I went through a period of time when I did not even notice that I was picking the skin by my nail.

Occasionally it is a habit of mine, and I am sure many of us do this unconsciously. And when I manage to make my skin bleed, I berate myself and promise never to do that again. It hurts, it bugs me, but at some point, I just forget about it and it heals. It is truly amazing how our bodies can heal themselves when we do not pay too much attention to it.

This time, I went through something that I could not really bring to the surface. At my workplace people 'disappeared'. They were made redundant in a way that they were there one minute and gone the next. And survival mode kicked in. We were shocked but as we had no information on why, why this way, could it be handled another way etc.; after a while it was done and nobody really talked about it. We had lots on our plate. Of course, I felt stressed about whether I would be next, but never really went that deep in this, as I had projects, my plate was full, so in a way I felt safe.

Well, that is what I thought I felt. However, my mind felt differently because as this stress gradually intensified in me. Even though the winter festivities were coming - a time I usually love, when the world slows down and I feel calmer, more collected and centred – there was turmoil deep inside me. I didn’t notice at all. I had just kept picking my skin. And not just that, I was picking at the same spot. It was happening entirely unconsciously. Even when I sort of noticed, it was oh, okay, it should not look like that. But then I was busy with something else and of course kept doing the same... By the time I properly realised, when it really came to the surface of my consciousness during the holiday when there were quite a few days finally at home in peace; my finger was twice the size, a massive lump just attached to it on the side and was raw and bloody.

You can see the images at the bottom of the article. They are not easy to look at, but they show the reality of what can happen. Please view with care.

This is what happens when our nervous system goes into survival mode. Our conscious mind – with its limited capacity – goes onto auto pilot, while our subconscious mind hides even deeper. The brain, our main protector, wants us to be safe, and as it notices that skin picking creates a momentary calmness, it tries to regulate our overwhelmed system using this known (and tried) strategy, repeatedly sending the message: soothe me.

In survival mode, we simply miss all the signposts: just like when you are driving on the motorway at 100 mph, too fast to read the signs, the exits, the warnings. You are focusing on the road because everything is coming at you far too fast.

I was utterly shocked. How on Earth did I manage to do this to myself? When did it start, and why? And what am I supposed to do now? All the questions while I was navigating on figuring out the past – I always try to analyse what happened and why so I can avoid it in future – but also handling the present: trying to remedy it on my own.

A week later, when we were back at work, I made an appointment to see the GP and they sent me to a clinic of plastic surgeons. A plastic surgeon?! I thought they give me a cream or put it in a ‘cast’ or whatever method they know to hide it from me… I did not want to have a surgery, and what happens then? They cut it even more? I could not even imagine hurting my finger any more even with the surgery… Of course, what needs to be done, it needs to be done; but my mind then went into a ‘nononoooo’ mode while another part of it went on autopilot again – do as you are told. I got an appointment with the plastic surgeon for 2 months later. This gave me time, time to slow down, it was now in my conscious mind and I wanted to solve it. I am a cognitive behavioural hypnotherapist: I have all the tools in my box!

I worked on learning to notice when there is any urge to pick my skin, I worked on relaxing, I worked on replacing the need for the action with something else, something that is not damaging at all.

When two months later, I finally met the surgeon they were absolutely amazed, had never seen anything like it before. Neither did I! Never thought that “just picking the skin” could harm me so much. Never thought it was a 'thing'.

It was so 'easy' to ruin my body. It only took a few weeks, perhaps a month. How did it go so out of hand? And so quickly?!

CBH uses CBT techniques such as Habit Reversal Training and supercharges them with hypnotherapy. HRT is a highly effective behavioural therapy that combines awareness of the habit with replacing it with a competing, incompatible action. With hypnotherapy, this process is enhanced through awareness, relaxation, deepening and lasting change.

Skin Picking - Dermatillomania / Excoriation Disorder is also known as body-focused repetitive behaviours (BFRBs), and is listed under Obsessive-Compulsive Disorder and Related Disorders. You can read more about it on the NHS website: https://www.nhs.uk/mental-health/conditions/skin-picking-disorder/

It can be triggered by:

boredom
stress or anxiety
negative emotions, such as guilt or shame
skin conditions, such as acne or eczema
other blemishes that the person wants to get rid of (these may not be noticeable to other people)

You are not alone. While there are no bespoke statistics available for skin picking in the UK, it is fairly common and under-reported.

If you are reading this article, that means you are already halfway there. You have noticed your behaviour and you are willing to take steps towards change.

It took me about a month to realise and catch my behaviour. Another month to stop and focus on healing. And over two years for the damage to become barely visible; with full healing still in progress.

Skin picking thrives in silence. Awareness is the first step out, and change is not as far away as it may feel.

These images are not easy to look at, but they show the reality of what can happen. Please view with care: