Updated: Nov 20, 2019
How To Find A Psychologist To Drive Away Your Nail Biting
In the past few years, I have noticed that so many people, both children and adults, bite their nails or pick the skin around the nail. As a teenager and during part of my twenties, I also had nail biting issues, and I never paid any particular attention to it. This week, while speaking with my 13-year-old, I noticed that she had some scabs around her nails, but I didn't want to bring attention to it just yet. However, noticing the behavior in my own daughter, combined with seeing so many other kids and adults over the years who have had challenges with nail biting, it made me realize how this is an issue that doesn’t get talked about enough. It can seem harmless -- and sometimes it is -- but it can also be quite serious. In the following blog, I will address the questions that I have gotten from many of my clients, their parents, and readers over the years related to this topic.
What is Nail Picking? Nail Biting?
Nail picking or biting is a problem that plagues a lot of children and adults. When we talk about nail biting, the problem actually encompasses more than just what we typically think of as chewing on nails. Rather, there are several related behaviors, like cuticle picking and even toenail biting. Toenail biting might sound a bit strange, but I have seen several kids do it and heard from numerous parents who are concerned about their children biting their toenails. All of these behaviors are real problems, and having a stigma and shame associated with them does not help anyone stop. Bringing awareness to what is going on and speaking to a professional about ways to help and resolve these issues is extremely important. But first, I think it’s necessary to get a better understanding of what it is and why people engage in these types of behaviors.
With some people, it is obvious that they are nail biters (or pickers, etc.), but others become experts at hiding it. Often people assume that this is something that affects people who are insecure and nervous, but in the many years of working with people who suffer with these issues, I have seen people of all levels of functioning, ages, and professions struggle with these problems. Now, when I write about these behaviors as characterized as a psychological disorder, I want to be clear and state that I am not referring to the kind of little bites of rough nails or cuticles that everyone picks at or chews on from time to time. It’s also not the occasional blemish that you might pick or squeeze. The nail biters/pickers I am talking about will continue to bite their nails past the nail and pick their cuticles until they bleed. These people constantly walk around with red, sore, and sometimes infected fingers.
Is there a psychological term for that?
Many people might not know how to refer to these behaviors or even think of nail biting or skin picking as a psychological disorder. As a psychotherapist, I like to refer to the group of behaviors that include nail biting, hair pulling (also called trichotillomania), and skin picking as pathological grooming. These behaviors become automatic activities that have no relationship to external stimuli at all. Years ago, the DSM, which is the bible of psychology, treated pathological grooming like an afterthought and put it in a catch-all category called “not otherwise specified.” However, the new DSM 5 added a disorder called excoriation (skin-picking) disorder. It is estimated that between 2-4 percent of the population could be diagnosed with this disorder, but I personally think that the percentage is a lot higher.
If you start paying more attention to what people are doing with their hands when you are around them, you might be surprised to find out how many bite their nails, pick their skin, or do other related behaviors that damage their nails in other ways. Those who are clinically and medically affected have results such as infections, skin lesions, scarring, and even physical disfigurement. According to the APA (American Psychological Association), individuals with excoriation disorder must have repeated attempts to decrease or stop the skin picking, which must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. They also add that these symptoms can’t be better explained by another mental disorder.
Nail biting and other related behaviors were categorized into another group of disorders called other specified and unspecified obsessive-compulsive and related disorders. These disorders can include conditions such as body-focused repetitive behavior disorder and obsessional jealousy, or unspecified obsessive-compulsive and related disorder. For the purposes of this article, let's talk about body-focused repetitive behavior disorder. There is also a medical term that is called onychophagia, which involves repetitive biting, chewing, and picking of one’s fingernails and the cuticles around them. What’s important to note is that there are now several accepted terms and classifications because these behaviors have been recognized in the medical and psychological fields as actual disorders.The terminology can get a bit confusing, but it might help to read through the different classifications when determining whether you or your child has formed a bad habit or has a serious problem that requires treatment.