vulnerable, which impacts our capacity to love ourselves and to feel loved. And this creates pain. This creates inner turmoil. This creates a need for us to self-soothe in in other ways because feeling safe, feeling seen, heard, understood, feeling loved, feeling safe, they are inherently soothing and calming. They when we are in that space, that is where everything feels okay. But when we don't have that space, then we need to try and create it for ourselves. And we create a pseudo-sense of safety through these behaviors that trigger dopamine and serotonin. It's not the real thing, but it's better than nothing. Which brings us to where addictions come from. And this is another quote from Garvin Marty's book, In the Realm of the Hungry Ghosts. Highly recommend you read it. Addictions arise from thwarted love, from our thwarted ability to love children the way they need to be loved, from our thwarted ability to love ourselves and one another in the ways we all need. Opening our hearts is the path to healing addiction. How we heal the root cause is really all about this. Learn how to love yourself and others again. And when I say others, I'm not saying you don't know how to love people. But we can only love others to the level that we love ourselves. We can only truly embrace other people and truly deeply connect heart to heart with other people on the level we can connect with ourselves. And through my own healing journey and through my reading and research over the past five years, five years, and helping people like you to heal over the past three years, there's three things I've learned that make all the difference that allow us to open up our hearts again, that allow us to love again, love ourselves again. And the first one is emotional regulation. These are the skills to sit with and feel your emotions. Because a lot of the time we're just in our heads. We're trying to escape. We feel something bad and we take it personally. We think, oh, I'm feeling sad. There must be something wrong with me. Why do I feel sad? I feel angry. Well, that I'm not a good person if I feel angry. Then there's guilt around feeling anger. When you didn't learn how to sit with and process your emotions as a child, you start to take them personally and you make them an identity. When emotions are just things that we experience, they come and they go, they ebb and they flow. They're not supposed to sit and stay inside your body constantly. But when we identify and we become an emotion and say, well, this is who I am, I feel angry, therefore I'm a bad person. I feel sad, therefore there's something wrong with me. I feel anxiety, therefore I am an anxious person. You are not an anxious person. You are a person who experiences anxiety. You are per you are a person who feels anxiety. And yeah, maybe you feel it a lot more than others, but it's the identification with the emotion that is part of the reason why it's staying trapped inside your body. Because if we become the thing that we're struggling with, then how are we supposed to let it go if we are that thing? It's like I am a human being. I can't stop being a human being. I can't let go of being a human being. I am a human being. It's just fixed. It's how I came into this world. You didn't come into this world as an anxious human being. You came into this world as a human with a great capacity to feel many different things. Emotions are a language, not an identity. There is so much more. Don't shrink your world into this one small existence of I am this and I am not this. I feel this, therefore I am. I pick my skin, therefore I am a skin picker. The things that you struggle with, stop identifying with them. Even just in your language and the way you speak about them, stop saying, I am a skin picker. Say there's a part of me that really struggles with chronic skin picking. I feel a lot of anxiety sometimes or a lot of the time. There's a part of me that is really anxious, not I am an anxious person, I am an angry person, I am a happy person, I am a loving person, because you're not all the time. You're a loving person, but you're not always loving, and that's okay. You're a happy person, but you're not always happy. And you are an anxious person, but you're not always anxious. So therefore, you can't be an anxious person because you also experience other emotions. So that's the first thing. The first skill, the first thing we want to learn is emotional regulation, how to sit with and feel emotion, to let them go, stop taking them so personally, stop identifying them, stop identifying with them, because then you can start to access who you truly are as a person. Then there is emotional safety. And emotional safety is trusting yourself to be kind, compassionate, and curious rather than critical and judgmental of yourself. And if there is one thing that has stood out, starkly stood out to me inside this community, is that pretty much everyone, either you now or you used to, have a really loud inner critic. You can, if you know that you can expect criticism and judgment from someone if you make a mistake, you're not gonna trust that person too much. You're not going to want to come to them with mistakes or when you're imperfect or with struggles. If you think that person, if you're pretty sure that person is going to be mean to you about it, you're not going to trust them. We're also not going to trust ourselves. We're not going to have emotional safety with ourselves. So we really want to learn how to build compassion and kindness and get curious for ourselves rather than being so fucking mean all the time. Then there is connection to our authentic self. And this is really knowing who you are, knowing what you value and knowing that your beliefs and your values are reflected in your actions. A lot of people, myself included, we want to believe we are a certain way. But then our actions tend to contradict the beliefs that we have about ourselves. It's like a person might want to believe that they're reliable, but their actions may say the opposite. I used to want to believe that I was a reliable person. But the fact that I ghosted people and I didn't show up to appointments and I didn't commit and follow through on a lot of things. I had to really face myself and see, wow, I'm not a reliable friend. I'm not a reliable person. And I know I'm using that language now of like, I am not a reliable person. There's a part of me that's really unreliable or used to be really unreliable. But then that led me to analyze, well, how can I change that? I want to be more of who I am, who I believe that I am. And so I started to change my behavior. Started to work through the resistance that I had around being reliable, around not just ghosting people, but responding back, around saying no and not overcommitting. And this then also builds trust in ourselves. The difference between how I feel inside myself and how I felt inside myself 10 years ago is just worlds apart. I'm so grounded and calm and sure of myself. In difficult situations, I know where to find me.

unknown 21:59

I

SPEAKER_00 22:00

No way can rely on me to always come back to me, even if I have moments where I lose myself a little bit. I can find that strong ground inside myself and I can make hard decisions and have hard conversations and not spiral and think, oh, have I just fucked up bad and second guess myself and doubt myself. And I just want to give you something to reflect on, just to really see the power and the simplicity of this approach to healing. When we have allowed in a critic, being inside our own mind can be a harsh place to be. It doesn't feel welcoming or comforting or loving. It doesn't feel like we can come home to ourselves and just relax. Because there is a constant pressure to do more, be more or be less. There's a constant feeling of, I'm not there yet. I've got to try harder. I can't relax now. There's this underlying sense of urgency or anxiety or fear or just this heaviness. And when that is our internal experience, no wonder you found a way to escape. No wonder you escaped into skin picking or hair pulling or nail biting. No wonder your mind learned to use the chemicals of dopamine and serotonin to soothe that experience. Because you can't actually escape yourself. You can't just take a holiday from your own mind. We try to, but eventually it all comes back. And so now just imagine how it would be, what difference it would make to your life if your internal experience most of the time was nice, was loving, was forgiving, was understanding and compassionate and kind, was gentle and encouraging and motivating, even when, even on a bad day, you knew that you could rely on yourself to be kind to you? What if your internal experience felt like home most of the time? What difference would that make to your life? What difference would that make to other people in your life? How would that change how you behave and how you speak and how you interact with others and interact with yourself? Opening our hearts is the path to healing addiction and learning emotional regulation, cultivating emotional safety and connecting deeply to yourself is how we open our hearts. This is the core of the work that I do with myself and with those that I work with. And also the core of the motivation behind this podcast is to draw you into this place of listening to your heart, listening to your intuition, doing things that allow you to open your heart. Because that is how we heal. And this is why I believe that you can heal without even meeting you. I believe that you can. Because even if you maybe feel like, or a part of you feels like, I don't deserve to be loved or to feel loved. I'm not there yet. I'm not good enough yet. You're wrong. I know you're wrong, and I know you are deserving. And it's okay if you can't fully accept that right now, or you don't fully believe me. But there is a part of you that does agree with me. And maybe you're noticing that. Maybe you're noticing just a little part of you agrees. Because that is who you are at your core. And who you are at your core knows that you're worthy of good things, despite how messy you are, despite how despite your mistakes, despite your imperfections. And if you would like more support in your healing journey, make sure you book in the call to share your story with me so that I can share with you my insights and guidance. And if you are looking for further support and looking to join one of my programs or work one-on-one with me, then that option is there for you too. I wholeheartedly believe that you can heal. And it starts and it never ends with opening your heart. If you enjoyed this episode, make sure you hit like and subscribe. Leave a comment down below about what came up for you. I love to hear your thoughts and get your feedback. Thank you so much for hanging out with me. And I look forward to seeing you next week for the next episode of Beyond Skin Picking and Hair Pulling.