Mental Health Experts Explain How A Worry Stone Helped With My Skin-Picking Disorder
You can tell when I’m having a rough time with my anxiety by how my hands look. If my fingers are smooth, I’m doing alright. But if the skin on the last joints of my fingers is swollen, rough, and broken open, you know my stress levels are through the roof.
You see, I’ve got this condition called excoriation, otherwise known as skin-picking disorder. So, when I get really anxious, I dig my nails into the sides of my fingers until it hurts. If I’m feeling extra anxious, I keep digging away at my fingers until the skin turns raw. And if a callous starts to develop, that increases my anxiety level because callouses (which are dead layers of skin that have little feeling in them) get between me and the pain I need to feel to relieve my anxiety. In that case, I have to dig extra hard to feel anything, and that causes more damage to my fingers.
If this is sounding really bizarre to you, I’m actually not alone. About 2 to 5 percent of the population experiences excoriation, and around 75 percent of people affected are female, according to the TLC Foundation for Body-Focused Repetitive Behaviors. And other people with this disorder don’t just dig into their skin like I do; they might also touch, rub, scratch, or pick at their skin, says the TLC Foundation, which can cause “tissue damage, discoloration, or scarring.”
“This behavior can show up as picking the skin around the fingers and cuticles, pulling off dry pieces of skin on the body, or excessive facial grooming,” says Alicia Hodge, licensed clinical psychologist. “The most important aspect is that an individual is repeatedly touching their body in a way that results in physical damage.”
According to the TLC Foundation, people who have this condition might target both healthy and previously damaged skin, and they do it for a lot of different reasons: to ease physical tension or unpleasant emotions, beliefs about how they should look, invasive thoughts they’re having, and more.
“Skin-picking disorder is an act that is usually a self-soothing technique that people use to manage emotional moments,” says Hodge. “The act of picking at skin, biting nails, or even pulling hair can temporarily relieve stress or anxiety. Usually these moments can bring on shame or guilt that often restarts the same cycle over again.”
“Skin-picking can bring on shame or guilt that often restarts the same cycle over again.” — Alicia Hodge, licensed clinical psychologist
Picking at my skin definitely causes a lot of shame for me. I feel embarrassed about the way my fingers look every time I sign for a purchase at the store because my fingers are out on display. I’ve had my own employees yell at me to stop picking at my fingers as I was in the middle of leading a meeting. I’ve even had coworkers catch me wrapping Band-Aids around my damaged fingers in break rooms. But when I asked my psychiatrist how I could stop picking at my fingers, he said the only way was cognitive behavioral therapy.
How The Experts Treat Skin-Picking Disorder
Hodge says cognitive behavioral therapy, habit reversal training, and mindfulness are the most effective techniques for treating skin-picking disorder because they help you identify what might be triggering the urge to pick, and she says these treatments can also help you tolerate that urge. “Therapists will support you in understanding your thoughts and emotions as they relate to your patterns,” says Hodge. “They will also work with you to come up with some skills and other behaviors to do instead of picking.”
Celeste Viciere, a licensed mental health clinician and host of the Celeste the Therapist Podcast, says therapy is typically recommended to treat skin-picking disorder because the condition is so closely tied to mental health. “Cognitive behavioral therapy is a really good form of treatment,” says Viciere. “A lot of the disorder deals with your mental health. It’s helpful for people to understand their triggers to be aware of what leads them to the point of picking. There are many different ways this can manifest. I have seen it manifest when people are stressed and struggling with negative emotions.”
“It’s helpful for people to understand their triggers to be aware of what leads them to the point of picking.” — Celeste Viciere, licensed mental health clinician
And that makes total sense, except professional therapy isn’t always accessible to people. There are around 28.5 million people in the United States who don’t have health insurance. Those who do have insurance might not be able to afford the co-pays and deductibles required to see a therapist. Many others might not have access to transportation, childcare, or even the ability to take time off work to go see a therapist. There are so many barriers to seeking mental health care.
Treating Skin-Picking Disorder With Everyday Objects
I happen to be one of those people who just wasn’t in the position to seek treatment for my skin-picking disorder from a therapist. For a long time, I managed my condition by wrapping my fingers with Band-Aids when my behavior got really harmful. But recently I stumbled across a worry stone in the back of a drawer, and I realized it might be something I could use to redirect my skin-picking behavior.
If you’re not familiar with worry stones, they’re polished gemstones with thumb-sized indents in the middle where you can rub your thumb in a circular motion. Mine was a tear-drop shape that I carried around in my pocket so I could use it whenever I caught myself picking at my fingers. To make the worry stone even more accessible, I found a second worry stone that I turned into a necklace that I could wear and touch at a moment’s notice.
When I first started using a worry stone to redirect my skin-picking behavior, it was challenging. Remember, I needed to feel pain to relieve my anxiety, and worry stones don’t promote that. At first, I found myself pressing my thumb down hard into the stone until it hurt, but it wasn’t the “right” kind of pain to make my anxiety go away. Admittedly, I’d go back and forth between the skin-picking and the worry stone, but eventually I found a way to start feeling more pleasure in gently rubbing my thumb in a circular motion over the worry stone than I did in digging into my skin.
Both Hodge and Viciere say everyday objects like worry stones can help you redirect your behavior away from skin-picking. “Objects like worry stones are useful as they can provide you with another way to use your hands to divert from picking,” says Hodge. “They also are a form of refocusing as you are engaged in another behavior and sensation that provides comfort.”
Over time, I’ve actually reduced how much I pick at my fingers, and I seek out my worry stone when I feel the urge to pick. The skin on my fingers is healing for the first time in years, and I don’t feel ashamed about my hands anymore. I accept that this will be an ongoing battle for me and that a worry stone isn’t a cure, but I feel like I finally have a tool to help redirect my behavior.
If a worry stone isn’t your thing, Hodge says you can wear gloves or Band-Aids, pull pieces of tape off objects, squeeze stress balls, or play with Koosh balls. Choose something that offers the tactile sensation you need to feel soothed, says Hodge. Whatever that object is, Viciere says to keep it in your pocket so it’s always nearby. Or do what I did and make it into a piece of jewelry.
And, remember, your skin is a part of you, and you are worth taking caring for. “I believe that is it very important to emphasize self-care as an element of awareness and mindfulness,” says Hodge. “Revisiting the skin in a positive way, such as a new skin care routine, can keep you in the moment and encourage self-compassion and kindness.”