Monday, June 15, 2009

On Dermatophagia: Part Two, Therapy Edition

Another departure from your regularly scheduled programming, which will resume soon, promise promise.

****

About a month ago, I penned-- erm, computered this post about my ongoing problem with dermatophagia and dermatillomania. If you found this post in a search engine and haven't read that previous entry, please feel free to check it out for a bit of backstory and the like. I mentioned in that post that I was finally feeling as if I wanted to see what could come of therapy, if maybe it would be what I needed to stop my compulsive biting and picking for good.

I didn't know who to ask about treatment at first. I was unwilling to talk to my mother about it until I knew if I was actually going to go through with therapy, and even though I go to a college that's renowned for its psychology department, I wasn't really sure who to ask. I ended up spending a bit of time searching on Google for resources, which led me to the McClean Institute, a Massachusetts psychological in-patient hospital. Of course, I am not interested in being hospitalized over my problem, so from there I simply contacted Diane Davey with a plea for help. I told her about my 12-year-long problem with biting and picking, and that I would like to find someone on the North Shore (where I am) who could help me. She gladly forwarded e-mail addresses of two behavioral specialists and a link to a list of pretty much all of the OCD doctors in MA. Pretty great, huh? Moral of that story: don't be afraid to contact a stranger if you think they might be able to help you. I don't think I would've found the link list she sent me or been as confident contacting another therapist without the reference. It took out a little of the guess work.

From there, I contacted Dr. Ronald Longpre, a Newburyport behavioral specialist who was seemingly conviently located in the exact building that my boyfriend's gastrointerologist is in. I was really comforted by his quick response to my e-mails and the inclusion of an emergency number (his personal cell phone, I believe) for current patients in his voicemail. Making the appointment went off without a hitch, and The Boy agreed to be my chauffeur to therapy (and to take me out for ice cream afterwards-- SCORE).

About an hour before the appointment, Luke (the boy) dragged me kicking and screaming to the car so that we could head off on our adventure. The idea of having to talk to a complete stranger about a problem I've tried to keep very hush-hush over the years didn't really set in until we were in the car. My stomach was doing backflips, and it was the closest to tears and/or vomiting I would be all day. Luke assured me that my first visit would probably be pretty easy, pretty light on the emotional stuff and more about my problem in and of itself. I would not hear of it, and continued to panic and wonder if I was capable of living through a jump from a moving car.

A soon as we got to the office building we thought Dr. Longpre was located in, we hit a snag. His name wasn't on any of the lists of offices within the building, so we explored. We even explored the only suite that contained a counseling service. There was no one in the suite. It was really sketchy. We then stopped into Luke's doctor's office to ask them about Dr. Longpre, but the secretaries gave us dumbfounded looks and went back to their phone calls. Great. At this point, I didn't mind, as this whole caper was taking my focus off what I had been so sure was impending doom. We located a phone book and found that the address I had for the doctor was actually an old address.

"Did you ask Dr. Longpre for his address?" Luke asked.

"Ummm... well, I looked it up online."

"But you didn't ask him to confirm it?"

"Um..."

"Honey."

"I'M SORRY!"

"Never believe the internet."

"I won't do it again I promise I'msorryIloveyoudon'tkillme!"

Moral of that story: never believe the internet. Don't be dumb like me.

Fortunately, even though we were nearly running late at this point, the actual, real, for-serious office was right down the street. We sat down in a nice little waiting room with tons of magazines and filled out some forms. Luke picked up a car magazine (he forgot to bring his DS). The doctor took me right away.

This is the part of the entry that you're probably interested in. What is the first visit to the therapist like? Well, it was surprisingly low-stress. I picked at my hands the whole time I was in the comfiest chair ever, but the questions were pretty unemotional. Dr. Longpre asked about simple things, like where I grew up, who I live with, any history of psychological treatment, etc. I talked to him about my recent paranoia about death (I kind've tend to think that if I think about horrible things that could happen, they won't happen, because they can't if I'm expecting it), though I don't know if he'll find that significant. We discussed how I feel while I bite or pick, how I feel before, how I feel after. Mostly, he seemed interested in taking stock of what the behavior actually is for me and how I feel that it operates. He asked details for any time I'd attempted to stop and how often I do the behavior (daily, almost constantly). The man seemed nice. He looked at me when I was speaking. He was wearing Converse high-tops even though he was somewhere around 50. I had to show him my fingers. We discussed why I wanted to come to him for treatment.

Then, he gave homework.

For the next two weeks (when my next appointment is), I am being asked to fill out notecards throughout the day. Every time I bite, I jot down a "B," and every time I pick, a "P" gets written down. The times I think about doing it but don't or go to do it and resist do not get written down. The good doctor says this will be helpful in quantifying how much I actually do the behaviors and will help show if any of the treatment is helping. Also, since I am sometimes unaware that I'm biting or picking, it will help me become more aware of it.

At the very end of the appointment, we discussed what we'll do in two weeks: relaxation techniques and perhaps the beginning of actual "habit removal therapy." I'll report on that, too, when the time comes so that anyone who wishes to follow this process can see what that's like. I think that part will be a little more interesting, but I figured a lot of people would want to know what they could possibly expect on a first visit anyway.

I'm unsure of how many big ones therapy is going to run me. I'm getting billed at a later date. Oh boy.

So, IN CONCLUSION (yes, AP English teachers, I just said that) this visit wasn't too stressful. I got ice cream afterwards. That was the best part. Luke, are you reading this? I am now expecting ice cream every time we go to the therapist, kthanks. Seriously, the coffee oreo was great. The little ice cream place near his house gives HUGE portions, but most importantly, they put sprinkles on top of the ice cream and at the bottom of the cup. Brilliant.

****

When I first started looking for resources about my condition(s), I felt lost. I couldn't really find much of the information I was looking for. I'm hoping that writing about this process will be a positive addition to what little is out there about dermatophagia and/or dermatotillomania. Additionally, if anyone reading this would like to contact me about dermatophagia/dermatotillomania/therapy/whatever it may be, don't be shy. You can get me at vformato@clarku.edu.

14 comments:

Anonymous said...

Hi, I have been searching for helpfull things on thie "world Wide Web" on this problem I have. Not only is it a problem but it consumes my every waking hour. I cant stop my self from picking up my hand and chewing the sides of my fingers. It is scary too due to the fact that I have a child and she sees me doing this and I just know that this is the one thing that I do not want my sweetie picking up from me. My mother always tells me oh you have been doing this since you were knee high. But, I am 26 now and I cant stop. So I am curiouse to how the thearapy turned out. What else did you do. Have you possibly stoped and what eases your urge. I sometimes dont even know I do it. Weird. Your article was great and I am truly thankful I came across it. So if you have any pointers or helpful hints on what to do or if there is hope in this nasty habbit. Please let me know. Thanks again.

Anonymous said...

I'm so glad to have found this little pair of articles. I can't wait to see the next bit, to see how the therapy actually works. I've suffered this for as long as I can remember, and although I've come across people who pick/bite as well, I've never met anyone who has it as bad as I do. So its comforting knowing I'm not the only one who suffers it so severely. If I had health insurance I'd contact a doctor ASAP, but as I don't, I'll just have to keep reading these entries and hope that maybe I can glean some wisdom that will help me conquer it on my own.

Anonymous said...

I was reading your article and I felt like we had all the same experiences. I too couldn't sleep sitting in front of my labtop and finally said to myself, "just look it up on the internet." I have actually been wanting to do it for years but I have been afraid to do it for some reason. I share the same fears of shaking peoples hands and handing papers to people. When I start relationships with girls I don't hold there hand and I won't let them look at my hands which as you know is hard to do and I don't give a reason I just change the subject or say something to make them laugh so they forget. You even knew when I got to the part of the article I wanted to hear. The one thing you didn't mention that I know you deal with is going to the pool and how fast your hands prune. Its so easy for people to notice and its when they look the worse. You commented on how little is out there and how lost you felt when looking for information. I have had this behavior for ever since I can remember.I know exactly what it feels like to have my mom tell me to stop and immediately put my fingers back in my mouth. I guess I just wanted to thank you for writing that and to ask that you continue to write about your experiences (especially treatment, tips for disguising the look and feel of your skin, anything and everything).

Anonymous said...

I am 50 years old and have had this afflication my entire life. As a child I used to bite and rip my nails off the nail bed. I would lay in bed at night and my fingers would just throb. I would put them in my mouth to wet them and blow on them to ease the pain. My mother used to punish me for biting my nails which included painting my raw nails with a pepper liquid (that burned terribly yet never stopped me) to not letting me wear shorts for an entire summer. When I was 14 I stopped biting my nails but then starting picking my cuticles. I rip them down the sides to the point they bleed and scab. And as soon as they start to heal I get at them again. I, too, have wondered if this is a form of self-abuse like cutting. And to make matters worse, I now pick at scabs, my scalp and bumps on my skin which then becomes scabs and so the cycle continues. I am on anti-depressants and will see my psychiatrist regarding possibly changing my medication. Although I have done therapy in the past, I think I need to see an OCD specialist for this behavior as well as my many other compulsions. Thank you for your courage and honesty in sharing your story. This is so shameful an afflication for us all. Much luck in your recovery.

Anonymous said...

Re Dermatophagia. Remember exactly when I started picking my hangnails/nails. Sitting in grade 9 music class. I am now, that's right, 50 years old and still picking. This past year its gotten a lot worse. Not sure why. I'm on Effexor and Seroquel (not for the nail picking but for depression/anxiety) and those drugs don't even come close to alleviating my picking....sigh...

Anonymous said...

hey thankyou so much for this post
I am 17 and have picked and chewed the skin around my nails for as long as I can remember. I had never thought anything of it and never realised I was doing it . I don't think mine is a bad case but it still gets to me, my fingers are horrible and I hate the way people look at them :(

Anonymous said...

I read both parts of the entry, and throughout it I was gaping.
Not only did my skin-biting begin when I was younger, but I also have that EXACT same philosophy - that if I think about horrible things that could happen, they won't happen, or at least I'll be prepared for them if they do.
Of course, the parents just keep telling me not to 'chew', and it was only recently that I realised what I was doing actually had a NAME.
I've been skin biting ever since I can remember, and I never thought of it more than a habit.
My fingers are very sensitive and quite hideous because of it, and even though I've drawn blood several times I still continue to do it without thinking. It's very frustrating as dermatophagia isn't really recognized and people don't take it seriously.
I didn't think seeing a therapist would actually help...but now I feel more motivated to do it, thanks to your blog post.
Thank you for posting your experience.

Anonymous said...

Its amazing i also was bored playing on my laptop chewing myself to shreds and decided to look it up. I truly thought I was alone with this problem. I believe I have a pretty bad case. I chew my skin from around my fingernails all the way down my fingers, as far as i can actually. My pointer fingers are the worst. I have pulled skin all the way down to my lower knuckle. They will begin to bleed but that doent slow me down. Just like some of you said, I don't know why I do it and most of the time I dont realize it. I am in constant pain. There are many mornings I wake up and can barely bend my fingers because I have chewed them so much in bed the night before. When I was younger my parents would yell at me all the time and i would just wait for them to leave the room and start again. I tried the wearing gloves, putting pepper sauce(which burns like hell and tastes horrible) but still i would continue. I am 26 and my little girl is 4, even SHE yells at me on a regular basis! She always says, "Mommy, stop eating yourself!" Now thats rough to hear from a little girl, but i keep on. I unfortunately do not have medical insurance so therapy is out of the question right now. I am just so glad to hear that i am not alone and wow it feels good to get this out! Thankyou

Anonymous said...

haha well i think I was doing the same as everyone else on here. I was sitting on my laptop being bored and chewing and decided to look and see if my 'problem' had a term. I'm glad to see that i'm not the only one.. I've completely ruined my finger pads.I've done this since I can remember, but i stopped for a long time.. i started up again about 2 years ago because of stredd-i think. it's embarassing! The worst is when i get out of the shower and I can see how disfigured I made my fingers. Also, when I go swimming with friends and I am constantly trying to avoid them seeing my hands.Related to this I also am a compulsive picker I realized. I pick every bump on my body and it's starting to get out of control. I don't realize when i do that either and now i'm starting to scar! Anyways, I'm glad I found your post. It's been great learning there are more people who have the same peoblem I do.

Anonymous said...

I go through stages where i pick and bite the skin round my fingernails. I'm in one of those stages right now and decided to look it up as well. As a kid i always bit my nails and the skin. I am almost 40 and stopped biting my nales years ago. i occasionally do the nail bite but it's very controlled and i stop when its short enough. but the skin biting and picking hasnt stopped. I was even doing it while reading the blog - and typing this!! I have noticed it's always the same fingers. My problem is probably not as bad as others here. but looking at my fingers right now, the 4th fingers both hands both sides, pinkies one just healed one just attacked (this morning), middle fingers almost perfect, and thumbs almost perfect. My friend from school has always had perfect fingers up to this day and now his son (5yo) is doing it and my friend always tells him to stop. Nagging at someone is not going to stop them from doing this. I know. I didnt. and my cousin who has always been very bad (or is it good!) as he has never stopped either.
It's just weird, as i am typing this, i dont want to do it but i find myself just feeling the loose skin on one of the spots, and then i catch myself trying to bite that bit of skin off with my teeth. One way i find of stopping sometimes is to cut off the bit of skin so that its smooth and there is nothing to pick or rub. Also strange, is sometimes the skin seems to heal overnight.
See, just caught myself biting at my finger as i wrote the last sentence.
Anyway, thanks for writing this. All the best to everyone here.

Anonymous said...

Hey everyone. I recently started a new site called www.dermatophagia.org, it's an online support group for Dermatophagia sufferers. I just started it so I'm hoping people join and have discussions on there.
If you have an questions email me at admin@dermatophagia.org. Thanks!

Anonymous said...

I've been biting my nails ever since I could chew., I think I have dermatophagia but i'm not 100% sure. I bite my nails and the skin around it but only go as far as the nail to the first line on a finger. I mean I don't know why. Like you said in the first part it's just a habit. But I truly do want to stop. If you have any suggestions that would help. I've been biting my nails ever since I could chew.

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