Exposure and Response Prevention (ERP)

In the arsenal of psychological treatments for compulsive picking, Exposure and Response Prevention (ERP) is a treatment method used by behavioral psychologists as well as cognitive and cognitive-behavioral therapists for a variety of anxiety disorders, not just compulsive finger picking but also full blown obsessive compulsive disorder.

In a nutshell, ERP involves repeatedly exposing yourself to the object of your obsessions — a juicy cuticle perhaps — and then being challenged not to pick! May sound simple, but for those who’ve been picking their fingernails, skin and other body parts for a long time it is quite a challenge.

Think of it as immunotherapy for your own personal impulse control disorder. Just like getting injected with trace amounts of influenza to strengthen your body against the real thing — with ERP you get brief, intense “injections” of those intense emotions related to your picking:

• Fear of being imperfect — of having blemished or un-smooth skin
• Loathing of the psychological discomfort of not picking — i.e. you don’t “feel normal” unless you pick