Dermatillomania/ OCD

[Guest guest]

I was wondering if someone knows of resources for Dermatillomania (skin picking) or OCD? I'm looking for reading material, resources, literature, overall information to share with a client. 

Also, has anyone worked with this population? If so, would you be able to share your experiences and perhaps helpful therapeutic interventions. (Exposure therapy has been working minimally) 

Best wishes,

Liza Mordkovich-Kotlyar MA, ATR, LCAT, MSW Candidate Licensed Art Therapist and Psychotherapist 

[Guest guest]

Many years ago (1973-75), I taught nursery school in a mixed population school. I had one student, , cute as a button, who was obsessed with water, especially washing her hands. None of the teachers could figure out what to do with her. I did a home visit, where I watched her interact with her family (molto dysfunctional) and observed that she went to water when overwhelmed by noise, chaos, and the extremely strained, with a venemous undertone, relationship of her parents.

At school, I began to use going to the sink as a reward for doing what was required of a 3 year old in a school setting: playing with school mates, finishing a picture, identifying colors and objects, putting her toys away. Over time, we were able to have her focus more on healthy activities, lessening the time at the sink. I also worked with the family (2 older siblings and her mother. Her father refused to participate) to develop a similar structure for at home.

I ran into her mother a few years after had been my student and I was shocked. Her mother had left her husband, lost over 100 lbs., and she reported that no longer needed to be at the sink.

Presently, I have a patient with dementia who has Dermatillomania. He picks his scalp incessantly, gouging holes into it. Medication has proven unsuccessful, as he developed every known side effect. However, he rarely picks when occupied, especially when eating. Most of his picking takes place when he is alone in his room, or even asleep. In working with him, I always have a stack of magazines for him to flip through, and simple projects for him to do - sorting and filing activities. It's not "curing" the disorder, but at least he's having some successful time where he is not harming himself.

Hope this helps.

Margie Ann Stanko

Recreation Therapist

specializing in writing, movement & fabric arts workshops

"The body is a clear place" -- k Hawkins, American Dance Pioneer

"The soul is characterized by these capacities: self-nutrition,

sensation, thinking, and movement." - Aristotle

"The body is a soul space." - Margie Ann Stanko

[Guest guest]

I see many clients with skin picking as there is much overlap with body image, eating disorders and other OCD diagnosis. CBT, now mindfulness based MCBT and SSRI's have been the standard course of treatment as well as exposure therapy. Recently I have been using Internal Family Systems (IFS) in addition to these methods. By speaking directly to the part of the patient that is trying to protect her by doing the OCD behaviors and by finding out what this part of her/him is afraid of, the deeper fears can be addressed to help them to self-soothe.

This book gives a good overview in generalhttp://www.amazon.com/Trichotillomania-Picking-Body-Focused-Repetitive-Behaviors/dp/1585623989/ref=sr_1_5?ie=UTF8 & qid=1337260187 & sr=8-5

About IFS and books http://www.selfleadership.org/outline-of-the-Internal-family-systems-model.html

Hope that is useful.best,Adrienne

 

I was wondering if someone knows of resources for Dermatillomania (skin picking) or OCD? I'm looking for reading material, resources, literature, overall information to share with a client. 

Also, has anyone worked with this population? If so, would you be able to share your experiences and perhaps helpful therapeutic interventions. (Exposure therapy has been working minimally) 

Best wishes,

Liza Mordkovich-Kotlyar MA, ATR, LCAT, MSW Candidate Licensed Art Therapist and Psychotherapist 

[Guest guest]

One more idea:There can also be a repetitive movement component to look for as a way of self soothing, so exploring what happens on a body/movement level can be effective as well.best

Adrienne

 

I was wondering if someone knows of resources for Dermatillomania (skin picking) or OCD? I'm looking for reading material, resources, literature, overall information to share with a client. 

Also, has anyone worked with this population? If so, would you be able to share your experiences and perhaps helpful therapeutic interventions. (Exposure therapy has been working minimally) 

Best wishes,

Liza Mordkovich-Kotlyar MA, ATR, LCAT, MSW Candidate Licensed Art Therapist and Psychotherapist