M is a 26-year old, living on the East coast of the US.  This is how M is Conquering with Keen Awareness, in her own words.

BFRB Journey - From Perfectionism to Self-Compassion

For as long as I could remember, I have had a Body Focused Repetitive Behavior (BFRB). Little did I know as a ten-year-old thumbsucker that I would soon dive headfirst into nail-biting, and shortly after that, transition to skin picking. "Excoriation disorder" is not a term I knew at the age of 11, but I wish I did. Now I know that BFRBs run in my family - to varying degrees - from my uncle with severe Trichotillomania, to the rest of my immediate family with Dermatillomania and Dermatophagia. My cousin was actually the one who taught me how to pop my first pimple at 11. Immediately, I was hooked.

Being the high achiever that I was, always needing to be the prettiest, most popular, smartest student in my class, I was putting myself under a lot of stress without even knowing it. The nagging sense that unless I was superior to others, or, unless I was attracting praise and admiration from others, I was worthless, fed my perfectionist tendencies with my body. "This piece of skin around my nail isn't supposed to be here," I thought. Or, "this pimple has got to go for me to be pretty." 

Before I knew it, my positive intent for maintaining a beautiful outward appearance to garner others' approval had degraded into a full-blown mental health disorder. With no knowledge of mental health or behavioral disturbances, I was distraught. "Am I the only one who does this? What's wrong with me?" Quickly my desire for perfection, ironically, became the reason I could no longer see myself as worthy. "If others don't worship me, what's the point of being alive?"

Throughout my teenage years, I struggled with severe depression, bipolar type 2, eating disorders, self-harm, suicidal thoughts, recovery from sexual trauma, severe OCD that turned into binge drinking at the age of 16, and the loss of almost all of my friends. Accutane mixed with alcohol was a toxic mix for me, and the downfall of my already shaky mental health. My parents would yell at me for the hours I spent in front of the bathroom mirror picking, digging, popping all imperfections I could find to help me escape. Yet, picking was a healthier alternative to my other risky compulsions. 

Though my teenage years were turbulent, to say the least, my rock bottom came after a nearly lethal accident in February 2019. After breaking my spine, ribs, dominant arm, my lungs, and whole psyche collapsing, as well as my abusive relationship ending and having to leave the city I lived in, all at once, for the first time since I hit puberty, my skin became clear. Due to my immobility, I was unable to pick my skin for several weeks, and the transformation was unbelievable. At the time, it seemed to be the silver lining that accompanied this horrible tragedy. 

As you may have guessed, once I was able to move, I began to pick again, and I was devastated. Unexpectedly, several months later, after diligently, almost brutally pushing through my physical, mental, and spiritual recovery, I tried a new meditation practice. I had been an avid spiritual seeker since a young age. I practiced various kinds of meditation on-and-off again since 2015. This time, I pushed myself to the limit. Despite having broken my spine and ribs only four months prior, for three weeks, I practiced so-called "strong determination sitting" (a zen meditation where you do not move even an inch for at least an hour) for two hours a day. 

Miraculously, during those 21 days, I did not pick. Those 21 days were empowering beyond belief. Who knew I had it in me to stop for even a day, let alone three weeks! It had been more than a decade since I had gone more than five days without picking. My mind stiller than a waveless ocean. Urges arose and fell within my field of awareness without me so much as interacting with them (as a result of sitting through hours of immense discomfort without responding). A breakthrough, finally. 

Much to my disappointment, the intense tension required to hold my still fragile back upright, unsupported, for two one-hour periods a day took an immense toll on my physical health, and I had to change my practice. I needed a more compassionate approach. My picking ferociously returned, as did the ensuing self-criticism and self-pity. 

Awakening

Several months after moving back to the US from Germany, post-recovery, I found Ellen Crupi, and I contacted her to join her BFRB support group. My intention for going was "to stop PERMANENTLY," to "NEVER pick again!"

"Who are these unmotivated people who just want to get BETTER and not stop COMPLETELY?" I thought. Willingly, I ordered a Keen bracelet, and, after a short, determined period of black and white thinking, "If I don't stop entirely with this bracelet, I'm a failure. And if Keen doesn't work, I am a failure." So I quit wearing Keen, as I was afraid of failing. I did not think much about it until several months later.

More than a year has passed since I stopped my two hours of daily meditation. Though I have tried countless different practices over this time, Metta (from the Eastern Traditions), otherwise known as loving-kindness, has proven the most valuable healing approach. 

Synchronistically, almost magically, and after years of resistance, I began to turn towards myself in moments of suffering. This experience turned out to be subtler than I thought. Frequently, when I would pick, I had no awareness that I was stressed. Thanks to skin picking expert Anette Pasternak, Ph.D., and her book "Skin Picking: The freedom to finally stop," which I read during quarantine, I became aware of my underlying tendencies and the wisdom of my BFRB. What was my BFRB pointing me towards? What did I really need?

Keen Awareness

Thankfully, I decided to show up for myself increasingly and consciously turn towards my and other people's suffering more gently and kindly. I decided to give myself and Keen another chance. Keen has served as a tangible reminder that I am committed to my healing above all. By getting out of my head, I can get back into my body. Attending BFRB groups with Ellen has helped immensely. We agreed to say, "I'm doing amazing!" every time my Keen buzzes. Instead of thinking, I'm a failure for attempting to pick. I changed my mindset to -- "I'm growing! I'm training my awareness muscles." And, every time Keen vibrated, I would congratulate myself, pause, and inquire, "what do I need at this moment?" Additionally, I bought a smiling epidermis pillow from I Love Guts, some stress balls, and gel-filled gloves. Now I also have a piece of paper handy every time I get on a phone call or anticipate other trigger-situations. 

My journey has been long and arduous. I'm only 26, and it feels like I have been around for many lifetimes! My ultimate desire for you, me, and all others who feel frustrated and hopeless in their situation is: To use our BFRBs as an awakening.

You read that right. Awakening. When acting out your BFRB, whether you are aware of it or not, where is your awareness? When you give yourself "permission" to pick, pull, or bite, which is the part of yourself giving permission? Is it your most caring self, "allowing you" to act out this behavior that may harm you in more ways than one? For me, it depends on the situation. Maybe for you it is or isn't, I can't say. 

Awakening means to me:  

• waking up out of our trance-like thought of the past and future, and returning to the now.  
• waking up out of the false belief that acting out your BFRB is your only choice

No matter where you are on your journey, I ask you this: what is your highest intention for yourself, both long- and short-term? Mine is to be kind to me and others and turn towards my suffering compassionately to awaken to my fullest, most loving potential right here. 

On a good day, when I recognize the urge to pick, I quickly grab my phone, get out of the bathroom, or away from well-lit spaces. I close my eyes and listen to a five-minute self-compassion break by Kristin Neff. If I have picked but then stopped, I congratulate myself. "Hey, I stopped! That is amazing! I celebrate this success and give myself more compassion because I picked less today!" 

Compassion heals. Perfectionism perpetuates suffering. I have come to the conclusion that BFRBs are an enormous gift intended for individual and collective spiritual awakening. 

Let's get out of our heads and back into the body, coming home to ourselves. Can we awaken, with loving intention, and ask ourselves what our BFRB is trying to tell us? Your answer may be something like mine: "Oh, I didn't know I have to go to the bathroom," or "Oh, I'm thirsty, tired, need to move, or to have fun." 

Whatever it may be for you, your BFRB may wisely point you to how you can take better care of yourself in the present moment, the only moment that is real. And what is real, is perfect. 

I invite you to investigate these questions for yourselves. Try letting go of how things should be according to the voice of perfectionism. Try lovingly accepting things as they are. Listen to the whispers of your own body, mind, soul, and spirit. How do you feel? What is your BFRB telling you? 

My deepest wish for you, and me, is to find our peace, happiness, freedom, and love within you, my beautiful, fellow awakened being! May our BFRBs help us compassionately recognize that perfection already is who we are, the deepest truth of this moment, and not an ideal to aim to reach.