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Treatments

Habit Reversal

Habit Reversal is a CBT technique which was developed in the 1970s by psychologists Nathan Azrin and Gregory Nunn for treating nervous habits such as tics, stammering and skin-picking which are done automatically. Therapy should focus initially on developing Habit Awareness and patients may be asked to keep records of when, where and under what circumstances they normally pick.

Many people believe that if they stop one bad habit it will be replaced with another bad habit. However, one of the key ideas of habit reversal is to replace the harmful habit with another harmless habit that makes the bad habit impossible. This new behaviour is known as a competing response.

A suitable competing response for skin-picking might be clenching one’s fist, as this is incompatible with skin-picking. Another important part of habit reversal training is practising a suitable method of relaxation such as meditation, abdominal breathing or progressive muscle relaxation.

Successful CBT will also involve stimulus control. Once the sufferer has identified the particular environmental factors or mood states that lead to picking, steps can be taken to deal with such triggers. For instance this might mean avoiding or covering mirrors or challenging automatic thoughts and emotions connected with picking and replacing them with less negative responses.

It basically involves breaking down each part of the behaviour and attempting to change it. Initially it focuses on developing habit awareness (may include keeping record of when, where and under what circumstances the CSP or TTM occurs. Then the harmful habit is replaced with another harmless habit that makes the bad habit impossible. This new behaviour is known as a competing response.

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