This is not a “success” story, per se – instead, the victories are small and woven throughout. It hasn’t been easy reflecting upon my history with compulsive skin picking and translating it into words, and I admit that I’m still confused, still learning as my story continues to unfold. Ultimately, Dermatillomania is just one chapter of my overarching, ever-expanding story, but its lessons are pivotal. So here it is, Chapter One:
I started picking my skin when I was a kid, probably around the age of 8. My memory of that time is fuzzy, as most childhood memories are, but certain moments have stayed with me. I can vividly recall brief moments of intense and unfamiliar emotion, catalyzing the corruption of my peaceful innocence. I remember a boy in the second grade telling me I “looked fat in that shirt,” something that had not yet been brought to my attention, but has dominated it ever since. I remember a boy in middle school asking me what was wrong with my skin. Did I have chicken pox? Or a disease? he asked. I can still feel the knot deep in my tummy – shame – though I couldn’t identify it as such at the time. I can still hear my mom’s voice urgently whispering “stop picking” as she gently swatted my hand away from my skin. I could sense the love in her voice and discern its authenticity , and I wanted so badly to do as she said, but I couldn’t just stop. The knot in my tummy tumbled and turned, growing bigger and bigger.
That knot grew and changed until it became a heavy weight on my chest, just as I entered my teenage years. The anxiety and shame that had been brewing inside was morphing into something new – depression, as I would eventually learn. All my life, sadness had resonated with me in ways I couldn’t understand. Sad songs and stories were quick to capture my attention and my heart; I felt a strong affinity with them. Although I hadn’t known much sadness, I felt like it knew me.
I didn’t do too much skin picking during my teen years. That habit, too, had evolved into something that felt familiar – but it looked a lot different. Over time, shame had rooted itself inside my being and infected me with the assured assumption that I, as I was, was not enough. I became overwhelmingly obsessed with my body – my weight, diet, “health,” clothes size. It was all-consuming. My tendency toward obsessive compulsive behaviors, like the childhood skin picking, translated seamlessly into body dysmorphia and disordered eating – but that’s a story for another time.
It took several years to feel mostly “normal” around food, but I never truly healed my relationship with my body. I never would’ve expected my compulsive skin picking to creep back in as I entered “real” adulthood, my twenties, but there I was. My college experience was well underway and it wasn’t ideal. The same old demons kept me trapped in my head, left me desperate for a new obsessive distraction, so I swapped food for picking. It was far from a conscious decision to start picking my skin again. I imagine that my brain just dusted off the old neural pathways which once fueled the urge, and then I picked and picked and picked and picked until that old pathway became a busy highway, rush hour-ripe with neural traffic.
I scratched and squeezed and excavated every “imperfect” pore that I could find – sometimes mindlessly, sometimes gently so as not to cause too much damage, and sometimes with ill will, hatred for my body and myself, and disregard to the consequences. I picked at my arms, legs, chest, face – anywhere I could find a bump or abnormality. Depending on the season and how active my social life was at the time, I could mostly limit the damage to areas of skin that I considered “safe.” I’d furiously fight the urge to pick beyond the lines of my shorts or t-shirts, and the motivation to do so was higher in times when I went out more, but I was far from perfect. It was absolutely exhausting.
As a skin picker, winter feels the safest. It keeps my skin comfortably hidden in layers of clothing. But the dark and cold that winter brings tightens depression’s grip, despite having found relief in antidepressants as of 2017, six years into my battle. Winter offers the convenience of hiding in my darkness and forms a crucial caveat of my condition. There are good days and bad, better seasons and worse months. I do my best to adapt accordingly, though it takes intentional effort; a thoughtful focus which often renders me removed from the present moment and left devoid of energy.
I’d just graduated college when I had finally accepted the reality that my obsessive skin picking was a problem. I thought I was crazy for doing what I did and for feeling like I had no control over it, and I knew I needed help. I took one small step, a simple Google search of “skin picking,” and my world opened up. I started learning about Dermatillomania and other OC-Spectrum disorders, like Body Dysmorphia. Putting names to the things I was dealing with gave them validity, and it showed me that I was not alone, nor was I to blame. Suddenly, I could breathe a little easier; but I knew that if I really wanted to address this problem, I was going to have to take action. It would be my third try with therapy, but I found a derm-informed therapist for Cognitive Behavioral Therapy (CBT) and I gave her a call.
I started weekly CBT in November of 2019 and I continue to see my therapist weekly. While CBT has definitely not “cured” me, it has put me on a path to recovery that feels hopeful. We’ve come across many unresolved issues and sore spots in myself that I likely never would’ve realized on my own. I’ve confronted my demons and explored the darkness in which they hide; it’s been essential to my healing process. A few months of CBT under my belt and still, I struggled. I had gained a better understanding of myself and what was driving these impulses to pick my skin, but I still couldn’t seem to get them under control. Despite feeling like a failure, I wasn’t ready to give up just yet – so I carried on.
I moved in February, which was a happy occasion, but it overwhelmed my life with unfamiliarity. For the first month and a half, I spent a lot of time alone in my new apartment while my partner was at work. I was by myself in a new environment, alone with intrusively ruminating thoughts, feeling pressure from this stage of adulthood I’d just entered. I felt that old knot in my tummy, the tightness in my lungs. It was relentless.
I spent inordinate amounts of time picking – it was my shield from the endless barrage of unwelcome thoughts. Intense shame would wash over me as soon as I snapped out of the dissociative trance picking lulled me into. As my vision cleared and I saw what I’d done, the shame and crushing disappointment overcame me, sometimes bringing me to tears. The condition of my skin had reached an all time low. How could I ever leave my house again looking like this?
Just days after my 23rd birthday on March 19th, Oregon’s stay-at-home order for COVID took effect. It looked like I wouldn’t be going anywhere or seeing anyone for a while. It also meant my boyfriend would be transitioning to an entirely work-from-home schedule, so I wouldn’t be alone all the time either. My daytime picking surely reduced, but the urge loomed and constantly taunted me. I picked when I could, taking long visits to the bathroom or staying up later than my boyfriend to steal some alone time. As I went to greater lengths to hide the picking and its resulting damage, the shame I harbored grew and grew. We were stuck at home and he was the only one who would see me – that felt safe. Though as months flew by in quarantine mode, an important date was creeping up on me. Then the pressure was back on.
July 19th – my sister’s wedding. Only about 6 weeks prior did that reality reach my consciousness. As the Maid of Honor, my skin was certainly going to be seen, and the photos taken would last a lifetime. I’d gained experience in “turning it on” when it mattered most – a skill that carried me through college while I endured some of the deepest throes of my depression. The reality hit and the switch flipped, and for the next month or so, I saw more success than ever in managing my skin picking. I found myself cautiously encouraged by my skin’s willingness to heal and forgive, yet found it difficult to forgive myself. Marks and scars remained where sores and scabs once ached and itched; a constant reminder of the harm I’ve caused my body.
The scrounged-up supply of sheer will and strength only lasted so long. I began to crack just days before the wedding, but made it through the day nonetheless – even enjoyed it. And that brings us to now. Each day is a battle, and some days are better than others. Just days ago, I broke down in tears, feeling defeated and exhausted by this condition. I remain hopeful that I’ll be able to achieve recovery from Dermatillomania, but also realize that it will always be a part of me – and I’m learning to accept that. Having recently discovered the Body-Focused Repetitive Behavior (BFRB) community online and the nonprofits which advocate for us, I feel more supported and understood than ever. I refuse to live any more of my days feeling suffocated by shame, and hiding all of myself in an attempt to hide my picked skin.
If you’re struggling with skin picking or a BFRB, you do not deserve to hide from the world or feel ashamed. I know the feeling all too well. Please don’t hesitate to reach out! I’m always happy to help in any way I can.
Geez, Maddie Louise! 