Solving the problem of repeative traumatic behavior, oriented on the body, in psychotherapeutic practice

Relevance. Over the past few years in Russia, there has been an increase in patient visits to dermatologists with complaints of specific skin itching, repeated pulling out and/or eating hair from different parts of the body, picking, scratching the skin in various parts of the body, biting cheeks, lips, nails, eating cuticles, skin on fingers. As of 2023, more than 19 million people in the United States suffer from these behaviors and often seek help from a dermatologist for skin damage, a challenge for mental health professionals.

The aim. To acquaint dermatologists, psychiatrists, psychotherapists and clinical psychologists with the specifics, tactics of psychological examination and complex treatment of repetitive traumatic behavior focused on the body and skin.

Results. This article details the clinical manifestations of body-focused repetitive traumatic behavior or skin picking disorder. One model details the range of forms of repetitive traumatic behavior directed at the body. A diagnostic algorithm and psychological approach to the assessment and initial treatment of psychosocial stressors in this group of patients are proposed. General treatment tactics are presented and emphasis is placed on the specifics of cognitive behavioral therapy (CBT) for repetitive traumatic behavior directed at one’s own body, as well as its effectiveness and limitations. It has been shown that the “classical” CBT protocol (for example, habit change training, habituation, attention control, stimulus control) is an insufficient tactic for psychotherapeutic treatment, because unable to help the patient cope with internal experiences and emotional dysregulation. In this regard, it is recommended to use a multimodal protocol with an emphasis on metacognitive features of situation perception, regulation of impulsivity, maladaptive perfectionism and minimization of empirical avoidance of one’s own experiences.

Conclusion. This article fills the gap by providing a summary, understanding of the disorder and how professionals can diagnose and help this group of patients. We encourage not only dermatologists, but also mental health professionals to expand their knowledge about this disorder.

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