Overcoming Body-Focused Repetitive Behaviors Self-Monitoring Form

Self-Monitoring Form

Where and What:

When:

S C A M P

S C A M P

S C A M P

S C A M P

What I did with the “product”:

First aware of urge/behavior (0-4): Amount that I picked or pulled (0-4):

0 = Entering situation, 0 = None, 4 = Extreme
4 = Mid to late in episode

Comments:

© 2019 Charles S. Mansueto, Sherrie Mansf ield Vavrichek, and Ruth Golomb / New Harbinger Publications.
Permission is granted to the reader to reproduce this form for personal use.
Overcoming Body-Focused Repetitive Behaviors Action Plan

Action Plan

Situation (Location/Activity):

When Started:
Interventions S M T W T F S
(Circle Relevant Domain Letters)

Problem:

Intervention:
S C A M P

Problem:

Intervention:
S C A M P

Problem:

Intervention:
S C A M P

Problem:

Intervention:
S C A M P

Awareness (0-4)
0 = Entering setting
4 = Mid to late in episode
How much did I pick or pull? (0-4)
0 = None, 4 = Extreme

Comments:

© 2019 Charles S. Mansueto, Sherrie Mansf ield Vavrichek, and Ruth Golomb / New Harbinger Publications.
Permission is granted to the reader to reproduce this form for personal use.
Overcoming Body-Focused Repetitive Behaviors Master List of Interventions

Master List of Interventions

THE SENSORY DOMAIN

Healthy Grooming—Products and Activities:

• Skin products that will gently clean, moisturize, or gently exfoliate face and body.

• Natural oils, mineral bath salts, and other products in the bath or shower.

• Products for softening cuticles, hands, and feet.

• Hair products that medicate, nourish, moisturize, and hydrate the hair and scalp.

• Comb or brush hair and eyebrows to stimulate the scalp and skin and to distribute natural oils.

• Get or give yourself a manicure or pedicure.

Minimize Sensory Triggers:

• Tactile
• Wear clothes (including pajamas) that cover your arms, legs, and feet.
• Use eyeglasses/sunglasses, hats, or scarves to decrease access to target areas.
• Wear bandages, tape on your fingertips, or gloves to delay or prevent point of contact.

• Visual
• Dim lights in bathroom.
• Cover mirrors in bathrooms/bedrooms.
• Put makeup on in rooms with softer lighting.
• Avoid magnifying mirrors.
• Use eyelash curlers to address eyelashes that are not properly lined up.

• Both Tactile and Visual

• If split ends bother you, go to hairdresser more often.
• Get hair dyed or highlighted.

© 2019 Charles S. Mansueto, Sherrie Mansf ield Vavrichek, and Ruth Golomb / New Harbinger Publications.
Permission is granted to the reader to reproduce this form for personal use.
Overcoming Body-Focused Repetitive Behaviors Master List of Interventions

Substitute Healthy Sources of Sensory Stimulation:

• Use touch toys or other objects that feel interesting or soothing to the touch.

• Engage in hobbies or activities, such as gardening, cooking, baking, knitting, needlepoint, jewelry making, artwork,
or doodling.

• If you like to handle gooey textured substances, you can make or find products that are made just for that purpose.

• Decorate your “trigger” locations with paintings, posters, or other artwork.

• Listen to music, nature recordings, or other types of auditory input that you find soothing, stimulating, or other-
wise pleasurable.

• Engage in singing, dancing, or playing a musical instrument.

• “Pop” bubble wrap.

• Get foot or body massages.

• Groom nails, polish fingernails and toenails.

• Use oral stimulation: edibles that are chewy, that taste strong or interesting, or that you can suck on, or nonedibles
such as toothpicks or gum stimulators. Brush/floss your teeth.

Get Professional Care If Needed and Affordable:

• Hairdresser, manicures, esthetician, makeup artist, dermatologist, pedicures, podiatrist

• Laser treatments, electrolysis

THE COGNITIVE DOMAIN

• Picking/pulling will make my skin/hair look better. Rebuttal: Who am I kidding? Besides, having imperfect skin/hair
is better than the mess I am making of my own doing.

• If I keep picking/pulling, eventually I’ll fix the problem. Rebuttal: In my heart, I know I will only make things
worse.

• New growth and healed skin must look just like the rest. I can’t stand the prickly new hairs. Rebuttal: I have to
accept that regrowth will probably be uneven or imperfect and may not look as good as I hope, especially in the beginning,
but it will look and feel better over time. And even if the new growth is never perfect, I can live with it.

• I’ll just pick/pull for a minute/just one. Rebuttal: How often do I stop after a minute or after just one? Answer: Never!

• The urge will not go away until I give in. Rebuttal: Urges don’t really last forever. When I get my plan into place I will
see that urges come and go.
Overcoming Body-Focused Repetitive Behaviors Master List of Interventions

• I will never be able stand the thought of something gross or uncomfortable under my skin (acne, ingrown hairs,
other imperfections); I need to remove them now. Rebuttal: Picking or gouging will lead to more blood and scars and
just make things worse.

• I just have a small bad habit. It’s no big deal. Rebuttal: I’m just kidding myself—it has caused me more pain than I can
admit.

• I’m not always aware when I pick or pull, so it’s not my fault. Rebuttal: No excuses! I have to find ways to become
more aware so I can heal.

• Progress should be even and steady. I can’t let myself slip because it will mean I’m back to square one. Rebuttal:
This will take time and involve setbacks. I can use slips as learning opportunities. I can’t go back to square one because
now I know things I didn’t know before.

• This is not getting better. I might as well give up. Rebuttal: I may need to get professional help if my skin/hair doesn’t
look better over time.

• I have ingrown hairs or hairs that anyone would want to get rid of. The more I extract or tweeze, the worse they
get, but I guess that’s the way it has to be. Rebuttal: I can look into treatments such as electrolysis or laser treatments.
And I’ll research other treatments that may be out there, and not give up.

• I can stop when I want to. I just have to decide to do it. Rebuttal: I should know by now that willpower alone is not
going to solve my problem.

• No one will ever love me or want to be my friend. Rebuttal: Other people with BFRBs have found love and friendship.
I am not going to give up on myself.

• If people find out, they will lose respect for me and maybe even tell everyone else. Rebuttal: I’ll choose carefully and
hope I will get some support and that my privacy will be respected. If I’m wrong, I’ll accept it and move on.

• I can’t accept so much frustration and failure. I might as well give up. Rebuttal: I need to be patient and stick with it.
There are always new ideas for me to use. I’ll try to learn from my setbacks and start fresh each day.

Some Other Ideas Include:

Cognitive restructuring: Challenge BFRB-facilitating thoughts in accurate, undistorted, nonjudgmental language.

Adaptive self-talk: Talk to yourself in positive ways that are encouraging—like a best friend would.

Problem-solving: Find ways of dealing with problems in ways that don’t lead to damage to hair or skin.

Mindfulness.

Acceptance technique.

Other: 
Overcoming Body-Focused Repetitive Behaviors Master List of Interventions

THE AFFECTIVE DOMAIN

Healthy Ways to Address Emotional Triggers:

• Get information, support, and access to resources by joining TLC!

• Engage in healthy personal grooming routines.

• Put more structure in your life.

• Spend more time out of doors.

• Do moderate exercise on a regular basis: walking, yoga, dancing.

• Reach out to friends, join some new organizations if you are lonely.

• Write in your journal.

• Make daily gratitude lists.

• Do volunteer work.

• Learn some relaxation or breathing exercises.

• Try some different types of meditation.

• Work on your communication and relationship skills.

To Better Manage Other Internal Feelings:

• Get to bed at an earlier time so you will be more rested during the day.

• Limit TV time and computer time, especially late at night.

• Consider drinking more water, herbal tea, or juice, and decreasing use of caffeinated and alcoholic beverages.

• Listen to music that will give you energy, help you focus, or promote relaxation.

• Keep your hands and mouth busy with certain foods or “fiddle toys.”

• Give yourself more structure to help you over the “hump” when you feel overwhelmed, stuck, or indecisive.
Overcoming Body-Focused Repetitive Behaviors Master List of Interventions

THE MOTOR DOMAIN

Use Barriers on Fingers or Hands:
• Wear bandages on fingertips (thumbs, forefingers, etc.).

• Use rubber fingertips (items often used by clerical workers).

• Apply adhesive or cellophane tape to fingertips.

• Wear lightweight cotton gloves.

• Apply fake nails.

• Wear thumb brace (prevents thumb from bending into pulling or picking position).

Use Barriers at the Site of the Target:

• Wear a hat or bandana.

• Apply bandages over sores/pimples/scabs.

• Wear glasses/sunglasses to impede access to eyebrows and eyelashes.

• Wear long-sleeved tops and long pants, pajamas.

Make It Difficult or Less Appealing to Grasp, Pull, or Pick:

• Leave your hair wet and wrapped in a towel while watching TV, on the computer, or doing paperwork.

• Spray your hair with hairspray.

• Try a different hairstyle: cut your hair short or wear your hair in a high ponytail, a bun, or a braid.

• Wear an elbow brace to make it harder to bend your elbow.

• Use petroleum jelly on eyelids, eyelashes, eyebrows, or scalp.

• Apply eyelash conditioner.

• Put antibiotic ointment and/or bandages on scabs.

Overcoming Body-Focused Repetitive Behaviors Master List of Interventions

Keep Your Hands Busy in Beneficial Ways:

• File/polish your nails.

• Brush the family pet.

• “Pop” bubble wrap.

• Knit or crochet or do needlepoint.

• Doodle, draw, takes notes, or color in an adult coloring book.

• Do something productive with your hands (such as folding clothes, mending, ironing).

• Have an item that provides pleasant or interesting sensations as you hold, fiddle, or manipulate it in your hands,
such as a squishy ball, a feather boa, silly putty, clay, worry beads, a pot scrubber, or a stone that is smooth or jagged
or that provides some other kind of interesting sensory input.

THE PLACE DOMAIN

• Decrease privacy:
• Leave doors open.
• Go to bed when the rest of the family does.
• Study/read/pay bills in a public area of the house.

• When doing sedentary work or other activities (computer, paperwork, paying bills, etc.):
• Try using a standing desk.
• Stand at a counter.
• Avoid being in a physical position that triggers your BFRB (e.g., sitting with elbows bent, head resting on
hand, or lying down).
• Take timed breaks that include physical movements, such as stretching, yoga, or household tasks.

• Increase your awareness of time:

• Use a timer, alarm clock, or app when getting ready for work/school/going out.
• Get out of the bathroom before the toilet stops flushing after using the toilet, or right after a bath or shower.

• Decrease environmental cues:

• Dim the lights or use a night light.
• Put makeup on at the kitchen counter using a small mirror on a stand instead of the bathroom or bedroom
mirror.
• Rearrange furniture, sit in a different place, avoid sitting where you can use an armrest.
• Cover the mirrors.
Overcoming Body-Focused Repetitive Behaviors Master List of Interventions

• Don’t get bewitched at night:

• Try to avoid using screens late at night (the light emitted stimulates the central nervous system and can make
it difficult to wind down), or at least install an app that adjusts the lighting of your computer in darkened
rooms.
• Go to bed earlier.
• Try to do mental tasks early in the day when you are more alert, and more physical tasks in the afternoon
when people tend to feel restless.

• Make your environment a safer place:

• Have boxes or baskets within arm’s length wherever BFRBs are a problem for you.
• Have a variety of at least six or seven SCAMP objects/supplies in those containers.
• Use your interventions as soon as you enter the situation—before you get an urge or your hands travel to their
target.
• When you are on the phone, walk around, doodle, or color with supplies that are near the phone.
• Put notes, reminders, and coping cards where you can see them easily, and read them (aloud if possible) when
you enter your trigger situation.
• Make it harder to use tweezers or other implements that facilitate picking or pulling (e.g., use a lockbox, put
them in a container of water and then place them in the freezer).
• Get more physical exercise, ideally with a friend.