Body-Focused Repetitive Behaviors (BFRBs) or Trichotillomania, Excoriation Disorder:

Dr. Dawn Dugan has had over 5- years of experience helping people who have BFRBs. I was trained at the TLC Foundation ( and have completed a certification in the treatment of hair pulling (trichotillomania) and skin picking (excoriation). I know that many people who have struggled with this have been embarrassed to come forward to seek help. You should know that you are not alone and many people struggle with it. There are many reasons why people engage in this behavior and that is why it is important to work with someone who understands how important not only assessment is but to understand how to tailor the interventions to fit the underlying causes. Please reach out, I am here to support you and to help reduce pulling and picking.

How is it treated?

I use a behaviorally based approach based on the ComB model. What is the Comb model? It is understanding what happens before you have the urge to pick or pull. For example, I got into a fight with my friend, I felt overwhelmed and I picked my skin to regulate my emotions. Another example might be that I am sitting in front of the computer and am bored. I am pulling my hair to pay attention. Each of these would have different methods to break the cycle. I have also incorporated DBT skills and ACT as an adjunct to the ComB model.

Resources for BFRBs:

TLC Foundation for Body-Focused Repetitive Disorders

Association of Behavioral and Cognitive Therapies