Understanding Body-Focused Repetitive Behaviors (BFRBs) with Roberto Olivardia, Ph.D. 

Starts at 4:46 for those who need timestamp.

I'm 52 and was diagnosed with ADHD 4 months ago. Watching this is the first time I've found out that my trichotillomania (which I've had since I was 6), and the fact that I sucked my thumb until I was 11 are probably all related. How many more surprises should I expect? 😄

Dr Olivardia, I really hope you read this, because you would love it! 52:43 You describe the weird habit your son inherited from you. How strong is that genetic component?! I must tell you of something equally weird! I knew a man who was phobic about buttons. He couldn't touch them or look at them. His clothes needed to be converted with zips or velcro before he could wear them. On one occasion, he had a one night stand with a woman he hardly even spoke to.... and he never saw her again. About three years later, someone made him aware he had a son by her. He wanted to play a part in the boy's life. Reluctantly, the mother allowed a first meeting between them. Before they met she said, "I have to warn you. All his clothes have zips or velcro. Please don't let him see any buttons, he has an extreme phobia of them." Needless to say, we were absolutely stunned!

I've always had BFRBs but I always dismissed them because tf can be done. For me there can be months where there's nothing, but when I start, it goes on and on and on, becoming engrained enough in my lifestyle I don't even question it. From obsessive hair correcting, to neck twisting and ankle twisting for years. After dental work however, it turned to mouth damage, such as licking (until ulcers develop), grinding retainers, chewing cheeks to now tongue biting, where it gets so bad i shove my hands down and try to go at it myself, causing bleeding, salivation and triggering of gag reflex. The most embarrassing one so far is my voice, where i feel the need to hit and maintain a certain pitch (super high or super low), and it can go on all day, grumbling or squealing, often hurting my voice and being hard to hide in public. I have joked about it to my friends, talkin bout how my tongue is fked. My family and friends have very much noticed these over the years with remarks here and there, situations that I can't explain, but I don't think I have any disorder, I'm pretty normal, however this is an underlying thing that I can't feel seriously towards when talking about it to people, but when it happens the pain and rhythm needed for my satisfaction is exhausting

Thank you so much! Dr Olivardia describes the variants, subtleties and development of these conditions with such detail and clarity. Now I realise I have dermatillomania, which I would never have suspected before. And I never linked my son's trichotillomania with his (severe) ADHD until today. This channel is a whole education in itself!

Thank you for bringing awareness to these all-too-common, but rarely discussed conditions!

I didn't realize I've done all of these. I would have said these weren't going to apply to me. But his descriptions exposed the subtle ways I do them.

Thanks for relieving my self-doubt! When my 8-year old was diagnosed with trichotillomania, I agonised over the specialist's sympathetic advice: "Don't ever stop him pulling his hair out, the stress has to come out somewhere". What I ACTUALLY did was very close to your description - "uncritical distraction/diversion retraining" is how I thought of it. Why? Because I pictured my son at 14 being mercilessly bullied over the bald patches on his head. With his Rejection Sensitive Dysphoria, which I recognised but could not name, I could see him going under and becoming self-destructive. It was fairly easy to help him change a habit which at that early stage was not very ingrained. He did express his stress in various ways throughout school, but never became a target. I always knew I was right for MY son, but it worried me that I went against medical opinion. No longer. 👍

I’ve had this since 11, it’s evolved from picking acne to picking scabs, lesions, dry skin, scalp, and even lip and cheek biting. To this day my parents believe that they can eventually shame me out of it. They routinely tell me “that’s disgusting!” “No one else does that” “if you had any willpower or any sense in that brain of yours you wouldn’t do it”. If I tell them it’s a disorder, they deny it saying it’s personal choice. I think they believe that as long as they don’t classify it as a disorder, it will be easier to correct by “just stop”ing. Despite the fact that that has never worked for over 10 years.

This is so so helpful - thank you for sharing this online here.

Incredibly helpful presentation, thank you!

Very well articulated and informative! Appreciate much for this presentation

Thank you I don't feel so alone.

I had an aunt who I had not seen in a while and saw her around the holidays when I was 11. I started getting mild acne at that age. I hugged my aunt when I saw her, and the next day, she singled me out in front of my entire extended family, including cousins, and said: "See--you gave a pimple yesterday when you hugged me." I was so embarrassed, I wanted to crawl in a hole and die. So I became acutely aware of my acne. Fast forward to high school, and I had a friend who had acne bad, and she had these horrible green and yellow puss filled acne all over her face. People talked a lot of crap about how gross she was behind her back. So I got messages that gross pimples/acne were "disgusting." So I started trying to get them off my face as fast as I could and make sure they were not green or yellow like "puss-y Chrissy's" acne. I guess this fear combined with my ADHD and I picked at my face a lot because of social pressure. How do unconscious things like teeth grinding in sleep relate to this??? I have always ground my teeth really bad in my sleep or bite my cheek in sleep to the point of bleeding, and not even be aware of it.

44:09 hair straightening/stroking

I have ADHD and OCD. I've had doctors from psychiatrists and therapists who tried to convince me that rubbing/ dragging my nail/ picking at the dry skin on my fingers when i had to sit still and listen was my OCD. It's a completely different thing.

Oh my gosh! Nail biting is me! I am now 72 and started biting my nails since I was 5. I cannot believe this. I can’t help it. I drive my husband crazy. I bite my nails to the point they are so painful and bleed. I was diagnosed with PTSD WITH ADHD. 😮😢

My dentist: "What's all this scar tissue on your cheeks?" Me: "I bite them." Dentist: "You shouldn't do that." Yep, I do it cause I can control it. I want my cheeks to look like Swiss cheese. I'm unique, and no one else does this. How tf did you become a dentist?

Could these behaviours not also be related to stimming behaviours in people with ADHD and comorbid ASD?

I also stim through "tics". They are not completely involuntary, I just HAVE to squeeze the muscles in my neck or arms or stomach etc Or it's blinking

This one was great! I still had to FF through the intro because the hostess smacks her mouth (PLEASE address that!), but the keynote speaker was gold!

Is this the same as Stimming?

We know what it looks like get on with why they do it

1) Has he been watching me?😮 2) Anyone else’s significant other a victim of their dermatillomania? 😂🫣😔