Body-Focused Repetitive Behaviours
Have you heard of body-focused repetitive behaviours? They’re more common than you think (approximately 1 in 20 people). That being said, sometimes they’re dismissed as ‘bad habits’ or hidden as a result of stigma. While some people do engage in similar behaviours as a bad habit, such as biting fingernails, these behaviours become a disorder when they begin to cause damage to a person’s body. Here we are going to discuss the potential use of cannabis for managing body-focused repetitive behaviours.
Description of Body-Focused Repetitive Behaviours
Body-Focused Repetitive Behaviours, or BFRBs, are a cluster of habitual behaviours that include;
- hair pulling (trichotillomania)
- hair eating (trichophagia)
- skin picking (excoriation)
- nail-biting (onychophagia)
- lip or cheek biting.
Currently, the most recent edition of the clinician’s diagnostic manual (DSM-5), lists both hair pulling and skin picking as BFRBs that are of clinical concern. They’re currently listed in the DSM-5 under “other specified obsessive-compulsive and related disorders.”
Often, these types of behaviours are a result of a person’s need to self-soothe. Therefore, they can be a result of stress or associated with other disorders (such as OCD) and often they occur without the persons’ conscious awareness.
These behaviours are not classified as self-harm even though they can do damage to a person’s body because inflicting pain is not the intent of the behaviours.
How to know if body-focused repetitive behaviours are a habit or a disorder?
Here are some signs of these behaviours being disordered;
- frequently and repeatedly gnaw on and eat your skin, usually on your hands
- have red, raw skin in the affected area
- bleed in the affected area
- have skin damage, such as scarring, calluses, or discoloration
- are significantly distressed by the behaviour or it interferes with your daily life
Treatment typically focuses on therapy such as cognitive behaviour therapy that focuses on adjusting behavioural responses. This also sometimes includes habit reversal training which focuses on bringing awareness to the behaviours, competing response training, as well as social support. In some cases, professionals suggest replacement behaviours to minimize the physical impact, such as chewing gum instead of biting the skin.
Therapy is sometimes accompanied by medication. The medications prescribed are typically similar medications for depression and anxiety, such as SSRIs.
Cannabis and Body-Focused Repetitive Behaviours
A 2011 study on 14 subjects treated with dronabinol (dose ranging from 2.5-15 mg/day) found that it reduced hair pulling behaviours without negatively impacting cognition. A 2010 study on mice found that CBD reduced non-body-focused repetitive behaviours (burying marbles) when treated daily. They found that CBD was more effective in managing these symptoms than traditional medications that showed decreased efficiency over time.
Although the research focused specifically on BFRBs is minimal many people are using cannabis to manage their symptoms. We can look at studies focused on anxiety, obsessive-compulsive disorder, and even stress management to more fully understand why cannabis may help to manage symptoms.
Using Cannabis to Manage BFRBs
It’s important to note that for some, THC can increase anxiety at particular doses. Therefore, those who experience body-focused repetitive behaviours as a result of anxiety can see an increase in symptoms at higher doses. Because of this, we recommend starting with CBD alone, such as CBD capsules or CBD tinctures.
If you’re new to CBD, learn more about calculating the best dose.
If you aren’t seeing the results you’d hoped for, consider slowly adding THC into your routine. Since CBD and THC bind to different receptors, they can work together for additional benefits. A 3:1 CBD/THC tincture is a great place to start.
Cannabis, particularly CBD, has the potential to help manage symptoms associated with BFRBs. That being said, cannabis should not replace traditional treatments such as therapy that help to manage the impulses and the underlying causes of the behaviours.
If you’ve used cannabis to help manage BFRBs we want to hear from you! Let us know how cannabis has worked for you in the comments, or share your story with us on social media.