Body-Focused Repetitive Behaviors (BFRBs): When the Hands Speak What the Heart Holds

Some habits start quietly, barely noticeable. A small tug at your hair during stress. A subtle picking at your skin when you’re lost in thought. Nibbling on your fingernails while looking at your phone.

Nevertheless, for a multitude of people globally, these are not simply "habits." They are Body-Focused Repetitive Behaviors (BFRBs), the very behavioral patterns that could express the states of being overwhelmed, tensed, and emotionally drained more succinctly than verbal communication (Grant et al., 2022).

If the thought crossed your mind that your hands are moving before your brain gets it, take a long breath. You are not the only one, and you are not at fault either. Come on, let’s move to a peaceful place of tolerance, questioning, and cure.

Defining BFRBs?

Body-Focused Repetitive Behaviors are compulsive actions that cause damage or manipulation of one’s body. Among them are:

• Hair pulling (Trichotillomania)

• Skin picking (Excoriation disorder)

• Nail biting (Onychophagia)

• Biting of lips or cheeks

• Picking cuticles

• Picking scabs

• Picking nails or pulling nails

The persons suffering from these disorders are categorized under the Obsessive-Compulsive and Related Disorders group, but develop their own particular emotional and neurological characteristics (American Psychiatric Association, 2022).

Individuals with BFRBs cannot help it; they do not pick these behaviors as an option. They become, if not always, then mostly, involuntarily, especially in cases of stress, boredom, sensory overload, or emotional discomfort (Roberts et al., 2021).

Reason Behind the BFRB?

BFRB can be seen as the mind’s way of controlling feelings by means of movement or sensation.

Scientists have identified the following links:

• Genetic predisposition (Monzani et al., 2021)

•Disruption in the pathways of dopamine and glutamate (Fineberg et al., 2022)

• Childhood stress and trauma

• Perfectionism and self-criticism

• Difficulty in identifying emotions (alexithymia)

• Sensory sensitivity (Snorrason et al., 2022)

To put it simply:When feelings do not have a safe exit, the body makes one.

What Do BFRBs Look and Feel Like?

BFRBs might manifest as something that gives you comfort in the moment, but later on turns out to be a cause of distress. Quite a few people claim that it is like becoming unaware of one’s surroundings… and then all of a sudden coming to know what one’s hands have been up to.

Among the symptoms, there are the following:

• Visible baldness or loss of hair in certain areas

• Open wounds, scabs, or traces of scars on the skin

• Persistent damage to nails or bleeding of the skin around nails

• A feeling of “rush” or relief during the act

• Feeling ashamed, guilty, or keeping that behavior secret

• Certain situations, like stress, boredom, or irritations to the senses, trigger the behavior

• A strong desire to quit, but with a strong difficulty in stopping

• Being in a state similar to being hypnotized while doing the behavior (Woods et al., 2021)

For numerous people, BFRBs are one of the reasons for their continuous emotional turmoil: introducing the tension → picking/pulling → slight relief → guilt → tension again.

You are the one who deserves to get out of that loop with kindness, not with criticism.

Gentle Home Strategies to Support Healing

It is a well-known fact that professional therapy (such as Habit Reversal Training) works wonders, but it is also true that the daily environment you create around yourself can make recovery feel warmer and more sustainable.

What follows are practices that have their origin in calmness, intention, and emotional wellness:

1. Come Back to Earth with Sensory Substitutes

Your hands must be kept busy; therefore, let them have safer options:

• Finger rings that can be played with

• Textured pebbles

• Crocheting or knitting

• Balls for relieving stress in the shape of clouds

• Soft, eco-friendly fabrics (yes, even activewear that is comforting)

Such substitutes can effectively disrupt the habitual cycle (Flessner et al., 2022).

2. Create a “Nervous System Reset” Ritual

A few seconds of calm can reduce the urge dramatically.

• Hand-over-heart breathing

• 4-7-8 breath

• Slow tea-making ritual

• Stepping outside for sunlight

• Rinsing hands with warm water

Think of these as mini love notes to your overwhelmed, nervous system.

3. Heal Your Environment, Don't Make It Harsh

The small decisions make a big difference:

• Cozy blankets

• Soft morning sun

• Safe skincare products

• Clothing that is comfortable and lets your skin breathe

• Clean, calm areas

Living in a sustainable and conscious way nourishes emotional clarity, and a clearer mind has fewer picks and pulls.

4. Identify Triggers with Compassion, Not Condemnation

Observe:

• The timing of the occurrence

• Your location

• Your emotions

• The actions of your hands just before

• What you were feeling

• What your hands were doing right before

This builds awareness, not shame (Lee et al., 2023).

5. Move Your Body Without Pressure

Gentle yoga, mindful walking, or slow Pilates calms both the body and the mind.

And if you’re wearing your favorite Mellow Active gear, think of it as wearing softness that supports your back.

How BFRBs Affect Life—And How You Reclaim It

Many people navigate BFRBs in silence—covering patches, hiding hands, avoiding mirrors. But community, understanding, and connection transform that silence into strength.

Research shows that people who learn to approach their behavior with curiosity and compassion—not punishment—see better long-term healing (Franklin et al., 2021).

Healing isn’t about “stopping the habit.”It’s about creating a life soft enough, safe enough, and supportive enough that the urge loses its intensity.

And that healing is absolutely possible for you.

A Warm Call to Action

If you see yourself in these words, take this as a gentle reminder:

Your hands are not your enemy. They’re just trying to protect you.

Reach out—whether to a therapist, a support group, or someone you trust.And if you’d like more nurturing tools, soothing routines, sustainable lifestyle tips, or community stories, join our space.

We’re here to walk with you as you reconnect with your body, your emotions, and your beautifully resilient self.

Your healing is not a race. It’s a remembering.

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).Fineberg, N. A., et al. (2022). The neurobiology of obsessive-compulsive and related disorders. Progress in Neurobiology, 208, 102212.Flessner, C. A., et al. (2022). Habit reversal training for body-focused repetitive behaviors. Journal of Anxiety Disorders, 88, 102584.Franklin, M. E., et al. (2021). Cognitive-behavioral treatments for BFRBs. Current Psychiatry Reports, 23, 69.Grant, J. E., Leppink, E., & Redden, S. A. (2022). Body-focused repetitive behaviors: Advances in understanding. Psychiatry Research, 317, 114908.Lee, E., et al. (2023). Emotional and sensory triggers in body-focused repetitive behaviors. Journal of Psychiatric Research, 158, 200–208.Monzani, B., et al. (2021). Genetic contributions to trichotillomania and skin picking. Journal of Affective Disorders, 286, 1–8.Roberts, S., et al. (2021). Environmental and emotional factors in repetitive behaviors. Clinical Psychology Review, 86, 102029.Snorrason, I., et al. (2022). Sensory processing in BFRBs: A review. Comprehensive Psychiatry, 117, 152337.Woods, D. W., et al. (2021). Understanding the habit loop in BFRBs. Annals of Clinical Psychiatry, 33(4), 243–253.