On Being Compulsive
It is 01:12am, Friday 27th of November 2020. My wife and I had a perfectly normal evening. Of late, that means I cook a nice meal whilst enjoying a couple of beers, whilst she sips a cider, the children settling down upstairs. Then more often than not since lockdown, we will crack open a bottle of red, watch some tv and around 10:30pm, after the evening news, head to bed – much like many other households. So why then am I up writing this, you may be asking? Because, I have woken with my latest compulsion, the incessant need to itch. I cannot fathom why? In the past, I have had a fungal skin issue, which does cause mild irritation and seems determined to remain no matter how many times I treat it. But this has caused me little or no bother. The itching is unbearable, all across my shoulders, arms and thighs. It prickles like a rash and yet there are no visible markings, apart from the remanence of the skin issue in some, but not all areas. So here I am, writing this blog in a vain attempt to make it go away and get back to sleep – something else I am not particularly good at.
Previously, around a year ago, I developed excoriation disorder or dermatillomania, a compulsive desire to pick at the skin. Mania, huh, that sounds about right, it certainly begins to drive me a little mad! Apologies, this isn’t pleasant reading, but in my case I picked to the degree that I would draw blood and was left with pockmarks and scarring on the areas I would do this. The only common theme is that this also happened when I settled to go to bed. During the day, when in the throes of my usual routines, not even the slightest itch seems to tempt me into this silly habit.
All this got me thinking, what makes us develop these compulsive habits? So, like most people these days, I asked Dr. Google. We are all familiar with obsessive compulsive disorders, ranging from triple checking if the door is locked, to severe anxiety at a seemingly benign issue such as a misaligned carpet. It is commonly known that these anxieties are masking a more real underlying issue that needs addressing, usually with talking therapies such as counselling. But low and behold, the first article I read in Psychology Today, states that –
‘Related to obsessive compulsions are body-focused repetitive behaviors {sic} (BFRBs), such as hair-pulling and skin-picking. In some cases, BFRBs are engaged in to decrease anxiety’.
So, does this mean this is a healthy coping mechanism? Rather than a more logical medical explanation such as an allergy or reaction to the latest washing powder on our clean linen? If it is a healthy coping mechanism, should I be concerned with what the underlying anxiety is? As a therapist, it would appear a little hypocritical not to address this. After all these compulsions only provide short term and temporary relief. In some extreme cases, they become unhealthy coping mechanisms, obsessions that begin to take over people’s lives. Then they really do need to seek help. Let’s hope I don’t become some itching maniac who people stare at in public then.
We know that these compulsions can arise after a period of stress, or even as a consequence of trauma. In some cases, survivors of abuse will develop compulsive behaviours. Doctors will prescribe anti-depressants or serotonin reuptake inhibitors (SSRIs) – to me this seems extreme, though I understand why people would resort to taking these medications. After all it can become insufferable. Other treatments for these wide-ranging conditions might include hypnotherapy, counselling, acupuncture, Chinese medicine or any other popular alternative medicine or natural remedy. Compulsive behaviours are very wide-ranging too, including hoarding, compulsive shopping, gambling, hair pulling and nail biting to name just a few.
In the cases, of hoarding or gambling for example, people can develop long term and debilitating problems that can cause significant damage to them and those around them. This is when a compulsion becomes a problem, and it is time to seek help. But for now, the clock has struck 2am and it is time I go back to itching and hopefully sleeping too.