Comprehensive Behavioral Treatment for Body Focused Repetitive Behaviors (ComB)

ComB is used to treat Body Focused Repetitive Behaviors including diagnoses such as hair pulling, skin picking, and nail biting.

Body Focused Repetitive Behaviors include diagnoses such as trichotillomania (hair pulling), excoriation (skin picking), and biting nails. The ComB model of treatment focuses on the underlying reasons why an individual may be engaging in their body focused repetitive behavior using the acronym S.C.A.M.P. The S stands for sensory which is all about the sensations involved with the behavior, for example someone engaging in hair pulling may like the particular textures of certain hairs, or someone skin picking may find satisfaction with certain sensations they experience while picking. The C stands for cognitive which is all about the thoughts experienced before, during and after picking. Some examples include thoughts about how the behavior will provide relief, thoughts that they've already started so they might as well keep going instead of stopping, and self critical thoughts. A is for affective which is just a fancier word for emotions. For many individuals engaging in the body focused repetitive behavior is triggered by certain emotions such as stress, boredom, anxiety and often while engaging in the behavior and immediately after there is a sense of relief which may be later on followed by shame depending on the messaging the individual has received about their behavior. M stands for motor which is all about what was going on in the moment which often speaks to patterns for example many students find homework can be a time where they are engaging in the behavior because of this habit that has formed while doing homework of one hand engaging in the behavior while the other one works, others find watching TV in their designated position or being in the car with their position being a certain way to be locations it happens habitually. P stands for place and just like it sounds is all about the location in which the person engages in the behavior's the most frequently. The beginning stages of therapy are all about finding out what each of these letters are for the individual and from their interventions are used to address the underlying triggers and needs. For many individuals working on self compassion is also an important aspect of therapy. If you are in Utah or Idaho, I would love to help you work through your body focused repetitive behavior, please reach out for a free consultation today!