Copyright © 2012 Tracy McCullough
www.TheLoveVitamin.com
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© 2012 Tracy McCullough
Disclaimer: You do not have permission to change, share, or republish this content in any way. No portion of this e-product may be reproduced, transmitted in any form or by any means, electronic, photocopying, mechanical, recording or otherwise, without the express permission of the Author of Cure Your Skin Compulsions. The information contained within this document is for information purposes only. It is not intended to be used as medical advice and is not a substitute for medical services. The statements made within this e-product have not been evaluated by the Food and Drug Administration (FDA). These statements are not intended to diagnose, treat, cure, or prevent any disease. You should always consult with a health care professional before starting on any health plan or taking supplements. The Author of Cure Your Skin Compulsions, The Love Vitamin, and anyone and any business associated with www.thelovevitamin.com does not assume any liability for the misuse of the information contained in this e-product and will not be held accountable for any adverse effects or consequences resulting from the use of any suggestions or procedures described in this e-product, whether it be direct, indirect, consequential, special, exemplary, or other damages.
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Hey there good looking! Thanks for purchasing this ebook! You CAN get rid of skin obsessions and compulsions. So thanks for showing yourself that you are totally worth the effort. Lots of love, Tracy xo
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Table of Contents Cure Your Skin Compulsions
5
What is a Compulsion?
6
Common Skin Compulsions
7
Why Do We Have Compulsions?
10
How to Stop Pimple Popping That Is Not Fear Based
11
Compulsions Based in Fear, Anxiety, and Low Self Worth
12
How Are We Going to Stop The Compulsions?
14
Limiting Beliefs
16
How to Identify a Limiting Belief
17
How to Start Loving Yourself
21
Releasing Anger in a Healthy Way
23
Check Out The Ebook “Skin Deep”
25
The Main Psychology-Based Techniques
25
How I Discovered These Techniques
26
Habit Reversal Training
28
The Steps in Habit Reversal Training
29
Step 1: Self Monitoring
29
Step 2: Becoming Aware
31
Step 3: Stimulus Control
34
Step 4: Competing Response Intervention
36
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Exposure & Response Prevention
37
Step 1: Accept the Urge
39
Step 2: Don’t Respond to the Urge
39
ERP Modification
41
Resisting Urges During HRT and ERP Therapy
42
Making Your Brain Healthier
44
Defining Healthy Skin Behaviour
44
The First Two Weeks of Changes
47
Getting Up and Over the Hump
48
The Science of Willpower
49
Fuel Your Brain With Proper Nutrition
50
Fuel Your Brain With Proper Rest
52
What Happens After The First Two Weeks?
53
Accepting your Thoughts and Embracing Uncertainty
53
Meditate
54
Exercise
55
Do Stuff You Don’t Like Doing
55
What Happens If I Fall Off the Wagon?
56
Recap On This Whole Thang + Planning Your Path to Success
57
Wrap Up
61
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Cure Your Skin Compulsions
If youʼre like me, youʼve probably had your fair share of issues with your skin. Maybe, like me, you have suffered from acne, or some other horrible skin issue. Or perhaps youʼve been obsessed with some other imperfection that has lead you down the road to some extremely unhealthy, self destructive habits.
No matter which struggles you have gone through, you are here with me for a reason you recognize that these habits arenʼt serving you and you want to finally take the steps necessary to stop them once and for all!!
First of all, letʼs take a look at what a “compulsion” is, and some of the common compulsions people deal with when it comes to their skin.
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What is a Compulsion? The dictionary definition of compulsion is: “An irresistible urge to behave in a certain way, especially against oneʼs conscious wishes”.
So just to clarify, there are healthy ways and unhealthy ways to interact with your skin. Thereʼs nothing wrong with popping the occasional pimple that is just waiting to burst, glancing at your skin as you wash your face or do your makeup, or brushing off the odd piece of flakey dead skin.
This is stuff that normal people do with their skin. Regular olʼ folks that donʼt have weird destructive feelings about their skin. Skin to them is just skin.
However, what creates a compulsion is not so much the action itself, but the quality of the action. Itʼs not even really how much you do it. You could pick at your skin every once in a long, long while, or it could be for hours every night .
What sets it apart from normal behaviour - and those regular, every day, non skinobsessed people - is that you feel controlled by the action. You do it because you feel like you HAVE to, and as a result, itʼs creating stress for you or other negative side effects.
I think of it kind of like alcohol use - drinking sometimes because you choose to... hey, no big deal. But if itʼs because you feel like you need to, and itʼs having a negative impact on your life... itʼs a problem. You see, it doesnʼt actually matter how MUCH you drink, itʼs only if itʼs having negative consequences for you that there is an issue.
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But luckily, unlike the usual treatment for alcoholism which is to completely abstain from alcohol, the answer to skin compulsions is not abstinence from yourself or the mirror. In this book, you will learn how to break your compulsions so that you can interact with your skin in a healthy, normal manner.
Common Skin Compulsions Popping and Squeezing
This is a common one, because in many instances, the intention behind it is quite innocent. Most people simply donʼt realize that their skin would be a lot healthier and look a lot better if they didnʼt pop or squeeze their pimples, blackheads, and whiteheads. They believe that itʼs necessary and that pimples will never go away if you just leave them alone.
If you get an occasional pimple with a white pussy head thatʼs just waiting to burst (and would practically pop itself at the slightest touch), then itʼs usually no big deal to very gently squeeze something like this to get the white stuff out. Almost anyone would do that.
However, if you have a lot of acne and you are popping it all, or you are squeezing every little thing you can find on your face, including pimples or minor imperfections that are no where near ready to pop, then you are probably doing your skin a lot of damage. Every time you squeeze, it damages the skin cells and pushes bacteria farther into the pore, which invites more acne to pop up in and around that spot in the future. Plus - yes, that little pimple might have been a little red, but after you squeeze it, it is usually way more red than it was before and thereʼs usually an unsightly bright red scab. Believe me - the aftermath often looks a lot worse than if you just didnʼt do it!!
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The truth is that most pimples will dry up and go away in good time if you just let them, which prevents acne from reoccurring in that spot, and makes your skin look a lot better due to reduced redness from squeezing. However, many people have never left a pimple unpopped and would never even know that is true (and here, I include my former self).
If this is the first youʼve heard of this concept, then do the techniques in this book and before you know it youʼll find the habit will be a thing of the past.
If youʼve already realized all this and have tried to stop popping or squeezing, but still feel irresistibly compelled to on a regular basis - despite seeing that it makes your skin more blotchy and marred afterwards - then this is probably an issue for you, and you need this book!!
Skin Picking
This is when you have compulsions to repetitively pick at, rub, scratch, dig into, or aggressively touch your skin, usually in an attempt to remove small irregularities or perceived imperfections. So for example, picking at pimples, scabs, moles, digging around the nail beds, biting your lips, etc. In psychology, I believe compulsive popping and squeezing is also included under the term “skin picking”, but for this book, Iʼve referred to them separately.
In extreme cases of skin picking, it is classified as its own disorder - Compulsive Skin Picking (CSP), or Dermatillomania. However, even in mild cases, it can result in pain, injury, and permanent scarring. People are often extremely secretive and ashamed about having this problem, which can lead to avoiding people, relationships, friends, work, and public places as they try to conceal what they are doing to themselves. I believe the shame and secrecy often comes from the fact that people feel like they
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“donʼt deserve help or sympathy, because theyʼre doing it to themselves”. Remember that if it causes you distress in any way, then no matter how mild it is, you deserve help to get better.
The techniques described in this book are the ones that are used clinically for treating Compulsive Skin Picking, so in theory this ebook should be all you need to get better without ever leaving your house (as long as you are fully dedicated to doing so). However, in extreme cases, you still may need a therapist familiar with CSP to help you to work through the program and give you one on one support.
Skin Touching
This is one that I have had a lot of trouble with. This is when you repeatedly feel the need to touch your skin, usually to feel existing acne, or to feel around to see if any new acne is coming up or forming under the surface. Touching your acne prone skin produces irritation, which can lead to more acne. And when we compulsively touch our acne and our skin over and over, it continuously reminds our brains of it, which leads to anxiety and sadness.
I also find that when you are touching your skin imperfections, your mind also tends to exaggerate how bad and big the spots really are, which again, leads to anxiety. Yet for some reason, we still feel compelled to keep touching our skin and feeling for acne and canʼt seem to stop.
Obsessively Staring in the Mirror
Many, many acne sufferers are familiar with this one. Running to the mirror over and over again, or spending hours in front of it obsessively staring at our acne, is a major problem. The more we stare at it, the more it comes to be on our minds 24/7, which means we canʼt really enjoy the rest of our dayʼs activities - they become clouded by Copyright © 2012 Tracy McCullough
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this ugly acne-coloured storm in our brains. Yet for the life of us, we just canʼt stop doing it!
Okay, so Iʼve gone over four common skin compulsions. You might have one or two of them, or even all four. And often one of them leads to another (staring in the mirror --> popping, or touching your skin ---> picking). But even if your exact compulsions donʼt fit into the above categories, it doesnʼt matter. If you have a compulsive habit that you know isnʼt serving you and you want to stop, then this book is for you.
Why Do We Have Compulsions? For the vast majority, compulsions are based in fear, anxiety, and feelings of low self worth. Weʼll talk about that in a second.
This isnʼt the case all the time though. As Iʼve said, sometimes the intention behind, say, popping all your pimples, is fairly innocent. It can often come from a simple misunderstanding that itʼs necessary to pop all your pimples in order to get them to go away.
For me, this was the case. I had always popped all my pimples, and when my acne was mild, it really wasnʼt such a big deal. But when my acne got severe, it was really ravaging my face.
My popping habit was not based in fear - I just didnʼt know any other way! I had never not popped a pimple in my life! I didnʼt realize that not doing so was an option.
What worked for me, simply, was having a read through this website: http:// www.stoppickingonme.com. Copyright © 2012 Tracy McCullough
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Go ahead and read it. DO IT NOW!!! It scared the bejesus out of me.
All it took was the fright that website gave me, and I managed to quit popping my pimples with just a wee bit of willpower. It was really tough at first to leave pimples unpopped (unknown territory up until that point!), but it was do-able. And the good news is that after that, my skin made a huge, significant leap forward toward being clear. Iʼm serious - it looked sooooo much better after I stopped! I never would have known.
Now the idea of popping or squeezing my skin is a horrible, repulsive thought to me. Occasionally there are times that I will give in and pop or squeeze something, and every time I regret it because my skin always looked a lot better before I went and squeezed it. Every time I slip, it helps me to remember why I quit!
How to Stop Pimple Popping That Is Not Fear Based If you were only popping your pimples because you genuinely thought that was what you had to do, and not because of anxiety, fear, or low self worth, then some of these simple techniques (which are actually part of the psychology based interventions weʼll talking about later) might help you to kick the habit pretty easily:
Putting a rubber band on your wrist and snapping it every time you feel the urge to pop or squeeze
When you get the urge, immediately do an incompatible behaviour - like sitting on your hands, or making a fist
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Put gloves on when you go to look in the mirror
If you donʼt feel like these interventions are going to be enough, feel free to go through the ebook and put the entire program into action.
Compulsions Based in Fear, Anxiety, and Low Self Worth Most of the time though, if you have a compulsive skin habit that you canʼt scare out of you, or one that some mild willpower wonʼt fix, it is likely that the reason you are doing it is because of underlying feelings of fear, anxiety, or simply a lack of self love.
These are the types of compulsions weʼre mainly going to be talking about in this book.
Our deep fears and anxieties - even if these arenʼt conscious to you as you perform your compulsion - are what compel us to act out our destructive habits. The act is a way of pushing that anxiety away or distracting yourself from it. Unfortunately, in the long run, it usually just serves to create more anxiety and the feeling that we are trapped.
For example, you have probably heard of Obsessive Compulsive Disorder or OCD (Iʼm not suggesting you actually have OCD, but itʼs a disorder that is closely related to Compulsive Skin Picking (CSP). CSP is in the OCD spectrum of disorders).
When someone has this problem, they are overwhelmed with fear and anxiety, and sufferers come up with all sorts of creative ways to deal with it.
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For example, an OCD sufferer may have intrusive thoughts that maybe he didnʼt lock his front door. Then he begins to imagine all the horrible things that could happen if he really hadnʼt locked the door - a burglar could get in, rob him blind, even set the house on fire!
Wow. Anxiety City.
As a result, he feels absolutely, irresistibly compelled to go home and check that the door is locked. But then once he has gone and checked and left home again, the thoughts appear once more. And then he feels overwhelmingly compelled to go check again, even though rationally he knows he just checked and that heʼs being nuts. HE JUST HAS TO DO IT!!
As he acts out his various compulsions over and over again, he feels even more anxiety, plenty of self loathing, and trapped in a nightmare within his own mind.
There are very extreme cases of OCD, and very mild cases of OCD. But labels arenʼt really important - and Iʼm not trying to say that you have OCD - all Iʼm trying to illustrate is that when you feel compelled to pop your pimples, pick at your skin, touch it compulsively, or obsessively stare at your skin in the mirror - in any capacity, mild or severe - itʼs the same pattern.
Underlying the compulsion is anxiety about ourselves: our skin, our acne, who we are, how we are perceived. We imagine we wonʼt be loved. Fear eats at us, and itʼs extremely painful. So as a coping mechanism, we go after our skin in some way, even if we consciously donʼt know why or what it is that is making us do it, and more anxiety and self loathing follows.
We know our lives would be better without these horrible compulsions, but we just ... canʼt ... stop!
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You desperately want to stop - and maybe youʼve tried. But nothing has worked. You donʼt know what will work or if anything ever will. You feel lost.
Well, there is good news! Iʼm here to help you.
How Are We Going to Stop The Compulsions? Well, first of all, before we even get into the actual techniques, we need to talk about how to treat the root cause - the fear. Dealing and processing the pain you are feeling inside will help the main techniques to be more effective.
So the question you want to ask yourself is: What are you afraid of?
Nothing might come to mind right away, so you may need to dig a little deeper. A good bet is to start pondering why it is that you want your skin or appearance to get better. Why is that you want clear skin, free of the ravages of acne and scabs?
Without the meaning we give it, acne and its scabs are quite meaningless. They are just bumps, and if no one could see them, they wouldnʼt be nearly as big a deal. The real reason we want clear skin is because without it, we fear that we arenʼt attractive, that we are different from other people, that we wonʼt be loved, and so on.
So a lot of it comes down to feelings of doubt.We feel that we arenʼt worthy to have these things (love, acceptance, etc) if our appearance is imperfect or marred in some way. Copyright © 2012 Tracy McCullough
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One step beyond that is when people feel totally worthless no matter what their appearance (if it wasnʼt acne, itʼd be something else), and acne and scabs just give them a logical reason to feel that way. The same could be said about chronic touching or staring in the mirror - we donʼt want to let ourselves forget how bad we feel on the inside.
If they were to stop having acne or stop picking their skin and their skin got better, or if they stopped looking or touching and were able to forget about their skin for a while, they would lose their reason to keep feeling worthless. They feel compelled to pick to keep their outer appearance matching the way that they feel inside.
In other cases, we feel bad on the inside because of something (this could be any drama in your life), and weʼre angry and upset about it. So we need to take it out on something, and that something ends up being ourselves!
The possibilities of anger producing situations are infinite, but some examples of situations that could trigger compulsive self-destructive habits include:
Having acne Stress at work
Having to spend a lot of time with extremely annoying or abusive person Having your parents pick on you
Having people at school pick on you An unhealthy relationship
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Not feeling smart or good enough
Of course, this all unconscious reasoning. Most people donʼt consciously think these things while they are picking or staring. It just happens.
These unconscious reasonings are there because of what are commonly called “limiting beliefs”.
Limiting Beliefs Limiting beliefs serve as a filter to your reality. No two people see the world, and each situation, the exact same way. Thatʼs why you might think a certain piece of art is ugly, while someone else thinks itʼs a masterpiece.
The way we see the world is an accumulation of all the experiences and messages you have absorbed throughout your life.
Sometimes these messages are good because they keep us safe. For example, maybe one time when you were young, you went to pet a dog. You put your face in his, and the dog bit you.
So then you learned that maybe you shouldnʼt go straight up to dogs and put your face near theirs, because they could get scared and bite you. In truth, no one knows if the dog will bite you, but you BELIEVE he will, because you had that experience and it got burnt into your psyche. Being somewhat cautious around new and strange dogs is usually a good thing, so this belief is now keeping you safe.
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On the flip side, you might have also gained a “limiting belief” in this situation. Because of that experience, maybe you are afraid of dogs now, and believe all dogs to be inherently “bad”. Because this is what you believe to be true about dogs, your brain now filters out information that doesnʼt fit with that belief.
If you see dogs that are happy, friendly, and obedient, you donʼt tend to notice that (your brain filters it out because it doesnʼt fit with what you “know” to be true) or you make excuses in your head like “Oh, heʼs friendly now, but I bet he bites when heʼs at home”.
However every time you see a dog being disobedient, you take notice right away and think: “Of course. That dog is being bad, because thatʼs how dogs are”. Your brain sees this and agrees, because it fits with your already established belief. Now every time you see a dog being disobedient, the experience goes straight into your mounting pile of “evidence” that plainly shows that dogs are just all ʻround bad to the bone.
As a result of this belief, it becomes limiting to your life. You might make up awkward excuses as to why you donʼt want to go to your friendʼs house who has a dog. You might feel a little nervous going to public parks or beaches where there are a lot of dogs. And maybe you are keeping yourself from enjoying a special and fulfilling relationship with a canine friend of your own!
How to Identify a Limiting Belief You can notice your limiting beliefs by catching yourself saying things like:
“Life is... ”
“I am person who is ....”
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“I could never do this this because...”
If you find that you repeat a certain phrase over and over again, you can realize that this is simply a belief that you have. Remember, a belief could be good or bad. So if you keep saying “Wow, Iʼm so lucky. Life is so easy.”, then great. Thatʼs an awesome and expanding belief to have!
However, if you keep repeating disempowering and negative phrases like “I can never do anything right”, then those are the beliefs that need to be changed - because subconsciously you are going to do things that fit with that belief in order to keep it alive, and this is going to limit your life.
If you believe that you canʼt do anything right, then itʼs likely that you wonʼt try as hard as you can to reach your goals. You donʼt do this on purpose - itʼs all subconscious. But then when you fail to “get it right” because you werenʼt giving 100%, you take that as evidence that itʼs the truth. You just saw it with your own eyes, right?
Another common belief with us acne prone crowd is “No one thinks Iʼm pretty if I have acne”. This is isnʼt the truth - you will never know the truth, because you have not taken a poll of every person ever on whether they think youʼre attractive or not. But because itʼs what you believe, if youʼve ever had an experience where someone has mentioned your acne, that will be burned into your memory. However, you will totally disregard and forget about that time that cute guy asked you out, or that time your friend said she thinks youʼre gorgeous and that she never notices that you have acne.
Sometimes itʼs hard to recognize limiting beliefs because many of them were formed when we were very young and came from our parents. But you can identify them by taking notice whenever you dislike a certain thing or situation, and then try to figure out what it is that you donʼt like about it.
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For example, if you look down on people who drive expensive cars and think “What a show off”, then look at why you think that. Underneath that thought might be a limiting belief about money - you may believe that people who have money are greedy and perhaps even bad people. Therefore you will never allow yourself to flourish financially because you donʼt want to be thought of as a rich jerk!
Examples of limiting beliefs that I have personally had are:
“I look young, so nobody is going to take me seriously.”
“No one will find me attractive if they know I have a problem with acne.” “There is never enough money. I can never afford anything.”
“I like to spend a lot of time with myself at home instead of getting more involved with the community, so I’m pretty boring and there’s something wrong with me.”
Behind our skin picking/looking/touching/staring compulsions are often some pretty strong limiting beliefs. They are usually things like:
“Even if I had clear skin, I still wouldn’t be very attractive.” “When I look in the mirror, I think I look ugly, so obviously other people think I’m ugly too.”
“My dreams will never come true. I will never get married/find my dream job/travel/, etc. I can’t because of this skin problem.”
And the big one that may stand in your way that you really need to move past if you want this to work is: Copyright © 2012 Tracy McCullough
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“I can’t do this. I will try, but I know it won’t work. It’s impossible. I’m never going to be able to stop picking my skin.”
Now, how do you get rid of these limiting beliefs?
Well, thereʼs no point in me writing it all out here when someone else has already said it so brilliantly. Please check out the following blog posts - the first of which gets you thinking more about the beliefs in your life, and the second tells you exactly and precisely how to get rid of your limiting beliefs:
EVERYTHING is a Belief!
How to Change Your Limiting Beliefs - The Ultimate Guide
So, there are two things you can do in order to start clearing out your limiting beliefs:
1.
Sit down and think about the beliefs you have in your life (especially the ones related to your skin), and write a big list of beliefs you feel are limiting you and your potential for greatness!
2.
For each belief, write down the emotional evidence you have that supports that belief (if you donʼt know what I mean by emotional evidence, read the second blog post above: “How to Change Your Limiting Beliefs”)
3.
Over the next little while, after you read this book, go through your list of limiting beliefs and do the exercise for getting of it, as described in the above article. Go through one belief per day.
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How to Start Loving Yourself As weʼve been saying, one of the most common limiting beliefs that we have (especially people with skin compulsions) is that we donʼt believe we are worthy of love and acceptance. A lot of the time, this belief stems from not having enough love and compassion for yourself.
We all have flaws. We all have problems. We all have limiting beliefs. We all have insecurities. We all have dramas in our life. We would like to try to get rid of as many of these problems as possible, but there is no shame in having flaws and problems.
Seriously - everyoneʼs got ʻem.
Either way, we often forget that we are people too, and we deserve just as much love and kindness from ourselves as we do from other people. We are often calling ourselves names, putting ourselves down, comparing ourselves to others, and just being downright mean.
Loving yourself is all about treating yourself the way you would treat a friend whom you loved. You would never judge them or treat a friend so harshly. You would never want their feelings to be so hurt! And if your friend was sad or having a rough time with something, youʼd give them a hug, listen to them, and be there for them.
For some reason, we donʼt afford ourselves the same luxuries. Instead of giving ourselves a hug or doing sometimes nice for ourselves when we are feeling down, we rip our skin to shreds, or engage in other self destructive habits.
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Making a point to foster self love is super important. Along with going through and changing your limiting beliefs, this will make the main techniques more effective and youʼll be more likely to stick with it, because itʼs removing the emotional pain behind the behaviour. Itʼs also a way to show yourself that you are WORTH IT!
(YOU ARE SO WORTH IT!)
Making any positive change is difficult, and when you feel low on yourself, itʼs hard to be motivated to make the necessary changes - because we donʼt feel that we are worth putting in all the effort.
Before we go forward, please read this article on my blog if you havenʼt already:
How to Start Loving Yourself
The article shows why not having self love can cause so many problems in your life, how to change your thinking on the matter, and other ways to start loving yourself. And donʼt worry - fostering self love is actually tons of fun. Please begin working on this now and you can continue on with it indefinitely!
Here is another article from my site that you might find interesting if you happen have a problem with staring in the mirror too much, and is related to loving yourself:
Learning to Love the Person Behind the Acne
THIS STEP IS IMPORTANT! PLEASE DONʼT SKIP IT! If you donʼt love yourself, you wonʼt feel that you are worth the effort it takes to get really get better and recover from your skin compulsion! The main psychology based techniques weʼre going to be talking about later require dedication and effort. If you really truly want to see results and get better, LOVE YOURSELF! YOU ARE SOOOO WORTH IT!!!!! Copyright © 2012 Tracy McCullough
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Releasing Anger in a Healthy Way Another reason I mentioned earlier that may be the culprit behind skin compulsions is that you are just feeling really crappy and angry about something in your life and you feel the need to take that out on something.
Well, this kind of goes hand in hand with “not enough self love”, because if you loved and respected yourself, youʼd find a better, healthier way to release anger that doesnʼt involve taking it out on yourself.
So the first thing you want to do is go back a square and work on self love.
The second thing you want to do is to learn to release your anger in a better, healthier way. It does need to be released, because bottling it up inside is almost as bad as taking it out on yourself. Internalized anger always has to come out eventually, and often it can come out either on other people, as a disease, or other mysterious ills. You donʼt want that!
Once you get the feelings you’ve been suppressing out in this healthy way, you are likely to experience fewer urges to “get things out” by taking it out on your skin.
So some ways you can release anger:
Literally just rant and scream and beat your fists or a baseball bat against your pillow or mattress. Throw things (only unbreakable things at unbreakable things). Get a little crazy, and just let all that anger out in whatever way feels good. Do this preferably when no one is around or they might drag you to the loony bin. They also might absorb your angry vibes, so
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protect your loved ones by doing this alone. But yeah... really. Punching and kicking and screaming in the comfort of your own home where no one and no thing gets hurt is super cathartic for getting anger out.
Exercise. Moving your body really is one of the best ways to get out excess anger and energy that needs to go somewhere. Plus it releases endorphins at the same time which make you feel a lot happier. Boxing might be a particularly great sport for releasing anger! Running is too. Anything that you can just throw yourself into and really give ‘er. Lol - I found this one on la internet: “Get one brick, and one hammer. Hit the brick on the ground with the hammer. Take the smallest of the pieces, and hit that. Take the smallest of *those* pieces, and hit that. Repeat until you have one little bit, pounded to dust. Then move back up the chain to the next smallest piece. Pound it into oblivion. Switch hands. Keep pounding. By the time the entire brick is dust, you will be so worn out you’ll make the most hard-core stoner look like a speed freak. Did this many times in high school and it kept me from killing someone.”
Journal! Journalling is sooooo good for getting out anger. Just take a pen and paper and start writing anything and everything that comes to mind. Anything that makes you mad, sad, glad, or anything in between. Just get it all out. Burn the piece of paper after if you want to.
Remember that itʼs okay to feel anger. Itʼs a normal emotion and all emotions should be felt. Itʼs the emotions we donʼt want to feel that we bury inside and cause us problems ... donʼt worry ... feeling anger doesnʼt make you a bad person! You are still a darling!
If it makes you feel better, I can get pretty dang angry myself sometimes! RARRR :()
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Check Out The Ebook “Skin Deep” My last tip for getting to the bottom of and treating the emotional cause behind the compulsions is to read the free ebook “Skin Deep”. Iʼve already recommended this ebook numerous times around my blog and in my other ebook so you might have already read it... but even if you have, itʼs probably worth doing it again.
This ebook is written by Dr. Ted Grossbart. Dr. Grossbart is an expert known worldwide in the field of psychodermatology (the area of psychology that treats psyche related skin disorders) and focuses a lot of his work on Compulsive Skin Picking. Skin Deep is an AMAAAZZING book and asks just the right questions to help you to figure out what it is that your skin and behaviour is trying to tell you.
You can get it for free at his website: www.grossbart.com
The Main Psychology-Based Techniques There are two main techniques weʼre going to be discussing, which are forms of “Cognitive Behaviour Therapy (CBT)”. The best technique for you depends on how aware you are of the problem.
By aware of the problem, I mean how well you recognize what sets you off and gives you the urge to perform the compulsion. What are your triggers? Which situations and events precede the urge to pick / pop / touch / stare?
Depending on your level of awareness of your triggers, your main technique will be either be:
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1.
Habit Reversal Training (HRT), or
2.
Exposure and Response Prevention (ERP)
Wahooo! Ssounds pretty boring and clinical, hey?
Well, give ʻem a chance and take ʻem seriously, because these techniques are your ticket to finally freeing yourself of these sucky obsessions and compulsions!
How I Discovered These Techniques If youʼve followed my blog for a while, you may remember when I wrote this article about how to quit doing these things. It was entitled “5 Ways to Stop Touching or Picking Your Skin”.
I had already beat my popping habit, but I was sick of nervously touching my face and feeling around for acne. I also stared in the mirror at my skin way too much. I had great intentions of quitting these things, but unfortunately, none of my own advice worked for me. It was hard to know if any of these methods would actually lead to the urges going away, or if Iʼd be stuck resisting them on willpower forever - which is extremely draining!
So the habits remained.
It wasnʼt until I was searching for something to help me stop my compulsive internet use that I found the solution.
You see, I was finding that I was in the habit of using the internet extremely compulsively. Every time I was near the internet, but not on it, I would desperately want
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to be on it. Iʼd walk away for one second, and Iʼd get the strong urge to look up something on google, check my email, or just be connected in some way. I often didnʼt know what it was that I wanted to check, I just had an overwhelming urge to check “something”.
And Iʼd always give in to the urge.
This would lead to tons of time wasting, I felt like I couldnʼt enjoy other activities, and generally it was having a very negative impact on me. I felt miserable and trapped. All I wanted was to throw my computer out the window. But I couldnʼt just give up the internet! I need it to work and blog. And it can be extremely useful when used properly.... so what to do?
Thatʼs when I came across Exposure & Response Prevention (ERP) from an ebook called “Web Rehab” (wonderful book, by the way, and a big inspiration for this one). I put it into action, and while it was very difficult at first, and I did have a couple of relapses, in the end, I was able to eliminate my compulsive internet urges. I began to interact with the internet in a much healthier (and MUCH more productive) way, and it felt like a huge weight had been lifted off my shoulders. I felt free.
I realized that perhaps this method could be applied in the exact same way to other compulsions, which lead to me to find out more about which clinical therapies they use to treat skin picking.
I found that there are quite a few differences between OCD (the main disorder in which ERP is used for) and compulsive skin picking, and therefore while sometimes ERP is used for skin picking, the primary method that is used is called Habit Reversal Training.
So I tried out HRT with my unconscious skin touching habit, and guess what? It worked!! I then used ERP to stop myself from always looking in the mirror at my skin for no reason (more of a conscious habit).... and guess what??? IT WORKED! :) Copyright © 2012 Tracy McCullough
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It was difficult at first, but I felt like another weight had been lifted. I have noticed the day to day anxiety about my skin has been significantly reduced because I am not constantly bringing it to my brainʼs attention. I am much more able to focus on other things for long periods of time without my acne popping into my head and subsequently causing me to get caught up in my fears.
Habit Reversal Training Habit reversal training is the first of our main fancy psychology techniques, and itʼs most appropriate if your skin compulsion is mostly an unconscious habit. Unconscious meaning that you donʼt really think about it before you do it - it just seems like it suddenly happens before you even know what youʼre doing.
For example, my touching habit was DEFINITELY unconscious. I would only notice once my hand was already on my face! And often I wouldnʼt even notice at all. And many people will just start picking at their skin without really realizing theyʼve started.
On the other hand, if your habit is a conscious habit, it means you are aware of your triggers and fully realize in the moment what you are doing.
Popping pimples and squeezing blackheads is mostly a conscious habit. Seeing the pimple in the mirror is generally the trigger (and perhaps a staring habit might be the gateway to this), you feel bad about yourself, and then it begins. Itʼs pretty hard to pop a pimple or squeeze blackheads without thinking about it or realizing that youʼve started doing it. Ya see what Iʼm sayinʼ?
So anyway....
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Using HRT for unconscious habits is based on the principle that the compulsion whatever it may be - is a conditioned response to certain situations or events.
Those particular situations or events are what trigger you to perform the action, but if you arenʼt really aware of what the triggers are that suddenly makes you unconsciously begin picking or touching, then Habit Reversal Training is the technique for you.
That being said, even if you think you are fully aware of what it is that sets you off and you feel fully conscious while performing the behaviour, itʼs still worth having a closer look at what Iʼm about to talk about, just to make sure you havenʼt missed anything.
The Steps in Habit Reversal Training 1.
Self-monitoring
2.
Becoming Aware
3.
Stimulus Control
4.
Competing Response Intervention
Step 1: Self Monitoring Okay, so the first step in Habit Reversal is self monitoring. This is where you get down to business and really start paying attention to what it is that sets off your habit.
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You are going to be need to write down and document every time you catch yourself in the behaviour, and write down where it was, when it was, how you were feeling at the time, and all of the rest of the things on the following list:
1.
Is there a place where the habit normally occurs? A likely place is the bathroom for many of these habits, but it could be anywhere. For example, I tend to touch my skin when Iʼm sitting on my computer or zoned out on something else. Also, is there a time of day when you find that you tend to do it?
2.
Do you have a habit which then leads to the main compulsive behaviour? As I was saying, long sessions of staring in the mirror are highly likely to lead to popping or picking sessions. So is touching and feeling your skin (you find something to pick, and then you just start picking it). Do you tend to find that one thing leads to another when it comes to your habits?
3.
Do you enjoy any of the sensations that you get when you perform your habit? Many people find skin picking or squeezing to be enjoyable. You might find that you enjoy the actual sensation of picking or popping, or that you like some kind of after-sensation - example: the satisfaction when you get the “white gunk” out of your pore. Which sensations associated with the behaviour do you enjoy?
4.
What emotions do you feel when you start your habit? Many people find that they begin the habit when they feel stressed, down on themselves, or sad. This builds up tension and then the picking, or popping gives them a temporary feeling of calmness or relief. On the other hand, some people end up doing this when they feel bored or restless, and the habit helps them to
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feel more energized and less bored.
5.
Which thoughts occur when you start the behaviour? What thoughts do you have about your skin or yourself right before the habit starts? Examples include “Iʼm ugly”, or “my skin is ugly and uneven”, or “I wonder if there are any new spots...”, or “I wonder if that spot has gotten any bigger....”
6.
Who is around when you feel the urge to start your habit? Do you only perform the habit when youʼre alone? Or are you more likely to start the behaviour (or sneak away to perform the behaviour) when certain people are with you? If so, is it any old person who triggers it, or is there a certain person who makes you particularly nervous/upset which sets it off?
Something that can help is if you have someone you trust, who knows about your problem, and whom you spend a lot of time with. You can get them to keep an eye on you and point out every time you are doing the habit. This will help you to wake up to it in the present moment and help identify when and what sets you off.
Another thing you can do is wear jangly bracelets on your wrists, which will make you more aware of what your hands are doing.
Step 2: Becoming Aware Okay, so after youʼve figured all that out, you should naturally become more aware when you find yourself entered into a situation in which you are likely to start your habit.
So for example:
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If your habit is squeezing pimples and blackheads, you may have now realized that you tend to do this in the bathroom, most often in the evening as you are washing your face. Your trigger is a new pimple, which then makes you feel bad about yourself and think “Iʼm ugly”, which then gives you the urge to pop or squeeze it, even if the pimple hasnʼt come to a head. It feels really good when the white stuff does comes out, so remembering how good that feels when it happens draws you to do the popping.
Once you squeeze one, it feels good for a second, but you notice that you feel even worse about yourself after, which prompts you to squeeze more, with the thought: “Well, I already wrecked my face. Whatʼs one more gonna do”.
Another example might be if your habit is skin picking. You may notice that you happen to start picking and digging at your face when you are bored or have been sitting too long. This most often happens in class, or after watching too much TV. You may have noticed that you like the sensation of doing something with your hands and that you feel better while picking because itʼs giving you something to do.
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If your habit is staring in the mirror at your acne, you may notice that you tend to want to go check your face more when you are with friends. You find that tension builds because you are stressed and wondering if there are any spots not covered up or if your friends can notice your acne or how bad it really looks. You feel a small sense of relief when you get to see the acne in the mirror and check on it, but once you go back out, you feel the same anxiety and uncertainty and the cycle continues.
If your habit is skin touching, you may have noticed that what sets you off is when you feel some kind of itch or any kind of tingling sensation on your skin. Whenever this happens, your brain assumes it must be a new pimple coming up, so you are overwhelmingly drawn to feel around on your skin and see whatʼs up. You also notice that you often do it when you are working on something boring, like studying, and are feeling antsy to put your mind onto something else.
Okay, so yeah. You get it. Those are examples. Youʼve figured out exactly what sets it off for YOU.
Now that youʼve done that, you should be aware of
When you are actually performing the habit (in other words, waking up to it in the present moment if you had previously done it without realizing you were doing it)
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When you feel the urges that set you off as they’re happening When you are in a high-risk situation
The point of this is so that when you find yourself in a dangerous situation, you are highly aware of it and can be extra vigilant about not starting the behaviour.
See? Weʼre making progress ...
Before you didnʼt even know you had started and may not have ever realized what a high risk situation is for you. How can you prevent something that you didnʼt even realize you were doing? Now you know what triggers it and can notice when dangerʼs a lurkinʼ. Good for you :D
Step 3: Stimulus Control The third step in HRT, after having figured out your triggers and have become more awake and aware of when you are in high risk situations, is “stimulus control”.
Stimulus control is all about preventing the habit by interfering with your triggers.
This includes:
Avoiding situations in which you tend to perform the behaviour Using techniques to help you stop the behaviour
Using techniques that prevent the behaviour
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Letʼs look a little closer at these...
Avoiding Situations in Which You Tend To Perform the Behaviour This is not practical in all senses - but for example, if you tend to perform your compulsion when a certain person is around, you would do your best to avoid that person as much as possible.
If you only perform your compulsion in the bathroom, you would need to cut down on the amount of time you spend in the bathroom, or completely avoid looking in the mirror.
If you only perform your compulsion when you are bored, make sure that you are staying busy and avoid becoming bored!
Using Techniques to Help You to Stop the Behaviour
The first part of stimulus control is about avoiding known trigger situations, but if you are in one that canʼt be avoided and you are having strong urges, this is when you do something to prevent yourself from having the urges escalate.
Depending on your triggers, this could include things like:
Getting up and changing rooms if you’re bored while studying
Grabbing a jump rope and throwing out 5 minutes of jumping
Journalling out all your thoughts and emotions in that moment Copyright © 2012 Tracy McCullough
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Leaving the bathroom
Using Techniques to Prevent the Behaviour
Okay, so this is like putting up barriers between you and your skin that physically prevent or discourage the action from occurring.
Things you could do include: Wearing gloves around the house or in high risk situations Taking down your mirrors or placing blankets over them Getting your nails done in big gel or acrylic nails so it’s hard to pop and squeeze Having makeup on (many people find this a huge help - if your makeup is done nicely, it can be a big deterrent to picking, popping, and touching)
Step 4: Competing Response Intervention Competing Response Intervention is about replacing the compulsive behaviour with a different action every time you feel the urge to perform it.
You need to choose an action that is incompatible with the picking / popping / touching / whatever, and every time you feel the urge, you do that action instead for a
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predetermined amount of time. Perhaps one or two minutes. In most cases, by the time itʼs up, the urge will have passed.
Itʼs best to choose an action that you can do anywhere and can do it subtly if need be. There may be plenty of times you get urges around other people, and if you choose a really weird, obvious action, you may avoid actually using it when you really need it!
Ideas of competing actions include:
Holding your hands open “Gluing” your hands to your lap
Repeatedly flicking your middle finger into the palm of your opposite hand Making fists with your hands
Gently massage your leg or arm in a circular motion Sitting on your hands
Exposure & Response Prevention Exposure and Response Prevention (ERP) is the second psychology based treatment that you can try. Itʼs preferable to jump straight into ERP only if you are already very conscious and aware of your habit and its triggers. If not, go back and do the first part of Habit Reversal Training!
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ERP is a slightly different technique than HRT, but can actually be used alongside most of the same techniques from the last two steps of HRT - Stimulus Control, and Competing Response Intervention.
But first, letʼs talk a little about ERP.
ERP is primarily used in treating Obsessive Compulsive Disorder (remember, itʼs a disorder very closely linked with compulsive skin picking) and is around 80% effective in causing remission in symptoms, and is just as effective as medication.
One huge advantage ERP has over medication, aside from avoiding harmful pharmaceutical drugs, is that unlike medication that you need to be on indefinitely, ERP seems to be an actual cure - the majority of people who do ERP donʼt require any follow up treatments, even 5 years later. And thatʼs really cool. So even if you donʼt feel your compulsions are even close to being on par with an OCD diagnoses, it doesnʼt matter if it works for them, youʼre going to find that it helps you too.
Here is how it works. I know, I know, itʼs going to sound a little too easy and ridiculously simplified ... but ... basically, this is all there is to it:
1.
Expose yourself to the urge
2.
When you feel the urge, donʼt do the thing you feel compelled to do
So ... yeah. Thatʼs it!
In order to resist the urge, you can use the following techniques from HRT, which include choosing a competing action (like flicking your hand, or sitting on them), using techniques that help you stop from giving into the urge once you have it (like changing rooms or leaving the bathroom), and using barriers to prevent you from picking/popping, etc (like makeup, wearing gloves, etc). Copyright © 2012 Tracy McCullough
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However, this technique is slightly different from HRT in that you donʼt actually want to avoid the trigger at all. You actually want to expose yourself to it as much as possible, so no putting blankets over your mirror, or avoiding the bathroom.
I can hear you saying now “Um. Seriously? Is that all there is to ERP?
Yes. Thatʼs it. Hereʼs a more detailed description of the two steps in ERP:
Step 1: Accept the Urge Often when we feel or think a negative emotion or thought (like “I want to pick my skin”), we will fight it, or try to rationalize it. You might be angry at yourself for having the thought, or try your hardest to push it from your mind (often unsuccessfully).
However, I donʼt want you to do that.
What I want you to do is that when you get the urge to pick, pop, look, whatever, you just accept that you want to do it for whatever reason. Maybe you desperately need to see if that pimple has gotten any smaller, or thereʼs this red scab that is a bit ugly and just NEEDS to be picked at... whatever it is, you just feel extremely compelled to do it.
Just acknowledge the feeling. Go ʻHm. I feel the urge. Okay”. No beating yourself up, no trying to push it away. Just accept it and leave it. We need the urge to be there, because this is the “exposure part” of ERP. Youʼre exposing yourself to the urge.
Step 2: Don’t Respond to the Urge Copyright © 2012 Tracy McCullough
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After youʼve acknowledged and accepted that you do have this urge to pick or touch or look at your skin - donʼt do it.
Take a deep breath. Feel the urge. Make a conscious decision that you will not do whatever it is that you feel compelled to do. Use Competing Response Intervention and sit on your hands!
This part is the Response Prevention part of ERP.
After youʼve managed to keep yourself from picking, or touching, or looking, you will probably notice a huge spike in the urge to do it (but still donʼt do it!).
At this point, you will probably get a bit anxious and frustrated. Your brain is going to come up with all sorts of disastrous reasons why you badly need to go check the mirror, or pop that zit. People will be looking at you. What if you look terrible and donʼt know it? What if that zit has gotten ten times bigger than it was, how will I know unless I touch it???
What if, what if, what if???
Itʼs okay! Just accept that. If you feel really uncomfortable at this point, you are doing the right thing. Itʼs okay to feel uncomfortable. You will survive it. So much of our emotional distress is due to over-reacting to unpleasant, unwanted feelings that are a normal part of being a human being!
With ERP, we want to learn to accept and tolerate these normal feeling states, despite the fact that they are unpleasant. By tolerating the unpleasantness but choosing not to partake in your compulsion, you are beginning the process of retraining your brain to act in a healthier way. Copyright © 2012 Tracy McCullough
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ERP Modification There is a modification to ERP that the OCD Center of Los Angeles finds very effective for their Compulsive Skin Picking clients.
Instead of planning to resist the urge forever right off the bat, you can instead decide to resist the urge only for a pre-determined amount of time. Say, 24 hours. And then once that time has elapsed, you can go ahead and decide if you want to pick or pop or do whatever you wanted to do, if you still want to do it. The pimple or scab might have even dried up or gotten smaller in that time.
By starting small, you can build on your successes, and gradually learn to tolerate the urge to pick, instead of trying to go in cold turkey. When the urge comes, just acknowledge it, accept it, and make a pact with yourself to wait at least 24 hours to look or touch again.
By waiting, you are showing yourself that you are able to resist and are able to wait it out to see what happens. Remember - you donʼt have to pick or touch your skin just because you had the urge to do so.
As you build up your tolerance, you can extend the amount of time you wait between indulging in the behaviour. Soon you might find that you can go for 36 hours, and then 48, and so on. In the mean time while you are waiting, you can work on identifying the emotions behind the compulsion, loving yourself, and getting your anger out in healthier ways!
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Resisting Urges During HRT and ERP Therapy So as you can see, whether you are doing HRT, or ERP, or a combination of them both, you are going to have some pretty strong urges that you need to have the willpower to overcome.
However, as weʼve said - youʼve probably tried using willpower to overcome your compulsions before and failed miserably. Plus, during these efforts, you probably beat yourself up a lot. Youʼd probably yell at yourself for having the urge, or when you gave in, be angry with yourself for not having more willpower. Or try to control or change your thoughts, which usually doesnʼt work.
Another problem is you probably werenʼt following a tried and true process. I have found that when I am just making up a way to do things, it doesnʼt always work - you arenʼt as committed because you donʼt know that it will work. But now youʼve got a solid plan!
So ... whatʼs the deal? What happens next? Are you going to have to resist the urges forever? Because ... hey ... that sounds kind of impossible, right?
Youʼre right. It is impossible, and that isnʼt the goal. The goal is that by resisting the urges repeatedly, your brain rewires itself and it stops screaming the urge at you.
Every time you resist, your brain is getting closer to being healthy. Itʼs kind of like when youʼre exercising - you have to feel the burn a little before your muscles can grow and you can get faster and stronger. In this case, itʼs like boot camp conditioning for your brain! Every urge you resist makes it easier for your brain to resist them in the future.
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The thing is, during the process of getting there, your brain will come up with all sorts of amazing and rational sounding reasons as to why you need to squeeze that one last pimple, or look in the mirror just one last time. Your brain will argue you like itʼs the captain of the debate team. At first, it will be incredibly difficult to be able to resist. But each time you do it, it will get easier and easier.
You see, your brain is quite primitive, and does things for the purpose of pure survival. Itʼs programmed in a way that when you do things repeatedly, it learns that that must be a good thing for your safety. It doesnʼt know what itʼs actually doing, and it doesnʼt realize itʼs harming you in the process. It thinks itʼs helping you stay alive by getting you to give into that urge.
So when you resist the urge, youʼre teaching your brain that resisting the urge isnʼt harmful. You show it that you really are going to survive if you donʼt pick, or look (yes... you will survive! I promise!!). And every time you resist the urge and stay alive, it learns this lesson a little better. Soon your brain will learn that it gets greater survival rewards from not doing that activity, and you will no longer feel the urge.
I believe that with ERP, the urges begin going away a little bit faster because you are purposely exposing yourself to the urge, so your brain has more opportunity to rewire, where as with HRT, you arenʼt as much. The diminished urges could come as soon as a a few days, or it could take up to a month, it all depends on your brain.
For the purpose of simplicity in this book, weʼre going to say that itʼs going to take about two weeks. However, with ERP, it might take shorter... perhaps three to ten days, with HRT, probably more around two to three weeks or longer, since that is how long it takes for a new habit to form. Either way, you have to just keep resisting until they go away, and then you are on your way to being home free.
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Making Your Brain Healthier So now you know what the actual goal of this whole thing is, and that is rewiring your brain so that itʼs healthier and can serve you the way you want it to. Brains with compulsions and anxiety arenʼt healthy brains!
You see, we often think of our brain as a separate entity in its own little world in your ʻnoggin, but itʼs not. Your brain is an organ that is connected to the rest of your body, and its health and proper functioning depends on lots of things - including the nutrition you bring into your body, the thoughts you think, the actions you take, the mental exercise you give it, the stress in your life, and the exercise you give your body
So resisting the urges isnʼt really all there is to it - you also have to support your brain in this process so that you can be successful in getting up and over the hump (aka the first couple of weeks until the urges go away).
You also have to define for yourself what healthy behaviour looks like. You have to decide how it is that you want to interact with your skin in the future after youʼve beaten your compulsions. If you donʼt define a healthier way, your brain wonʼt know what to replace the unhealthy behaviour with, and you are more likely to relapse.
Defining Healthy Skin Behaviour So by defining healthy behaviour, I mean this:
Using skin picking as an example, there are three levels of skin picking called the “ABCʼs of Skin Picking”. This is taken from the OCD Center of Los Angeles blog:
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An “A” is something that almost anyone would pick. This could be a piece of dry skin hanging off your arm, a pus-filled whitehead on your chin that pops at your mere touch, or a scab that’s barely hanging on which you can easily detach.
A “B” is a “bump”, pimple, scab, etc. that only a skin picker would pick, frequently causing it to bleed, ooze, scab, and possibly become infected. This in turn will cause two additional problems – it will cause the picker significant distress, and it will give him or her something new to pick at later. In my experience, clients with Compulsive Skin Picking classify at least 50% of their picking as “B’s”.
“C” stands for “Create”, meaning the individual with CSP is not picking at anything objectively “real”, but in the process of picking at her skin, she “creates” something such as a blemish, scratch or scab. A “C” is something that only someone with Dermatillomania would pick. There is often nothing apparent on the skin, but the picker starts picking or scratching, and in the process creates a wound.
There are times in life that you will actually have to look at your face, and may need to attend to something on it. It canʼt be avoided. Normal, healthy people who donʼt have skin compulsions look at their face, and itʼs totally fine.
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If there is an “A” - a piece of dry skin, a waiting-to-burst whitehead, or a falling off scab, a normal person will do something about it. Normal people also wash their face and look at their skin in the mirror as they do it. Or they look at their skin to do their hair or put on makeup.
So seeing as underneath all these compulsions you are a healthy, normal person too, there are going to be times in the future where you do need to look at your skin. But before you find yourself in these situations without any planning and suddenly it leads to something you didnʼt intend, you have to decide when and how you are going to do these things.
You need to set parameters for healthy behaviour.
So for example, you might decide that the ONLY times of day that you are going to look at your skin are once in the morning when you wash your face, and once at night when you wash your face.
You may also decide that at these set times, you will only briefly look at your skin from a decent distance from the mirror. You under no circumstances will stand there and examine your skin for more than a few seconds. You also wonʼt touch it at all for anything that isnʼt to do with washing/product/makeup application etc.... unless there is something that absolutely must be attended to (an “A”). And then after that ONE thing is attended to, you will STOP and not continue to pick / pop / squeeze /look incessantly / feel around for more.
By setting rules and parameters like this, you are training your brain to know that YOU decide when and how you interact with your skin. You rule your brain, your brain doesnʼt rule you.
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The First Two Weeks of Changes A lot is going to happen in the first two weeks after you start cutting out your skin compulsions. You are going to learn a lot about how your brain works, which will be incredibly interesting.
On the other hand, this challenge probably wonʼt be as easy as you might think and the first two weeks will probably be the hardest. Well, I donʼt know if youʼre thinking itʼs easy or not ... but I have found that the first day or two is pretty easy. Because this whole process is kind of new and novel, so itʼs easier to stick with.
But after that, it gets pretty tough. Real tough. Iʼm not trying to scare you, Iʼm just trying to prepare you.
Your anxieties will probably start getting pretty crazy. You will probably be extra self conscious about your skin and appearance. You will probably get cranky about other things as well.
This is because you were likely using your skin compulsions to deal with other anxieties and dramas in your life. Now that you donʼt have your skin to take it out on, your insecurities will start being really noticeable. Your brain just desperately wants something to cope and control your uncertainty about this whole thing.
Try not to fall into the trap of swapping your skin compulsions with other addictions in order to deal (like smoking, watching endless TV or internet use, drinking more, or anything else). If you do that, you arenʼt teaching your brain to be healthier, which is the ultimate goal.
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Remember to just feel these feelings, and accept them as they are! You donʼt have to tell yourself not to have them or that you are crazy for feeling anxious. Itʼs normal.
Accept that your brain is going to get all worked up and do some silly things to try to get you to give in. Itʼs a scary thing for your brain - this whole breaking your compulsive habits thing.
Your brain is actually very tricky and sly... it knows the exact things that will make you slide back into your “safe zone” of picking or looking.
It will say “Hey there. Just one look wonʼt hurt. What is one look going to do? And if you squeeze just that one pimple, then itʼs not going to make a difference. Honestly. Whatʼs one going to do? Nothing.”
And suddenly you are sitting there with red scabs all over your face.
So donʼt believe yourself! Accept that you are having these trickster thoughts. Go easy on yourself for having the thoughts, but donʼt act on them. Remember why youʼre doing this. ITʼS BECAUSE YOU ARE WORTH IT!
You can do this.
To help you with this, make sure to have a journal on hand to help you get out all your frustrations about this process, and you can also make sure youʼve planned lots of activities and fun things to do whenever you feel the urge so that youʼll always have a distraction.
Getting Up and Over the Hump Copyright © 2012 Tracy McCullough
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When you make a major change like this, in the beginning, uncertainty will spike dramatically because itʼs new and scary. It will be easy to want to fall back into what was familiar. However, if you go back, the uncertainty will diminish, but the skin compulsions will remain - no progress means that you havenʼt achieved anything and are still in the same painful place you were before.
This is very common - itʼs very easy to want avoid short term discomfort at the expense of long term health.
However, if you keep going forward, with time the new way of being will become habit, uncertainty about it will diminish, you will have accomplished something awesome, and life will be good.
Think of it like youʼre climbing a hill. Itʼs tough going up and youʼre not sure youʼre going to make it, but as you reach the summit and the hill rounds out, things start getting a little easier, and then itʼs just coasting on through after that!
The Science of Willpower In the first two weeks, you are going to need a lot of willpower to resist your urges, so that you can get over the hump and into the clear. So letʼs take a look at the science of willpower.
It is commonly believed that willpower is some kind of innate trait that people are either born with or theyʼre not. In reality though, willpower is a function of your brain that can be made or broken by stress, sleep deprivation, and poor nutrition.
And willpower isnʼt really a “trait”, itʼs just your brainʼs response to an internal conflict where you want to do one thing, but know that you should do something else that is Copyright © 2012 Tracy McCullough
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better for your long term goals. Like you want to watch TV and play with your dog, but you know you should do your taxes. Or you really want to eat that chocolate brownie, but you know you have a bad reaction to wheat and sugar and will feel bad tomorrow. Or in this case, you really want to pick that pimple, but you know you really shouldnʼt.
Your brain has something called a “pause-and-plan” response that happens when you are faced with these decisions. This is the response that can help you make the right decision - the one that is good for the long term goals and motivation. It does this by overriding the stress response of the decision and putting you into a calmer state. It also sends energy to the front of your brain to the area that is responsible for long term planning and goals.
In other words - stress bad, willpower good.
Stress and willpower are two completely incompatible states to be in. The fight or flight response stress generally overrides the ʻpause-and-planʼ button, and automatically steals the energy needed by the brain for wise decision making. Itʼs really hard for your body to be in both states at the same time. So any time your body is under stress, it makes it that much harder to be strong and stick to your guns.
Your body comes under stress from traditional things we think of as “stressful” - but lack of sound nutrition, and a lack of regular, good quality sleep are both types of chronic stress that can greatly affect your willpower!
Fuel Your Brain With Proper Nutrition So, as weʼve said, willpower is a function of the brain that can be heavily boosted by choosing healthy foods. Nourishing yourself especially during the first two weeks can greatly increase your chance of success.
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Hopefully, if you are trying to get rid of acne, you are already thinking about this (and if you arenʼt, be sure to check out my other ebook Ultimate Secrets to Acne Freedom which goes over diet in detail).
Of particular importance here is that you are eating a low glycemic diet. When performing a complex mental task (believe me, resisting urges is a complex mental task), brain cells use twice as much energy as other organs. Which means that during this two week time period when resisting the urges is really hard, your energy is probably going to be depleted. You might find that youʼre more tired and exhausted than usual.
If you are someone who eats a lot of sugar, refined carbohydrates, drinks alcohol, or is addicted to coffee, you probably go through blood sugar swings throughout the day. You get high and then you crash.
Well, when you crash, your brain is going to be particularly susceptible to giving into urges because you just donʼt have enough energy to resist. This is why you may be more likely to find yourself in a staring / picking session late at night before you go to bed... youʼre tired, and your brain is tired.
By choosing nutritious low glycemic foods during this time (like vegetables, fruits, legumes, meat, whole grains, coconut products, and good fats) and avoiding sugary and processed foods, coffee, and excess alcohol, you are going to better equip yourself for success.
For a list of foods and their glycemic ratings, please visit:
www.glycemicindex.com
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That being said, if you havenʼt already made healthy changes in your diet and donʼt really know how, doing so at this point could have the opposite effect, in that it might cause you more stress, which ainʼt so good for the brain either. So just do the best you can without overwhelming yourself!!
Fuel Your Brain With Proper Rest When you are sleep deprived, your pre-frontal cortex (the part of your brain that is responsible for long term planning) gets hit pretty hard, and it totally loses control over the parts of the brain that create cravings.
So make sure that especially during the first two weeks that you are getting a lot of rest. Even an hour of two of deprivation per night can have a negative impact on your willpower!
However, what “an hour or two” per night means to you will be different than the next person. People need a varying amount of sleep in order to feel normal. The “8 hour per night” rule is kind of a myth. Some people need only six or seven... some people need nine.
And as I said, because resisting urges is such a complex mental task that consumes a lot of energy, you might find that you need even more rest than usual during this time. So donʼt plan too many late nights, and sleep as much as you can. And you might want to plan to start all this at a time when you arenʼt overly busy or stressed (during exam week might not be the best bet).
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What Happens After The First Two Weeks? The rest of your life happens after the first two weeks!
Thatʼs right. The rest of your life is when you make a choice every day to stay healthy and strong and continue to interact in a healthy way with your skin. Making this choice is not going to be nearly as difficult as the first two weeks (as making a healthier choice has become a stronger habit now), but at any time you could make a decision that causes you to trip and fall.
There are things you can do to help you stay on the wagon though and they include the following things.
Accepting your Thoughts and Embracing Uncertainty Remember that your thoughts are not who you are. Your brain comes up with all sorts of ridiculous things all the time, and if youʼre like most people, you have spent your whole life believing your thoughts just because you thought them.
Well, thoughts are not necessarily true just because you thought them, and you also donʼt have to act on them just because you thought them.
However, itʼs hard to stop your thoughts. They just come up. Changing them and trying to get rid of them is too difficult and well, pretty much impossible, so donʼt. Just accept their presence there, note that they may or may not be true, and just let them lie. You
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can choose to act in ways that you know are healthy, instead of ways in which your brain says you should.
You see, there will probably be many times when you wonder whether or not you have a spot on your face, whether someone is looking at it, whether this person likes you, whether you are attractive, and the uncertainty that comes with these questions may try to spur you into taking action (in the form of picking, or looking, or touching, or whatever).
But you can just accept that you are wondering about these things, and then let them go. If you let these thoughts dictate your actions, it will only lead to more compulsive behaviours in the future.
Remember that uncertainty is normal. No one knows all the answers to everything. No one knows what other people really think. Trying to seek certainty on things that we can never be certain about only leads to compulsions as we try to control the uncertainty.
For more on this particular line of thought, please read the article I wrote called:
Do You Want to Be Happy? Stop Trying to Be Happy
Meditate Meditation improves a whole whack of willpower skills that include attention, focus, stress management, impulse control, and self-awareness. It changes the function and the structure of the brain to support self-control. It only takes eight weeks of very brief daily meditation to see these changes, too. Meditation can be simple - you donʼt have to spend years in a monastery in the hills.
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If you donʼt know how to meditate, all you do is sit in a comfortable position, start paying attention to your breathing (really focus on it) and notice your thoughts float by. The goal isnʼt to clear your mind - much as weʼve been saying, itʼs hard or impossible to do that. The goal is to notice the thoughts without getting emotionally wrapped up in them. You can then watch them float in and out of your mind, like clouds across the sky.
Meditation can really help you with the above point (about accepting your thoughts and embracing uncertainty) because it makes you more aware of the things that you are thinking and allows you to get less caught up in them.
Exercise Exercise, much like meditation, also leads to changes in the brain that support self control. Both intense training and slower paced activities like yoga lower your stress levels, which is a great boost to willpower.
With exercise, make sure you choose something you like to do so you will stick to it. For me, I like bike riding, doing yoga, and hiking with my dog and boyfriend. I used to try to run and do strength training routines, but deep down, I thought they were kinda boring so they didnʼt really stick.
If youʼre into yoga, check out My Yoga Online - for ten bucks a month you get unlimited access to hundreds of yoga videos so you donʼt have to leave home to get some stretchinʼ in. And you never get bored because thereʼs so many videos, you can do a new routine every single day. I love it! For me, itʼs worth every penny.
Do Stuff You Don’t Like Doing
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I know... no one likes doing things they donʼt like doing. Thatʼs pretty obvious. But thereʼs always stuff that you HAVE to do that you donʼt especially want to do. Like your taxes. Washing dishes. Taking the garbage out. Going to work. Going to the gym. Writing that paper.
The more proactive you are about doing these things and not putting them off, the more of a workout you are giving your brain, and preparing it to better resist urges in the future. Every time you have to do something you donʼt really want to, thereʼs a little battle going on in your brain. Every time you win the battle quickly, you are building your brain muscles so that you can win battles even better and easier later on.
What Happens If I Fall Off the Wagon? If you fall off the wagon, itʼs okay! Donʼt get upset. Use it as an opportunity.
Relapse is likely going to happen at some time or another. As I said, I still give in and squeeze pimples here and there. But every time you slide back into your compulsive behaviour, use it as a lesson learned. Notice the triggers that set you off and make a mental note to be more vigilant with that trigger in the future.
Something that happens a lot though is that if you have a relapse, you feel totally shit about yourself because of what you just did. So you go “Well, I picked one. Iʼve already failed, so I may as well pick some more.” You use the slip up as an excuse.
Donʼt use it as an excuse. As soon as you catch yourself, stop!
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A relapse is okay. There is no point in getting upset and distressed over it, because the more stressed about it you are, the more you are going to want to act compulsively (and pick or pop or touch more) in order to push that stress away.
Recap On This Whole Thang + Planning Your Path to Success Okay!! Weʼve pretty much covered it all!
Now comes the part where you have to write stuff down. Donʼt skip it, okay?! I mean it. It could mean the difference between success and failure.
The following are 20 questions that I want you to answer by writing them out in either a journal, or some loose paper - something that you can easily go back and reference. These questions also recap everything that you need to do, so that after youʼve written them all out, youʼll have a perfect map of how you are going to to get from where you are now, to where you want to be.
Writing down a plan for success sounds annoying and lame - I know, because Iʼm totally the type of person who buys ebooks, and never actually does the exercises where they tell you to write things down. But you actually get way more of the result you were looking for if you do make the effort.
The reason you really need to do this is because you are going to have times of weakness when your brain is screaming at you, and you canʼt seem to remember where youʼre going or how to get there. You need this to refer to in those crazy moments when everything is spinning out of control. Those times when your brain is saying “Hey you. Just one little squeeze. Just one. You know you want it. Come on baby.” Copyright © 2012 Tracy McCullough
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Your brain is super tricky! It knows you so well and itʼs going to come up with the BEST lines about why you should give in. And youʼre going to be tempted to believe it.
But now that you know that, you can go “NO, BRAIN! NO!” and then go read what you wrote down, and you know you can believe that, because you wrote it when you were of sane mind.
Here they are. Now go forth and writeth:
1.
Define exactly which behaviours you want to eliminate. Is it obsessive staring? Is it squeezing every pore on your face? Write it down at the top of your page.
2.
Write down your motivation for doing this. Why are these compulsions making you upset? Is it because of the way you feel after youʼve picked your skin? You hate the way your skin always looks worse instead of better after youʼve squeezed it? Is it because you know that by touching your skin all the time, you are simply reminding yourself of the acne that youʼd like to forget? Is it because popping and picking your skin is creating more acne? Write down why you want to go through this process and why itʼs worth it.
3.
Define rules for healthy interactions with your skin. What does a healthy interaction with your skin look like to you? So for example you might say: “I will only look in the mirror once per day for no more than a few seconds. I will not squeeze my skin or pop any pimples, unless itʼs an ʻAʼ.” Tailor this to your specific situation and write it down.
4.
Write down how you want to feel in the end once youʼve gone through with this. Write about how you will feel when your skin is more clear, itʼs not ravaged from
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your fingers, or you are able to be more carefree since you arenʼt looking at your skin and touching it all the time.
5.
Write down the challenges you think youʼre going to face during this transition. Be honest about it, but positive that you will overcome them. By accepting and acknowledging the challenges and anxieties that may come along, you wonʼt be surprised and will be able to stay stronger when youʼre faced with them.
6.
What do you feel are some of the limiting beliefs, fears, and anxieties that are behind your skin compulsions? Have a good think about this and write them down. Then go through the limiting beliefs exercises to change and eliminate the beliefs youʼve identified.
7.
Write down some ways in which you are going to work on fostering more self love. Write a list of ten things that you can do for yourself that really make you feel awesome.
8.
Write down the ways in which you will get your anger and emotions out, instead of taking them out on your skin. Will you choose to journal? Exercise? Scream it out while youʼre home alone?
9.
Decide if your habits are mostly conscious or unconscious. Choose if you are going to use Habit Reversal Training (HRT), or Exposure and Response Prevention (ERP).
10.
If your habits are mostly unconscious and you are going to start with HRT, start observing your habits and write down every time you catch yourself doing them. As per the Self Monitoring exercise, write down the place it usually happens, time of day, habits that precede it, what sensations you enjoy, what emotions precede it, which thoughts precede it, and if it usually happens in the presence of
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a certain person, or when youʼre alone?
11.
Write down a few practical ways that you can avoid situations in which you tend to perform the behaviour. Can you avoid the bathroom? A certain person that sets you off?
12.
Write down the techniques you will use to help you stop the behaviour once you have the urge. Can you start journalling as soon as you feel the urge? Can you pick up a jump rope and jump for five minutes?
13.
Write down the techniques you will use to prevent the behaviour. Will you get your nails done, or wear makeup? Will you wear gloves in high risk situations? Will you take down your mirrors?
14.
Write down which competing response will you use to replace the compulsive behaviour. Will you make fists with your hands? Sit on them? “Glue” them to your lap? Flick your finger against your other hand?
15.
If you are doing ERP, expose yourself to the urge, and then donʼt do it. Accept that you have the feeling and that itʼs uncomfortable, but still donʼt do it. Use the techniques you wrote down in questions 12, 13, and 14 to help you to not perform the habit once you have the urge.
16.
Alternatively, you can choose to do modified ERP and gradually build up your tolerance to resisting the urge. This is where you choose to delay the picking/ popping/touching/staring for a predetermined amount of time, after which you are free to go ahead and do it. The amount of time will be increased as you get stronger. If you are going to do modified ERP, choose the amount of time that you will delay giving into your compulsion, and how much time you will increase it by.
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17.
Write down ways you are going to support yourself during this process and the first two weeks (the most challenging part!). Perhaps a nutritious diet, lots of sleep, and spending lots of time out of the house and with friends will make you feel supported.
18.
Write down ways in which you are going to support your long term success so that you never go back to your skin compulsions. Are you going to accept unpleasant feelings and uncertainty more readily knowing that they canʼt hurt you? Will you take up meditation? Exercise? Doing things you donʼt like promptly, like taking out the garbage?
19.
Write down what you are going to do if you fall off the wagon and have a relapse? Are you going to give up and keep picking just because you had an accident? Or are you going to stop as soon as you slip up and take it as an opportunity to learn more about your triggers?
20.
Track your successes. Every time you felt the urge to pick or look at your skin, and decided to do something else instead, thatʼs a success. Write it down. It might seem silly, but as I said, it could be the difference between success and failure. When you can see your successes, it will give you confidence that you really can do this.
Wrap Up So weʼve come to the end of the book, and I hope that you feel more equipped now to deal with these compulsions that have been taking over your life. Remember that no matter how insignificant you feel your problem sounds, if it is causing you stress in any way, than you deserve to have the help you need to get better and live the life that you want!
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Donʼt forget that there are qualified therapists all over the place who can help you if you do feel you need professional help in order to move through this. It might be difficult to get to the true emotional issues behind the behaviour, and a professional can help.
Apparently it can be sometimes difficult to find a therapist who really truly “gets” skin picking though, so if I can recommend someone, I would say to get ahold of the author of ʻSkin Deepʼ, Dr. Grossbart. He is one of the leading experts in this area and he offers counseling sessions over the phone and Skype so that you can speak to him from anywhere and remain relatively anonymous. Again, his website: http://grossbart.com/
Lots of love my darling,
Tracy McCullough www.thelovevitamin.com
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