In this episode of Clinically Awkward, I sit down with Psychiatric PA Laura Hope Hobson to talk about body-focused repetitive behaviors, or BFRBs, like hair pulling, skin picking, nail biting, cheek chewing, and tongue biting. Laura shares her late ADHD realization and her long-hidden trichotillomania, and we immediately get into the thing most people miss: these behaviors are usually regulation. Not self-harm. Not a moral failure. Not proof that you lack discipline. Your nervous system is trying to manage something, even if the strategy is leaving you frustrated, embarrassed, or Googling “why can’t I just stop.”

We talk about why “you’ll grow out of it” is still somehow floating around as ADHD advice, and how that myth keeps people confused and unsupported for decades. We unpack why shaving your head does not magically solve hair pulling, why behaviors tend to redirect when the underlying dysregulation is still there, and why “just stop” might be the least helpful sentence in the English language. We also dig into the shame spiral, especially for women who are expected to look polished and put together at all times, and how that pressure quietly fuels secrecy and self-criticism.

Laura explains how BFRBs often co-occur with ADHD and how they can soothe both under-stimulation and over-stimulation. We differentiate BFRBs from self-harm and OCD compulsions so we can be precise about function instead of layering on more stigma. And we talk about what actually helps: habit reversal training, ARC as in awareness, regulation, compassion, IFS-informed parts work, and building regulation strategies that are tailored to your specific nervous system instead of some generic “try a fidget” solution.

This episode is about shifting from judgment to curiosity. It is about understanding unmet needs and dysregulation instead of attacking yourself. It is about learning that you cannot shame yourself into long-term change, and you do not have to hate yourself into healing.

Laura’s resources, including her free guide, are available at hopeandhealingcoach.com.

00:00 – It Was ADHD the Whole Time

04:23 – The “You’ll Grow Out of It” Era

06:16 – Hidden in Plain Sight

14:50 – Why “Just Stop” Fails

16:41 – The Regulation Connection

18:55 – The Shame Spiral

22:34 – Not Self-Harm. Not OCD.

26:35 – Beyond Fidgets

29:20 – ARC: Awareness, Regulation, Compassion

39:28 – Finding Your Fire Department

48:58 – Permission to Not Hate Yourself

54:56 – Redefining Recovery
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Your Nervous System is Just Trying to Help You