Key points

There is no demonstrated causal link between trauma and BFRBs.

Individuals with trauma histories can experience BFRBs.

BFRB treatment centers around building a fund of healthy self-regulation and self-care strategies.

When the causes of body-focused repetitive behaviors (BFRBs), such as hair pulling (trichotillomania), skin picking (excoriation disorder), or nail biting, are discussed, the question often arises: Are these behaviors caused by trauma?

It’s a fair question. The assumption makes intuitive sense. Many behaviors that cause physical harm or distress are linked to emotional pain or traumatic experiences. However, the science paints a more nuanced picture.

What Research Reveals (and Doesn’t)

Empirical studies exploring trauma histories among individuals with b

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