A movement re-education and relaxation approach quite similar to the Feldenkrais Method is Trager Approach. Similarly to Feldenkrais, Trager Approach was also the creation (and namesake) of one man — in this case physician Milton Trager. When used in a comprehensive plan to attack anxiety and stress, Trager exercises can help alleviate the physical symptoms and manifestations of a compulsive picking disorder.
Key elements of Trager therapy that differ from other alternative compulsive picking therapies:
- The practitioner-customer relationship in Trager is that of a “Teacher->Student”, not “Therapist->Patient”
- Trager Approach focuses on educating the student on better movement patterns, using rote learning methods — i.e. students repetitively perform exercises until they become ingrained as a better habit of movement
Though Trager has been more documented as a successful treatment for disorders related to compulsive finger picking — such as trichotillomania and stereotypic movement disorder — there is no reason it shouldn’t be tried for compulsive finger picking as well. The principles of relaxation and meditation together with habit reversal (kicking one bad habit by displacing it with a better one — such as more free graceful movements) are sound.
Body Psychotherapy (aka Somatic psychology) was first popularized by maverick psychotherapist Wilhelhm Reich. It is an umbrella term for a group of psycho-therapeutic approaches focused on the body’s intersection with the mind and its illnesses.
What most distinguishes Body Psychotherapy from other forms of so-called “talk therapies” for compulsive finger picking (e.g. cognitive therapy or behavior modification) is the delivery. Whereas interaction between patient and practitioner in other therapies is limited to oral or written verbal communication — Body Psychotherapy can involve guided touch, movement and breathing.
Body Psychotherapy is likely to be most effective against a compulsive picking habit when the treatments are focused on both of the following:
- The underlying anxiety and stress that may be causing the problem
- The repetitive, impulsive picking movements of the hand
An interesting and largely unexplored treatment is to combine Body Psychotherapy with other body-focused therapies such as biofeedback and yoga. But regardless of the treatment path you choose, working with a trained mental health professional is key to success.
The Feldenkrais Method is an extremely powerful system of self-education through movement.
- It Improves Movement — By focusing on correcting poor movement patterns and eliminating inefficiencies in the way we use our bodies, Feldenkrais Method dove-tails nicely with other complimentary therapies for compulsive finger pickers such as yoga practice and other movement therapies.
- It Increases Awareness — Feldenkrais belongs with a host of other natural treatments for compulsive picking that focus on the mind-body connection — such as body psychotherapy. These treatments increase awareness of the body’s poor patterns of movement in space, thereby providing opportunities to improve.
The two major modalities of the Feldenkrais Method are:
- Awareness Through Movement (ATM)
- Functional Integration
By working with a certified Feldenkrais teacher, a student with a compulsive picking habit will learn awareness of his movement patterns that keep his fingers bleeding and raw. He will also begin to ingrain better patterns of movement by participating in guided exercises with his teacher.
Remember the old Saturday Night Live character “Stuart Smalley”, played by Al Franken? Stuart’s shtick was his half-hearted, pathetic “self-affirmations”. When the idea of self-affirmation goes mainstream in comedy, you know that Autosuggestion as a concept has arrived.
The formula is simple:
- Find a quiet, comfortable place you can be alone in for at least 20 minutes
- Close your eyes and try to rid your mind of any feelings of fear and anxiety
- Visualize the tension and stress evaporating from your body
- Meditate — take deep breaths and consciously seek a peaceful place in your mind
- Make positive statements about your picking habit, such as:
So put your best “finger” forward and give Autosuggestion a try.
Some more tips for success:
- Take it seriously — like most behavior modification techniques, Autosuggestion only works when you mean it. Remember, you’re not Jack Handey!
- Phrase Suggestions Positively — Look at the phrases above and you’ll see what I mean. Say “I will!”, not “I won’t”
- Use the Present Tense — If you say you’re doing it now — instead of later — you’re more likely to do it now!
- Suggest Realistic Action — Don’t shoot for the moon — try something simple like “I am happy with my fingers and skin tone”
- Repeat, Repeat, Reapeat — The more you auto-suggest something, the more it takes on a life of its own…
- Mean Everything you Say — Get your head (and your skin!) in the game — mean what you say and what you say will mean something!
- Excite the Imagination — Imagine a better place for your body and your mind, and you’ll get there!
The idea that strong, natural scents can aid healing is as old as medicine itself. Not only did the famous Greek physician Hippocrates used scented oils in his treatments, but the very first physician in history known by name — the Egyptian Imhotep — recommended scented oils for bathing, massage, and embalming the dead.
Essential Oils are the key to aromatherapy — these are the liquid organic compounds extracted from herbs or plants. They’re used in everything from perfumes and cosmetics, to bath products, to flavorings and household cleaning products.
The focus on aromatherapy in the 20th century was on its ability to heal physical afflictions…
- A French doctor Jean Valnet successfully treated gangrene in WWII soldiers with essential oils
- French Chemist and perfume entrepreneur René-Maurice Gattefossé inadvertently discovered how effective essential oils could be in treating severe burns — by dunking his burning arm into a vat of lavender oil!
…however, the popularization of alternative and natural remedies for treating impulse control disorders (and even OCD) such as compulsive picking, has made aromatherapy a staple adjunct to more traditional psychological or pharmaceutical treatments.
Though the ancient oils used by the likes of Hippocrates and Imhotep are lost to history, we do know what works best today to treat several ancillary causes of compulsive finger picking and other related disorders:
As the name implies, Mind-Body Intervention is a family of therapeutic techniques aimed at training the mind to “intervene” in — and correct — undesired or unhealthy patterns in the body.
These “patterns” run a wide gamut:
- Skin picking disorders — compulsive skin picking or dermatillomania
- Finger picking disorders — compulsive finger picking and compulsive toe picking
- Hair-related disorders — Trichotillomania and trichophagia
Some Good Mind-Body Interventions for Compulsive Picking
Mind-body interventions that can be particularly helpful for compulsive picking include:
- Meditation and relaxation routines to lessen the impulse to pick
- To train the mind to focus in both active and passive concentration — use hypnosis in conjunction with meditation
- Visualization techniques — such as those used in habit-reversal training
- Yoga practice to condition the body
- Therapies focuses on the controlled stimulation of the senses like aromatherapy or autosuggestion
- Various other “branded” therapies such as Feldenkrais Method, Trager Approach and Alexander Technique
Biofeedback works just like it sounds — using a variety of different devices to measure tiny, almost imperceptible changes in the body during normal activities, one can receive immediate feedback on the state of the body. This raises awareness of one’s behavior, which can help change it for the better.
Biofeedback Scenarios for Compulsive Picking
- “Galvanic Skin Response” (aka “sweat awareness”) Training — This can give you explicit hints about when anxiety sets in — if anxiety is a cause of your picking. Thinking of the type of stressful situation that pushes you to pick will induce some imperceptible sweating, which will sound a tiny alarm on the biofeedback machine. GSR will definitely raise the bar of self-awareness — if it doesn’t make you even more neurotic, that is
- Electromyogram — This is perhaps the most common biofeedback test. It measures tiny changes in muscle tension. Imagine — if such a test revealed that your upper lip (of all things!) curled ever so slightly the moment before you start picking your fingers, you would pay more attention to your face and the inner stress that’s expressed there.
As you can see, biofeedback is only a window to explore your physical responses to stress. The step of controlling stimulus and changing behavior is another level entirely.
Take it Seriously!
At first Biofeedback therapy may seem a bit like a carnival trick — “Strap yourself in and try to peg the meter to red!” But as with any treatment, you get out of it what you put into it. Biofeedback has had its ups and downs in popularity and respect, but it is finally taking its place in the spectrum of alternative therapies for compulsive picking and other related disorders.
Picture these scenarios and see if it matches your experience:
Bloody Fingernail Picking
You’re busy picking a juicy spot on your finger — or a spot on the side of your thumb that’s constantly callused and easy to pick. Only minutes later, after moving on to other things, you notice blood pooling in your cuticle. You ball up a kleenex around your hand to staunch the flow and keep your clothes from getting stained.
Bloody Toenail Picking
You’re picking your big toenail, right inside corner where the nail is chipped and softer than the rest of the toenail. The sensation is really satisfying — until you tear off such a piece of the nail so large hat the skin its attached to rips off as well, causing a sharp pain. Seconds later the blood begins pooling
Drawing your own blood can be a sign that your compulsive picking habit is going to far. Whether you’re deliberately trying to harm yourself, or just absent-mindedly picking out of boredom or anxiety — picking to the point of bleeding can indicate a serious problem with psychological roots.
People suffering from compulsions to pick their fingers, skin, hair, etc. are usually “in it” for various reasons. Though many of these reasons border on the irrational, one particularly strange motivation is the deliberate seeking of physical pain.
Pain as Pleasure in Compulsive Pickers
Those who engage in deliberately destructive behavior like picking the fingernails and cuticles with the goal of causing themselves pain are said to be engaging in self-harm. When the “weapon” is a knife or sharp object — and not just the pinching fingers of the opposite hand — we nickname these people “cutters”.
Pain Caused by Compulsive Picking
Pickers who are not out for the thrill of painful sensations from their picking may still have a complicated relationship with pain:
Though its a mouthful to say — Selective Serotonin Reuptake Inhibitor drugs (better known as “SSRIs”) — are the godsend of millions of people with anxious, depressed, and obsessive-compulsive tendencies.
Among the most successful SSRIs are:
- Paxil — known as the safest SSRI drug on the market
- Zoloft — the oldest of the SSRIs
- Prozac — the 800-pound gorilla of the SSRI market, so popular that the brand-name has moved into the English insult lexicon (i.e. “You’re so cranky — did you skip your Prozac today?”)
- Inositol — a very exciting drug that has proven benefits specifically for compulsive skin pickers and dermatillomaniacs
- Lamotrigine — also an exciting SSRI with potential benefits for compulsive finger pickers