We sponsor a support group for adults with Body-Focused Repetitive Behaviors (trichotillomania, dermatilomania, etc). There is no charge to attend. We will meet on Tuesday, May 30, 2017 at 3443 Camino del Rio South, 1st floor Conference Room, San Diego, CA 92108.

Our May 30 meeting is open to members and “Friends and Family” – you are welcome to attend with your partner, spouse, parent, sibling, best friend….anyone who would like to understand BFRBs better.

RSVP required – email if you would like to attend, or have questions.

Sponsored by Fletcher Therapy, San Diego. Led by licensed psychotherapist Tammy Fletcher, PhD, LMFT.


What are Body Focused Repetitive Behaviors (BFRBs)?

Chronic skin picking (also called Excoriation and Dermatillomania) and chronic hair pulling (also called Trichotillomania) are two examples of disorders that cause the person to compulsively inflict physical damage to themselves, often through grooming-like behavior. Other behaviors include nail biting, thumb sucking, cheek biting, nose picking, and more. The person may be relieving anxiety, may be bored or tired, may have family members who pull or pick – there is no single reason people develop a BFRB. Similarly, there is no one single treatment that can erase this behavior. It is vital when choosing a therapist for help with a BFRB, that the therapist have training and experience in this area.

Body Focused Repetitive Behaviors, or BFRBs, are a group of behaviors in which an individual compulsively causes damage to his or her own body. This may be through chronic skin picking, hair pulling, cheek biting, nail or cuticle picking/biting, or other similar actions. BFRBs are generally considered to be Impulse Control Disorders. In other words, the problem is chronic, the person has tried to stop or reduce the behavior without success, there is no other medical cause for the behavior, and it has caused significant distress for the person. BFRBs affect family and friends, as well, who often feel confused and helpless. There is help available for conditions like dermatillomania and trichotillomania. It can be difficult to find a mental health practitioner who understands how to treat BFRBs, and the condition doesn’t always respond to traditional “talk therapy.”

How does the therapist treat Body-Focused Repetitive Behaviors?

At Fletcher Therapy, you can expect an individualized approach to your assessment and treatment. Marriage and Family Therapist Tammy Fletcher has a special interest in working with Body-Focused Repetitive Behaviors. She practices Integrative Psychotherapy, which takes a holistic view of the client as a whole person. Dr. Fletcher not only assesses and treats the chronic behavior, she takes into account diet, activity level, the client’s support system, their level of stress, and utilizes a 360 Degree approach in tackling problems like trichotillomania or dermatillomania. You will learn tried and true tools for changing unwanted behaviors, but you will also look at factors like exercise, stress, sleep, and nutrition. Treating the habit only with behavioral therapy is not enough. Chances for success increase greatly when therapy addresses the person from a holistic standpoint.

Along with Habit Reversal Training (HRT), Acceptance and Commitment Therapy (ACT), Exposure and Response Prevention, and where needed, family therapy, Dr. Fletcher offers an understanding and supportive space to reduce and eliminate these behaviors. Monthly support groups, up-to-date information on the treatment of BFRBs, and staying up to date in the field of BFRB research are a few of the ways we help people who want to stop pulling or picking.

We sponsor a quarterly Support Group in San Diego for adults with BFRBs –
please bookmark this page for dates and information, or follow us at bfrbsupport on Facebook.
We meet at 3443 Camino del Rio South, San Diego, CA, 92108, in the Conference Room. There is no charge to attend. We typically meet on the last Tuesday evening of every month at 7:00pm. Our next meeting is on Tuesday, May 30, 2017.
Please bookmark this page or follow us at

On her YouTube channel, Dr. Fletcher has produced numerous videos on BFRBs. Below are some of her videos, and she is currently working to develop educational materials for parents and family members.

If you would like to make an appointment with Dr. Tammy Fletcher, LMFT, give her a call at (619) 252-9811, send an email to, or click here to make an appointment.

Helpful Links is the newest project of Fletcher Therapy.

Trichotillomania Learning Center – the place for comprehensive information on any Body-Focused Repetitive Behavior, news, research, events, support groups, trained therapists, and conferences.

Angela Hartlin is the author of Scars of Shame, and one of the best known advocates for people with dermatillomania and BFRBs in the world. Her site is – well worth checking out. – an online therapy program for people with trichotillomania. They offer a similar program for those seeking help with dermatillomania, at

PickaDerms is an active Yahoo Group with over 2,000 members. Request membership here.


Body-Focused Repetitive Behavior Frequently Asked Questions (FAQ)


Strategies on the Go: Making a BFRB First Aid Kit


Apps to Help You With Picking or Pulling


How Can I help My Child Stop Picking or Pulling?


Body-Focused Repetitive Behaviors and the Highly Sensitive Person Trait


Fidget Toys for Distracted Hands


The Stop Skin Picking Coach – Interview with Annette Pasternak, PhD by Tammy Fletcher, PhD


Trichotillomania – Chronic Hair Pulling


Frequently Asked Questions on Dermatillomania


EFT Tapping for Dermatillomania


Dermatillomania – Introduction