How does Exposure Response Prevention (ERP) Treatment Work for Skin-Picking?
Exposure and Response Prevention (ERP) is a cognitive-behavioral therapy technique commonly used to treat various anxiety disorders, including skin picking disorder (also known as excoriation disorder).
ERP for skin picking involves exposing oneself to the urge to pick the skin and preventing the subsequent picking response.
Here's how it typically works:
Understanding Triggers:
The therapist and individual work together to identify the triggers that lead to skin picking episodes. Triggers can include certain emotions (e.g., stress, boredom), environmental cues (e.g., presence of mirrors), or bodily sensations (e.g., itchiness, rough skin).
Creating a Hierarchy:
A hierarchy of skin-picking situations or triggers is developed, starting with those that evoke less anxiety and progressing to more challenging situations. This hierarchy helps to systematically approach the exposure process.
Exposure Exercises:
The individual intentionally exposes themselves to the trigger or situation that typically leads to skin picking, but they refrain from engaging in the picking behavior. This exposure can be imagined (in vivo) or through visual aids (imaginal exposure). For example, they might intentionally sit near a mirror without picking or visualize themselves refraining from picking when the urge arises.
Preventing the Response:
During the exposure exercises, the individual actively resists the urge to engage in skin picking. They are encouraged to tolerate the discomfort and anxiety that arises from not engaging in the picking behavior. This response prevention is essential to break the cycle of the urge-response-reinforcement pattern.
Habituation and Reduction of Anxiety:
With repeated exposures and response prevention, the individual gradually experiences a reduction in anxiety and discomfort associated with the urge to pick. The goal is for the anxiety response to habituate over time, leading to a decreased urge to engage in skin picking.
Skills Training:
Throughout the therapy process, the individual learns and practices alternative coping skills to manage the underlying emotions, sensations, or triggers that contribute to skin picking. These skills may include relaxation techniques, stress management strategies, and healthy ways to address skin-related concerns.
Maintenance and Relapse Prevention:
Once progress is made, the individual continues to practice the skills learned in therapy and applies them to real-life situations. The goal is to maintain the gains achieved and prevent relapse by integrating the new coping strategies into their daily life.
It's important to note that ERP for skin picking disorder is typically conducted under the guidance of a trained mental health professional, such as a therapist or psychologist.
At Kairos Wellness Collective, we can tailor the treatment approach to your specific needs, provide support, and monitor progress throughout the therapy process. Please contact Kairos Wellness Collective to learn more.
