While we may not be fully aware when we are pulling and picking, these sorts of unconscious behaviors can be an indicator of dysregulation. Outside factors such as our environment, upbringing, and various traumas can all play a role in these self-soothing behaviors. Stacy Nakell has been an active researcher and pioneer in this field, and has dedicated years to understanding and educating others on how to abandon shame and treat these behaviors. By blending attachment theory and neurobiological research, Nakell has helped rewire the ways in which we navigate these behaviors and brought forward new perspectives like viewing BFRBDs on a continuum and how these overlap with body dysmorphic disorders.

Stacy Nakell’s book Treatment for Body-Focused Repetitive Behaviors is the first to establish the theory and practice of a psychodynamic approach to treating body-focused repetitive behavior disorders. Follow along as Sue and Stacy discuss the misconceptions, treatments, and science to better manage these behavioral patterns.

Stacy Nakell wants to help us talk about these shame-filled experiences

2:02 – Introduction to trichotillomania

7:26 – When these behaviors are considered a “disorder”

9:36 – The role of shame in repetitive behavioral patterns

11:56 – Are BFRBD’s considered self-harm?

13:33 – The overlap with body dysmorphic disorders

17:36 – Correlation between grooming and BFRBDs

21:08 – Perfectionism’s influence on BFRBDS

22:54 – The role of aggression in BFRBDs

31:14 – Metaphor of the stress cup

41:28 – Analysis of “psychic skin”

Click here to purchase Treatment for Body-Focused Repetitive Behaviors

Stacy Nakell’s Website

Stacy Nakell’s Blog

Pop Culture Storyline Reference

The TLC Foundation

Zoobiguity – Barbara Natterson-Horowitz

About Stacy Nakell 

Stacy Nakell is a psychotherapist in private practice in Austin, TX. For the past 20 years, she has worked with people who struggle with body-focused repetitive behaviors. Nakell is a Certified Group Psychotherapist and provides workshops and institutes locally with the Austin Group Psychotherapy Society and nationally with the American Group Psychotherapy Association.

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