A myth worth retiring: 'Just stop doing...

Picture a middle schooler wearing a thick wool sweater in 90° July heat or a teenager who spends an hour every morning meticulously applying heavy makeup before they will leave their room. Roughly 1 to 2% of students go to these extreme physical lengths every single day to hide their own bodies. Beneath the sleeves and makeup are physical marks, patchy eyebrows, missing eyelashes, and open source inflicted by their own hands. When an adult finally discovers these signs, the response is often reflexive. Sit the student down, look them in the eye, and tell them to just stop doing it. Telling someone to stop picking their skin or pulling their hair is identical to demanding someone with OCD stop

checking to see if the front door is locked. It is a biological impossibility. This willpower-based approach fails to stop the behavior. Instead, it breeds a profound isolating sense of shame. This vacuum of understanding pushes a condition that causes real functional impairment further into the shadows, making treatment nearly impossible to access. The Diagnostic and Statistical Manual of Mental Disorders classifies these behaviors as distinct medical conditions. They fall under the clinical umbrella of body focused repetitive behaviors or BFRBs specifically trickotilamania which is hair pulling and excoriation disorder which is chronic skinpicking. The physical action of picking or pulling operates as an automatic tool for emotional regulation. The brain utilizes these behaviors to soo the nervous system. Individuals

are often entirely unaware that their hands are even moving until the physical damage is already done. This neurological disconnect makes the behavior an automatic loop. BFRBs hijack the brain's natural soothing mechanisms, turning a physical act into a self-reinforcing routine rather than a failure of personal discipline. Treating a distinct clinical diagnosis requires evidence-based interventions designed to physically rewire that neurological loop. Habit reversal training or HRT inserts an awareness intervention between a trigger and the automatic action. Patients identify precise physical and environmental triggers. Once recognized, they introduce a competing physical response like clenching fists, making the behavior impossible, evolving into comprehensive behavioral treatment or COM. COM analyzes a matrix of five factors specific to each person. their

sensory environment, emotional state, cognitive thoughts, motor routines, and physical location. A licensed professional may also prescribe cognitive behavioral therapy or SSRI medications as clinical adjuncts to this behavioral training. Systematically replacing the automatic loop with conscious incompatible actions allows patients to achieve a meaningful and lasting reduction in the behavior. Untreated BFRBs that persist into adulthood carry severe medical stakes. Chronic skin infections, permanent scarring, and dental damage from nailbiting are common complications. Effective intervention must be rooted in clinical access and compassion, moving away from surveillance or punishment. Teachers and school nurses often serve as the first adults outside the family to notice physical signs and open the door to professional care. Mental Space School provides the systemic

bridge connecting K12 students and staff across Georgia to these specialized clinicians. Through same-day teleotherapy, licensed clinicians provide official diagnoses and evidence-based treatment for BFRBs within the school environment. Immediate access to specialized care means students no longer have to hide in shame. They can finally change the trajectory of their mental and physical health.