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OCD Family Podcast
S4E151: OCRD Series IV, Part I: BFRBs Explained: Lived Experience Meets Psychological Expertise to Benefit Families
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- [00:00]
A
Want a recipe for success? Step 1 Visit ocdfamilypodcast.com courses Step 2 Click on my link to browse OCD Training School's amazing course catalog. Step three Enroll. And step four Enjoy learning with no added cost to you. You can support the OCD Family community while grabbing some continuing education or learning how to bridge yourself to self help strategies for OCD. Again, that's ocdfamilypodcast.com courses and use my special link to sign up today. Welcome back to the OCD Family Podcast. We are kicking off our fourth annual OCRD series that's OC Related Disorders with an honest and informative conversation about body focused repetitive behaviors or BFRBs. These include things like hair pulling, skin picking, nail biting and so much more. But they are often misunderstood and incredibly real and challenging for those who live with them. So join me as I'm joined by the amazing Jason Yu and Dr. Lisa Conway because we are going to talk about lived experience, the family, ways to support hope and more. Intrigued or shall I say curious? Me too fam. And I can't wait to dive in. I'm Nicole Morris, licensed marriage and family therapist and mental health correspondent. And let me be the first to say welcome to the family, the OCD family that is. I am here to create a community of support for family members, spouses, partners, parents, adult children as there may be adult words and chosen family of OCD sufferers and their community. I've had over 22 years of experience in the mental health field, but please note that this information does not qualify or substitute as a diagnostic evaluation, therapy or treatment and it is presented on an as is basis. Please follow up with a qualified mental health provider in your area regarding concerns for yourself or loved ones. Thank you for joining us today. Now let's get started. Okay family. All right. It is November. What is going on? How is it already November? Hard to believe. And any day now the leaf collection truck, the city utilities come and collect all the abundance of fall leaves that accumulate in my area. And you know what I'm here for. It leaves accumulating, falling, the rhythms and rhymes, the whys, the why nots, how long the process takes. My analogy brain wants to go every direction with this as we talk about Today's topic regarding BFRBs. But before I get off track, I want to tell you more about our guests so that we can all dive into this conversation together. Because it's a great conversation and and if anything, I know hope is on the horizon. So first let me tell you A little bit about Jason Yu. Jason is a current counseling student based out of Vancouver, Canada who is doing powerful work you guys, because after a decade of shame with his compulsive skin picking, he left his job as a civil engineer to explore his mental health. And so not only is he investing in more ways to give back, he also is the host of Fidget, a BFRB Podcast. Now I'm going to have all the information about Jason Fidget and more posted over on this episode's blog, but I'm going to highlight his Low Fuel Light video because we're going to talk about it. It's a video that I like to give to clients. I find it to be a really helpful analogy and I just really appreciate the hard work he has put into this project. Additionally, we are joined by our sister of another Mr. And a C.O. trainer who also does a lot of advocacy and awareness training for clinicians around BFRBs. And that is Dr. Lisa Conway. You were first introduced to Lisa's greatness when I created my BFRB Water Cooler Chat to help educate us and think aloud together about some strategies, ways to track and again hope. Lisa is also an OCD Midwest native from the Chicagoland area and she works with sticky minds of all kinds, meaning she is a powerhouse in providing evidence based therapy for anxiety, ocd, bfrbs, and even trauma. I was fortunate enough to hang out with Lisa a little bit at this year's International OCD Conference and she's also come to hang out with a fam where we've talked about how different science, sensory experiences, regulation or even dysregulation can show up across a broad spectrum of neurodivergence, OCD, OCRDs, tics, BFRBs, you name it. So Lisa was a part of that. And I'm also going to link those panels over on this episode's blog, along with all the deets on how you can learn more about Lisa and her practice that she has out of Chicago. So without further ado, I'm going to go ahead and segue right into our conversation because we have a really meaty, really full conversation on the topic and I just can't wait for you to hear more. Welcome back to the OCD Family Podcast and we are kicking off the OCRD series. That's the OC Related Disorder series that I do every fall here on the POD with the topic of Body Focus Repetitive behaviors. And so as I mentioned, we're so fortunate to have both Jason Yu and Dr. Lisa Conway with us and to kick things off, you guys. Maybe we can all share our favorite way to recharge or refuel. Because not only are we going to talk about that today, fam, but also I. I'm all for brainstorming more ideas and solutions. So, Jason, why don't we start with you? Welcome to the show. And how do you like to refuel?
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B
Thank you so much, Nicole. So excited to be here. I. I don't think I have a new novel idea for you. It's just like the most boring option you have available. But honestly, I like to just go for a walk in my neighborhood. I kind of have like a standing meeting with one of my friends. And like every Monday we just like, meet up. We both work from home and we just go for a walk. I live in Vancouver, Canada, and there's like a little stretch where we can like walk down to the water. There's the beach. There's like a little farmer's market. I mean, it's a world class beach, so why not enjoy it? That's kind of what I have.
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A
Lisa and I are in the Midwest and we're like, tell us more about the Pacific Northwest. I went to Vancouver once, Jason, and I was with my boyfriend at the time. We went for a nice long run in Stanley Park, I think it was. Yeah, it's gorgeous. It's gorgeous up there. So going for a walk, like actually taking a pause, moving your body, getting some input.
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B
I love that.
- [07:03]
C
I'm here for.
- [07:04]
A
I love it. Okay. And Lisa, how about you? How do you like to refuel? Especially as we get into this more frigid kind of time of year for us.
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C
So this is gonna sound very similar to Jason, but add a 60 and a 50 pound pit bull. And taking our rescues for walks where I have been asked, are you walking for them because they need a lot of activity or are you walking for you? And sometimes we're walking for me. Like, we dig it out, get some stuff, space. Like they're goofball. So, like, they will get you out of your head really fast.
- [07:36]
A
I love that. So between the two of them, are they like strongly pulling you?
- [07:41]
C
I carry a lot of treats, but I also get a good arm workout. So, you know, we. We hit a lot of different activities in that singular walk.
- [07:48]
A
I like it. I like it. For me, refueling, sometimes it is just taking that break and going, when's the last time I drank water? Have I remembered to eat today? Have I stood up? I. I love the apple watch. It's, you know, my frenemy. But it's like, hey, you haven't stood in a while. And especially if you're used to sitting at a desk, it's really helpful to have a reminder to get up and move your body. So I love that. Well, we have a really important topic to cover today because we are talking about body focus, repetitive behaviors. Family may have heard the acronym for this. It's referred to as BFRBs. But we should just start with a real just broad brush overview of what a BFRB is because we're going to get into some different facets of it, how that engages with shame, how it impacts family members so many different parts. But Lisa, would you want to maybe give us that broad overview?
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C
For sure. So BFRBs are body focused. Repetitive behaviors are under the realm or umbrella of obsessive compulsive and related disorders. So they are dysregulate or compulsive engages to the parts of the body. So you can think about what we hear most often is trichotillomania or hair pulling disorder, excoriation disorder, skin picking disorder. And you can also expand that out into things like compulsive teeth grinding, cheek biting, lip chewing, nail biting, cuticle picking can happen on any part of the body. And it's these typical grooming behaviors because if you think about it, we're always going to have skin, hair, nails, teeth. And yet there becomes this piece to where it is hard to stop. Now I think an important piece to acknowledge about it is not just that the prevalence rate is pretty similar to OCDs, like 2 to 5% of the population gauges like a clinical level of a bfrb. And also there's a positive reinforcement of the behavior. It feels really good. Right. But there's also a negative reinforcement. It removes the trigger, the scab, the hair they didn't want anymore. It removes the stress, the thinking about it. So something that can seem on its surface like a very simple behavior, like just stop chewing your nails. But we're going above and beyond a bad habit, as some would call it, into a behavior that is really tightly wound. And so that's why I'm really glad that we're here talking about it today.
- [10:11]
A
Yeah, that's a really good overview. And one of the words that was popping up for me that I point out to listeners quite regularly is kind of the difference between something being egosyntonic and ego dystonic. And you're really describing the fact that there is value, there is kind of regulatory qualities, or there can be a number of kind of underlying needs being met. In addition to regulation. And so it is more of an ego syntonic behavior and we see it across not only our species, but you can look around to other species and see animals engaging in these different self grooming behaviors, et cetera. One of the main points though, when we get into an ocrd, the D in disorder is when it's bringing more distress to your life. When you feel like you can't reduce or control or have some even empowerment and self compassion around it and that can interfere with your functioning. Is there anything you would add to that, Jason?
- [11:12]
B
Yeah, I mean I think that's a great overview. I mean there's a pretty like blurry line as to people are like, oh, is what I have a bfrb. I thought I was just like, you know, fixing my nails or whatever. And that line is, is really different for everyone. But you know, and to your point of, some people, maybe they only pick like five minutes a day, but they hate it. It's the wor, you know, and it's like they, yeah, it's really like it consumes a lot of mental space. And so I think that's where to me on the surface a lot of people don't really realize it's just like, oh, it's just the behavioral component of like oh, I need to stop that. But I think we'll get into it. But like the, the emotional landscape, it, it can be all consuming and then that's where we start getting into things like, you know, we can talk about comorbidities, but like there's a body dysmorphic element to it. Right? Like how much you perceive you're doing it and then yeah, there's lots of overlaps with like sensory issues, the autism, the adhd.
- [12:09]
A
But yeah, I really like that you highlighted the point that it can be five minutes or so and something that popped up in my head. But you guys tell me if this would be a good way of saying it, that it's not even so much the quantity of time, but it's the quality of the time. So even if it's five minutes, that can be just as, or more distressing than somebody that's engaging in a lot longer, say picking episode for, for the sake of an example. Again, it all comes back to how much distress is it bringing. And do you feel, you know, I, I, I'm hesitant to use the word control. Do you have control over it? Because your, your brain is going to brain and ultimately it's gonna, it's gonna have that wiring to want to pick. So the the goal isn't never pick again because it's just unrealistic. Right. But what would be a better way maybe to gauge that? I don't know, is control the right word? Do you think there, or do you think there's a better word?
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C
I. I will use that. Or I'll. I'll stutter on it a little bit in session. Sometimes be like. But not control. Right. Because especially as like an ACT therapist. Right. We don't want to control things. But the idea of like management or regulation, because it's. If a client wants to be able to do their own brows.
- [13:29]
B
Right.
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C
Like Dr. Pimple Popper is a thing for a reason. Right. Better like take care of like the white head or the blackhead. Right. And yet feel a greater sense of management.
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B
Yeah.
- [13:39]
C
Over it. Cool. Let's get you to that state. Because grooming is a natural part of life. And you said brain's gonna brain, skin's gonna skin, hair's gonna hair. Do you feel like you can engage in that process of grooming in a way that you have, like more of an emotional center of gravity. Yeah. Around it versus feeling like you're. You're getting pushed or pulled one way or the other.
- [13:57]
A
Like, you have autonomy. You get to be the boss. And it doesn't mean it's never going to come up. Just like we are going to talk about. And I'm not going to get too ahead of myself, but with like a low fuel light, it's not that you're going to cease to need gasoline or fuel, but being able to feel some industry and autonomy over that.
- [14:17]
C
Yeah.
- [14:17]
A
Because I feel a little like I don't want to use control, but then that is the fit. So I appreciate that, Lisa. With that, we're going to go ahead and dive in and we're going to be talking about not just pediatrics, but also adults. And I would imagine as we talk about loved ones, it could be your spouse, it could be even an adult child. But we see this, and I hear about BFRB is being distressing often because parents are bringing in kiddos and going, fix them. They're doing this. That's really hard for me. And so can we start with maybe just talking about some of the common feelings? And to be clear, not everybody says that or even means that that's how it can feel sometimes to the patient or the client. But what are some common feelings that come up around BFRBs in the family?
- [15:11]
B
Yeah, I think, you know, it's a. It's a good question. Like, I think BFRBs are misunderstood in general. And I think that's like, this is a great example of that where, yeah. A parent will see their child, you know, engaging in this behavior that on the surface, it looks destructive. It looks, you know, gross. It looks. Why are you doing that? Like, please stop. And I think for the parent, it. Yeah, it creates this. Again, a combination of fear, there's a panic, embarrassment. I think, you know, I think it's really easy to project, like, there maybe an element of shame, of like, oh, no, like, what am I doing to cause this? Like, what have I messed up? Yeah, I think. Yeah, it's. It's a really, like, tough ball to untangle a bit. And I think it. It leads to already a stressful situation that just gets sort of heightened when, again, the parents are putting that added dimension.
- [16:10]
A
Yeah, yeah, yeah, that's a really good point. And, Lisa, would you have anything to add or perhaps even when you're looking across, say, at your partner or your spouse and you're seeing them engage, and it can become kind of a sore subject because when we speak into our spouses, sometimes they're like, are you criticizing.
- [16:29]
C
Wait a minute. What. Why are you watching me?
- [16:31]
A
Right, Right. Why are you this? Why are you that.
- [16:34]
C
Yeah, I think what. What I would tie back into is when you were mentioning, like, diagnostic criteria, Right. If we look at the Diagnostic and Statistical Manual, like, the. The last criteria for all them is like, does it cause functional impairment, including notable distress? And there's times in which it may cause you notable distress to see someone else engaging it. A child, a partner, a friend, yet it does not cause that person notable distress or may cause an internal, private distress, but they aren't yet ready to address it.
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A
Yeah.
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C
And so that's why. I know you had talked about kind of getting this. This podcast together, too, is like, so then what do you do instead? If it's not your thing? I'm not here to. Oh, my gosh, do not slap a hand, do not grab a hand, do not touch a person unless you have consent to help in that way, even though that is the natural reaction. All of this is about how do I open up lines of communication or offer that open space to support when and if it's warranted, and if I am not in the space to be able to provide that support or it's not working in the way that I'd like it to, how do I manage myself in that situation?
- [17:37]
A
Yeah, and sometimes, too, you know, sometimes I've also seen where it is their thing and they're triggered because they're like, no, I, I've gone through this. You're not going to do this because I don't want you to repeat or experience what I've experienced. And so you can see if we really zoom out, the ultimate intent of that is care, but it can come off as, no, don't do that. And that can bring up more distress and sometimes zap our fuel a little more. That can lead to more of the self reinforcing behavior. And so we've given a couple examples here. Family. And just like in talking about BFRBs more broadly, Lisa gave us some examples. But if you don't hear your thing and you're like, well, I thought that was a bfrb, but I didn't hear them say it. Please, please hear this. Everybody is unique and different. It's going to show up in unique and different ways and there's going to be unique and different reasons for them engaging in that behavior. And so what we're aiming to do is to kind of just generally think about this together and different supports and ways that we can really understand and then really gather around and rally around our loved ones. And so as we think about some of those common experiences that show up for family members, maybe this would be a good time to turn into more of the internal experience, more of the interoceptive experience for someone living with a body focused, repetitive behavior. And Jason, I know that you are very good with advocacy here and sharing your story and so to the degree that you're comfortable, would love to hear more.
- [19:19]
B
Yeah, I guess a part of the reason I'm so passionate about the topic is, you know, my own lived experience with compulsive skin picking. For me, it's like primarily concentrated around my hands for a long time. It would lead to like a lot of cuts and scars. I like bleed on things and it's just, yeah, not a good time. But I, I think something that I, that I have a hard time like articulating to other people and you know, taking the sort of the family dimension of this, is it okay if I tell a bit of a story?
- [19:48]
A
Oh, please. Story time it. Story time it up. This is the family, Jason. You can kick back, relax, and story time it.
- [19:55]
B
So, okay, for many years, many years, I had a lot of shame related to this behavior. And then eventually I kind of came to this point through sort of peer support and my own counseling and I got to this place of like, oh, like, you know, I don't need to be ashamed of this. I actually found that shame and hiding was stopping me from, like, healing, getting control, getting freedom from my behavior. And so I started talking about it. And when I started kind of being more open about my mental health, I told this coworker, and she sort of came back to me, and she's like, oh, Jason. Like, I, you know, this. This behavior, I feel like my son also has it where he, like, you know, I think he bites his nails. And I was like, oh, okay, cool. You know, thank you for sharing. I really appreciate that. Like, should we talk about it? And so we were kind of talking about it, and then at a certain point in the conversation, I asked her, like, oh, like, do you think your son feels any shame about his, like, the fact that he does this? And her response, I still remember it to this day. It was like, five years ago. She's like, yeah, Jason, if anything, I want him to feel more shame. Like, I'm actively shaming him because the fear is. It's like, oh, if I can't get him to stop here at home, he'll go to school and he'll be bullied at school. So, like, that was just her function of, like, the way that. Again, using this control word, it's like, I want to encourage him. I'm trying to help him stop. And her mechanism to do that is shame. So I share this story because, like, that is the. That line of thinking is the same line of thinking I use for myself of like, oh, if I, like, shame myself out of doing this, like, that's how I'll stop. And I think that's what people don't really understand. It's like when they see me picking my skin, it's like, oh, Jason, that's gross. Don't do that. I'm like, you don't think I don't know that? Like, I've had to live with this every day. Like, if it was just as simple as putting on gloves, doing lotion, stopping, if I could use more willpower, like, if that would have worked, I would have done it, you know? So I think that's what's so, like, frustrating.
- [22:07]
A
Yeah.
- [22:08]
B
About the. I don't know, the experience and how misunderstood it is.
- [22:12]
A
Yeah, I really appreciate that story and family. Since you can't see us both. Lisa and I went. When he said, oh, she said, I want to shame him more. But, you know, I look at some of the different generational differences even within parenting from, say, my parents generation to me as a parent now, and some of the tactics, again, if we zoom real far out, there is A desire to be protective, to try and support in. In one's own way, their loved one, as you said, she was this mother, was concerned about her child being bullied. But also, sometimes there is just that standpoint of if you have a negative enough experience, then you won't do this anymore. It's kind of like the picky eater. And they're like, well, you don't eat this, and you're not eating, and then you end up in the hospital for somebody that's not eating. And you're like, well, maybe this was a little more serious than I realized. And so I do appreciate that. And, you know, Lisa, maybe could you speak to the piece? I really appreciated the wording that Jason used in saying feeling like it was an issue with his own willpower. Can we do some myth busting there around willpower versus learning to kind of work with and befriend our neurocircuitry?
- [23:33]
C
Oh, man. Yeah. Because wouldn't it be nice if we could all just, like, stop the thing that we didn't want to do? Or it was just that if I just try harder or differently. Right. Or if you're an OC or OCRD therapist and are on any kind of social media, you're. You're flooded with the new fidgets or the new things or, like, the thing that galls me greatly are, like, the promises of buy this program and then you'll stop. Right. I have the magic key that's going to make you stop doing this thing. That's just going to happen. Right. Your brain works, body works. This is just what occurs. Right. And so one of the things that I think is so important and valuable to do, whether I'm working with the client, with the BFRB or. Or with a loved one who's observing it, is we need to put down that idea of the just stopping, much less if we think it's an issue of, like, you just aren't trying hard enough. Or, you know what? We talked about the plan. You had a plan for therapy. Like, why is the plan working? Which implies by nature you aren't doing it.
- [24:33]
A
Right, Right.
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C
Right. Which feeds that cycle. And that's like. Like, abandon hope all ye who enter here. Right. Like, shame is not gonna make us better.
- [24:41]
A
Yeah. And, you know, I'm sure you guys hear it a lot. I know. I hear it in my office, too, where, you know, you might go, how was this week? Well, I didn't pick. Okay, but how was this week? Because even if you didn't pick, maybe you, like, hung on for dear life. And you didn't pick, but it was a really hard week. Or maybe you did pick and it was a really good week. And so often that targeted body focused, repetitive behavior, the idea, the concept is, well, that should be at zero. And if I don't do it, then that's a win. And a lot of people will say, I want to reduce it, I want to not do it. Right. And so how do we address kind of what ultimately our goals are and how we really want to actually think about what is treatment and what is progress when it comes to being the manager of your bfrb?
- [25:38]
B
Yeah, it, you know, it's a, it's a tough question and I find sometimes not. I don't feel dishonest. But like there is sort of when a new client comes in, priority number one is stop at all costs. I never ever want to do it again. And I sort of, you know, I need to meet them there because that's like, you know, client centered honor what they're coming in with. But like there is sort of this like wise mind at the back of my head. I'm like, okay, but a relapse is going to come. Like, I know that and I don't. It's not because I don't believe in the other person. It's just like a function of.
- [26:17]
A
Yeah, like their brain.
- [26:18]
B
The brain, you know, just how accessible BFRBs are. And so the control conversation that we were having earlier, the comment I wanted to jump in with is like, I don't use the word control. I think what I'm looking for is more like trust, peace and freedom. Like that's kind of what we're cultivating, is we're trusting ourselves. That to your point, Nicole, like, hey, maybe it was a really bad week and I picked, hey, that's not a moral failing. It's just a, it makes sense. Like, yeah, of course I picked that week. It was horrible. You know, I had a breakup, I got fired, I got in car crash. Like, those are grounds for. I picked. And I'm not a bad person because that happened. It just, it happened. And so I'm at peace with that, you know, Whereas maybe if you asked me this question five years ago, I'd be like, no, that's not okay. I'm never allowed to pick ever again. And I would spiral because I did. Now it's like, hey, I'm at peace. It happened. I'm not gonna let it like clog up my brain space. I just had freedom from that. And again, that's sort of a tough sell for people at the start of their journey.
- [27:35]
A
But yeah, well, and like you said, you need to that trust is earned first. You establish that in the therapeutic rapport. And somebody needs to feel heard. I really wish it wasn't this way before we can really go, okay, so we can't take these rapids away, but we can calm the waters here a bit. Right? And in the ads for even the Keen 2 bracelet that Anila does through habit aware, I love the message. It's similar to that, Jason, of how even the building of awareness is a reminder of how can I love myself today? And sometimes you're gonna choose to pick and that's gonna be what you do. And sometimes you're gonna go, I need to go for that walk. It's time to meet up with my friends. Sometimes you're gonna be like, I haven't drank water in maybe a week. Perhaps that's why. And I'm not a camel, so this isn'. But it could be a number of different things. And so I love that. And initially that you're right, it might be a hard pill to swallow, but there's actually so much freedom in being able to accept and find peace and give yourself compassion and grace in any given arena, whether it's a BFRB or not. And so finding out that that's the way everyone listening is like, okay, so Jason, if you could just write down exactly how you did that so I can. So I can replicate it exactly. But thankfully we do have different evidence based treatments that help guide us in terms of how to manage this path. Right, Lisa?
- [29:07]
C
Yes, we are, we are lucky and fortunate in that regard. And the piece I would throw in an ad to what you both were saying is the place of if someone comes in with the fix it agenda, Jason, we'll talk about like the golden ticket. What the golden ticket into just stopping this altogether is that place of love and compassion. As a therapist of like, I hear you and I don't want to aid in a bet chasing a dragon, right? We're looking for this elusive, impossible outcome. Because the all or nothing thinking that also tends to go along with a lot of the obsessive compulsive related disorders has a very high standard for working, which is never again anything else is failure. And setting you, the client up for that kind of situation or you setting up for your loved one, there's no grounds in which that works. Right? And that's not my vibe as a therapist. It's like, hey, let's just see if it Happens for you. Let's talk about a more authentic Jason. I love those. I listen to Jason talk about BFR based Jason talk all day, trusting and peaceful. And this, this practice of equanimity that lets us move through these waves of life look more gracefully and compassionately versus you have to tow this exact line and never stray from it.
- [30:24]
A
I love it. And I'm gonna mark equanimity off my bingo card. I love Lisa's lexicon. And we, we word out. We're word nerds. So we, we talk about this often. But yes, I mean, it is, it's such a good point. And sometimes I know, you know, whether it's with bfr, other behaviors that are really concerning for people with lived experience of whatever in their family. I'll sit them down. And I said, we, we just need to like, embrace that this will happen again. Okay. And it's okay to grieve, but trying to prevent the next episode is really, like you said, setting us up for failure. Lisa, because our brain is going to engage and this is in an egosyntonic way. There are values, there is something beneficial that comes from this. And again, it, we can see it even in primitive form across the animal kingdom here. So thinking we can out willpower something that is going to be just the way our brain is flowing and processing information, we're going to be disappointed. And so being able to go, but, but that doesn't mean it can't reduce. It doesn't mean the needs can't be met or that you can't be the manager of these different urges, these different sensory needs, these different emotional needs, even body movement and habits and all of that. And so I think it's a really, really good point and it's freeing. I, I don't know about you guys, but like, for, for the person, even if they're disappointed, and especially for family members, going like there's nothing you to keep this from ever happening again. Like, it's just not a realistic goal. It will happen again. And sometimes just taking away that myth, like it's a mirage that you can, that you could even prevent that from happening again is freeing because so often that is just kind of the concrete. Anything outside of that is failure. And I've found that certainly in working with clients in this arena as well.
- [32:38]
B
Yeah, I find a helpful parallel to draws with eating disorders. It's like not like you can stop eating. You know, like it's just a necessary port. And yeah, like there, there'll be urges to control our eating, whether it's binge eating or kind of like on the other side, like kind of restrictive eating, like going to show up, it's going to ebb and flow and yeah, we just learn to manage it, ride the waves. And yeah. Again, getting to this point of like, like freedom or peace. Another concept that I've heard of is this idea of like food noise.
- [33:16]
C
Yeah.
- [33:16]
B
Like when people who are, who really struggle with kind of disordered eating, they're like every meal is like, it's consuming so much brain space of like, oh, how, how many calories is this? How much am I going to work off? Like, or being on edge around food. Like, oh, I don't want to go to that party because I know there's going to be a buffet table. And then at the, you know, blah, blah, blah, blah, blah. That's just like again the, the cognitive load of thinking about food just kind of copy paste that transport it onto our skin. It's like, oh, I don't want to be in that stressful situation because I know stress triggers my anxiety and like my anxiety leads me to pick. And so if I go for that job promotion, probably gonna trigger my skin picking. Ah, I'm not gonna do it.
- [34:01]
A
Right.
- [34:01]
B
Like no, like that's not, you know, like go for it. You might pick your skin, you might be anxious, but like you gotta like full send, right. Find that job or something.
- [34:11]
A
You're, you're, you're gonna, it's gonna happen. Might as well have the better job and the, the yeah, don't let it get in the way of life. And, and when we talk about that functional impairment, that's one of the many examples it could be just even saying I'm gonna maintain the status quo, which isn't what I ultimately wanted for myself because I'm afraid of what the change will bring and how that will metabolize. In terms of my engagement with my BFRB or any process based disorder, eating disorder, substance use, all sorts of different things. Anything you would add to that, Lisa?
- [34:44]
C
I think the piece that I would chime in along that too is we do the things that work right. The oft quoted statistics around OCD are 14 to 17 years on average. From onset of symptoms to accurate diagnosis and treatment. Every once I looked at the we have those numbers on BFRBs, I seldom found them. Could be a wonderful dissertation project for any grad students out there. Jason either. And these, this is a behavior that rarely do I see a client where they're like, man, I just kind of started doing this a year or two ago. It's calls that end in tears because I haven't told anyone else about it. And it's been decades. And so of course you fall back on something that has gotten you through so many stressful, difficult, heart wrenching moments before. And like Jason said, like, it's not like you can't stop eating. Right. It's not like you can remove all of your skin or always permanently wear gloves. Like, we've gotta find a way to help you manage through some of this while also making space for it if this happens again. That's something we can work with too. Yeah.
- [35:50]
A
Or when it happens again. Yeah. Just being able to have that plan in place and know again that you can be at peace with the toolkit that you've built and with your trust within yourself and all those different things. I love that. And so one of the things, I know you noted that shame spiral, Jason, and I know we're also going to hear it just a little bit about what are some of the ways that we do treat this kind of that roadmap. But I wonder too, Jason, when you started therapy, was your therapist knowledgeable and skilled and knew this was a bfrb, or did you happen upon this through the ever lovely journey of misdiagnosis or misunderstanding?
- [36:35]
B
Yeah, zero. I think I saw like maybe five, six counselors between when it first started happening. It first started happening for me when I was about 18, 19. Well, I think that's when it like showed up in earnest. You know, maybe as a teenager it was in the background, but then it kind of like ramped up, intensified. When I was 18, 19, I was like in my undergrad. I was living away from home. Yeah. And I started having like panic attacks around it. So getting into the like functional impairment of it. Like. Yeah, that was the, the extent to which it was upsetting for me. And yeah, the first few people, my first psychologist person I met, bless her, very nice lady. But I, like, I wasn't ready to talk about it yet. So we didn't even talk about the skimping.
- [37:28]
A
Right.
- [37:28]
B
But that was just my first exposure to kind of any sort of professional mental health service. Kind of going off of Lisa's point of the onset between like when the OCD shows up and when you actually get the diagnosis. 14 to 17 years for me. If anything, I feel like I was lucky. It only took me eight years, eight me years before it showed up, before I got my like, oh, this is what it is. It happened from Facebook, a Facebook post to be like, hi, world, I have trichotillomania. This is what a BFRB is. I saw that post. I'm like, wait a minute, what the heck is this? But I've also talked to people who have done it for 50 years. Like, they started when they were 10. At 60, they're like, the Google machine told me I have this disorder.
- [38:18]
A
Sometimes that Google machine gets it right. You're right. I mean, the thing is too, and you guys have probably heard this, when people start to learn more, what is a bfrb? They're like, oh, well, doesn't everybody do that? That's kind of normal. And if you look at a number, like 1 in 20 people doing something, yeah, it is kind of normal, isn't it? Like, there's. It's. It's not that atypical to run in, especially to things like nail biting or hair pulling, but it can manifest in so many other ways as well. And so really helping people understand helps to break down that stigma. A. But it also helps people to know, like, oh, and it can be better than what it is. I'm not at the mercy of my nail biting or whatever the behavior is. I actually can be empowered and I can be the manager of it.
- [39:11]
B
Totally.
- [39:12]
C
And you probably know someone else who has a BFRB too, either in your peer group, your family, what have you, whether they're talking about it or not. That's some of the. Like, I'm worried if. If I do share about, if someone does ask about it, what Jason was saying, like, oh, my gosh, why can't you stop? That's so gross. Like, oh, that looks like it hurts. Like, well, there might be more people out there who get it if you want to talk about it too.
- [39:34]
A
Yes, yes, absolutely. And so as we think about that shame spiral, shame is such a big culprit in really driving that distress and really wreaking havoc, not just in BFRBs, but certainly does show up in BFRBs. And I can think of my clients that feel incredible amounts of shame when they end up engaging in a picking episode, even if they met some of their goals, because they're like, dammit, I didn't want this to happen. And so can we talk a bit more about that shame spiral and how that looks? Jason?
- [40:12]
B
Yeah, Like, Nicole, are you one for New Year's resolutions?
- [40:16]
A
I mean, I kind of am not, but I won't argue with a vision board.
- [40:22]
C
And.
- [40:26]
A
Some might say, what's the difference? But I like to have a little looser boundary. Like, it's not that it's gonna start. I Tried to back away from the black and white thinking, but if you're going for a vibe, I'm all for rooting for a vibe.
- [40:38]
B
Well, I, I think the experience of having a BFRB is like every day is a New Year's resolution. And I think we all know what comes from the New Year's resolution. I think it's like January 6th or something. January 6th is like national Break Year Resolution Day. Because that's not, you know, you make it five days and then day six, it's like, oh, I just can't make it to the gym today. I just need that cigarette. I just. Whatever it is. And so for the listeners out there, if you've ever tried a New Year's resolution, just the, the. Again, the shame of. I made a promise to myself, I made a promise to my parents, I made a promise to my partner, I made my pro, you know, to be like, guess what guys, 2026 is the year I'm gonna stop it all. And then 48 hours later, it's just, oh my God, I'm glad you said.
- [41:33]
A
2026, because 2025 is not the year, my guy. No, I'm kidding.
- [41:38]
B
I.
- [41:39]
A
A little bit half kidding. But yeah, it's such a, it's a well made point because a, it's like cold turkey. You're going to just create a new behavior. But often what people are missing is what was this old behavior? What need was it meeting? We don't do stuff for just no reason. We do stuff whether it's grabbing the Ben and Jerry's at night or taking the cigarette or maybe not getting out of bed and just watching YouTube or TikTok or whatever. How is that functioning? Because if we're just stopping that behavior cold turkey and we're not meeting the underlying need, then we're just going to be even more distressed and frustrated and then we're more likely to overcorrect or really indulge in a given behavior if and when we break. Because we haven't been meeting that need. That need was getting neglected during that interim period of, you know, I think of in the substance use, the being dry versus being sober, like that need wasn't met. And so we're just kind of like a little pressure cooker mounting up with pressure. We need to meet that need.
- [42:50]
B
Totally.
- [42:51]
C
When I think that speaks, I know this is not a podcast episode directed towards all of the ways that we can treat BFRBs with evidence based therapies. And yet we have extended so far beyond habit reversal. Right? HRT to really look at the function of these behaviors. Right. Of the comprehensive behavioral model, the integrative behavioral model, like ACT informed, CBD for BFRBs. Because if we can practice curiosity about something, even if it is deeply painful, we aren't scared of it. And if I could get curious about it now, I can start to see what is it doing for me. And what are almost like reasonable facsimiles they can use. Cause not gonna feel quite as good if we're aiming for something that's gonna feel just as good. Again, we're chasing a dragon. And yet. Okay, here's the cobbled together set of things that is enough to move me away into a different choice.
- [43:45]
A
Yeah, I really like that. And you know what? Family. Lisa was on a sensory panel, a two part sensory panel that I had a season or two ago. And I remember when you said that curiosity. Because we were talking, we talked about it a little bit then too. I'll have those episodes linked along with all the info on Jason and Lisa over on this episode's blog. But one of the things we talked about is instead of saying capability, if we can, yes, we're capable of not picking, but can we be curious about why we were. Can we be curious about what need that was meeting? Can we be curious about really trusting ourself? And. And this might even be a really nice kind of segue into understanding that low fuel signal. And so I would love if you would be willing, Jason, to share more about this because you have this as a part and publicly available again. It'll be linked on this episode's blog from the Fidget podcast. But I would love if you could share with the fam here more that analogy that you came up with and how it's been helpful for you.
- [44:51]
B
Yeah, totally. Well, yeah, thank you, Nicole. I mean, it really sort of signified this relationship shift that I had with the behavior because, you know, I sort of mentioned earlier when, when I was starting on the journey and maybe when a new client shows up for me, they're really at war with it. Right. They're like, I. I've been with it for so long, I need to stop. Like, I know I shouldn't or my parents are on me about this. Like, it's this pact that we made with the devil of like, it feels so good. Like I like, like the behavior. It's so satisfying in a way that I say sometimes it's indecent. You know, it's like it's unreasonable how good it feels.
- [45:31]
A
Yeah.
- [45:32]
B
But it, you know, creates so much damage. And yeah, like, I stopped New Year's resolution, I need it over with. And every day was this kind of constant battle. But then sort of again, being on my journey, going through every fidget under the sun, every strategy to try to stop, I'm like, okay, you know, my approach isn't working. And when I started being curious about it of like, oh, okay, you know, I notice I pick more at night than in the morning. I notice I pick more at work than at home. Whenever a boss deadlines, you know, it's just like, okay, is it a stress thing? Is an anxiety thing? Is it a boredom thing? Is it a procrastination thing? Is it a jealousy? You know, like, you're just getting more in touch with this, like, emotional underpinning of the behavior. That's when I realized it's like, oh, like, my BFRB is kind of useful, but, like, it kind of like, tells me when I'm upset in a way that in this little short film that I made, there's a line of it. And it's like, my BFRB knows me better than I do. Like, I, you know, I think we. We're so cognitive in our culture. We're like, so, like, brain forward. Like, we have to think our way through things, but our body, we have this, like, intuitive wisdom that it's going to tell you when you need to pee. It's going to tell you when you need a glass of water or you miss your mom or you need to go for a walk. And like, in my brain, I wasn't focusing on that because I was so, like, work, work, work. Productive, productive, productive. But my body's like, jason, you gotta slow down. Yeah. Like, you gotta. You gotta find a different way. So that's kind of where this analogy of the low fuel, like, came from is actually my, my dad, My dad, he. So maybe you can't tell on a podcast, but I'm Chinese Canadian, and my parents immigrated from China in kind of the late 80s. And the very first car that he bought when he immigrated to Canada was just this, like $500 beater. And the fuel gauge didn't work. Like, it just. It wouldn't tell you when you were empty or whatever. And so his workaround was whenever he went to the gas station, he, like took out a little pencil and he just wrote on the receipt, like, here's the odometer reading. And then he just like added like 200 miles. Like, I don't. I don't own a car. So I don't know. But like, whatever. Whatever the size of a gas tank is. She like, just added that to his odometer reading. And from there he could like, back calculate. Okay, I don't have the information I need to tell me when I'm actually at empty. But I had to like, reverse engineer a way to like, send me the information to be like, car, you're about to run empty. And so rather than risking being in the middle of the highway, you just need to kind of like preempt that. And in a way, like, that's what I needed to do for myself. It's like I couldn't read the body signals of, like, my stomach is growling, so I'm hungry. And so I just pushed through that. And I would just like go 12 hours without eating. And that's when my skin picking would show up to be like, jason, you're just right.
- [48:43]
C
You.
- [48:43]
B
You need to like, eat or something or we're gonna collapse.
- [48:46]
A
Right.
- [48:47]
B
And right. And. And so again, that's a small snippet of like, how my relationship with my skin picking evolved. And in being curious about it, I realized it's like, oh, like it's giving me information that I wasn't listening to before, and that's why the urge was so big.
- [49:05]
A
But anyway, yeah, it's learning how to read the data. Yeah. Because it's data. It's giving you data, and I love that. You know, I'm thinking for. I work with a lot of neurodivergent processors and sometimes reading those interoceptive cues or just being able to gauge before it's like, last second too late, like zero to 60 experience, being able to go like, what do I need? Can be tough. But even, you know, within the allistic population, this happens as well. And I know you mentioned kind of as we were doing our intros there, Jason, you were talking about, you know, how we see this show up for people with ADHD or ADHD being autistic as well, and would love if you could speak to what you've learned or anything you could share with us.
- [49:56]
B
Yeah, totally. I mean, I think as we've sort of been talking about BFRBs, is this, like not always, but there is a soothing component of it. And so being this self soothing mechanism analogy that I find really helpful is if you have adhd, you're on the spectrum, you have sensory processing issues. Like the world can feel very loud. Like maybe our brain doesn't necessarily know how to like, filter out information in a way. Like, let's say you're walking through a crowd For a more neurotypical person, your brain kind of like knows, okay, this is relevant information. This is irrelevant information. I'm only going to focus on like my friends that I'm walking with rather than the like 20,000 people in this crowd. But if you have sensory processing issues, all of that stimuli is coming in all at once. Another example is like, say with like clothing tags. Maybe a more neurotypical mind knows that the tag on our sweater is irrelevant information. We don't need to pay attention to it. But for someone with sensory processing issue, that tag is really itchy, really bothering us. And then we're kind of being poked, stabbed by a needle all day long. And so we're on edge. And so whatever the processing issue is, the brain is so inundated with this information and what a BFRB sort of helps us do. I like it. Think of it like it turns the volume knob on the world down. Like it just like puts a little like heavy blanket over everything and just makes everything so much more tolerable, manageable. And so when you get into this mode of like, I need to get rid of my bfrb, it's like, okay, but like, how are you changing the fact that like the world is so oppressive to you? And that's where the expectations of like sobriety and like, oh, I'm never gonna do it again. It kind of gets complicated, right? Because the soothing behavior that helps you cope with the fact that the world is just so noisy.
- [51:59]
C
Do you mind if I actually ask Jason for a follow up? I think one of the things first of all to shout you out fam if you have not watched the video. It is a multiple award winning short animation that is phenomenal. Something I'm always so struck by when either we're presenting together in a training or watch your video is it's not just cold clinical intake of data. Oh, my BFRB is saying I need to eat. My BFRB is saying I'm dysregulated. It's the warmth you talk about in that relationship of like, it's like a friend. Can you share a little bit about that movement?
- [52:32]
B
Right? Yeah, yeah, yeah. Well, another line from, from the film is it's like, yeah, my BFRB was like an old friend that at first we didn't know how to communicate with each other. So I kind of think of like it's like a Disney princess movie where you have, you know, you're, you're Disney princess. But then there's the little like animal sidekick at the start of the movie. He's really annoying and he's just getting in the way. But as the movie goes on and you, like, they're like trapped in a submarine together or whatever. They kind of save each other and by the end of the movie, they're best friends. Well, they're still like annoying little brother energy, but it is like, oh, like you're looking out for me. You know, like, you're not being loud and annoying for no reason. Like, it's like you are trying to communicate something to me. You are trying to help me out. I'm just not doing a great job of being open to the path. And again, like a annoying sibling, it's like, I didn't necessarily choose to have you here, but like, the. The warmth is like a love. Like, it's like a. You do have my best interests in mind. And I. I'm sorry. Like, there's almost an apology there of like, I'm sorry I mistreated you. Yeah, the bfrb. But also myself for so long. And I think that's kind of where the warmth is. Is. It is like a grief process of, yeah, like, I was so mean to myself dead.
- [54:04]
A
And this might be also a good point as we kind of think about this in the context of shame. How do you allow yourself to grieve and say sorry to yourself but not like, shame yourself for doing the best that you could with what you knew? Right. Like that it becomes one of those things. And you know, perhaps this is where we look at that self compassion and we go. That's where we have to practice and say, okay, there were things lost in translation, but you were trying to help me and help guide me and really being able to kind of integrate those pieces, I'm sure is where some of that then inner peace you were talking about earlier comes from.
- [54:48]
B
Yeah, I mean, again, it's tough. Like, it's not just a snap your finger. All of a sudden. I'm in love with this behavior that's haunted me for so long. Right. Like, it. I think it is easy to fall into that shame piece and just being upset with yourself. And yeah, again, it's not exactly your question, but I would love to fill in another story I mentioned. I was with my behavior for about eight years before I really knew when it first showed up. You know, I'd get these cuts. My hands, they would bleed. It's like painful to like even hold a pencil sometimes just because, like the way I had to like bend my fingers, they would like, yeah, crack and cut. And so, yeah, I started having these panic Attacks, like, you know, I been to the hospital two times. Like, I was like handcuffed in a police car. I was just so upset and so distressed about the situation. So that was like the start of my journey. Fast forward five, six years where the cuts show up in my hand. They like get infected. You know, I think that's a fear for parents, right? It's like, oh, I, I don't want the cuts on my child's skin to get infected. They do get infected. It's like a important fear. But after so many years of living with these cuts on my hand every single day, trying to stop, but I can't stop. So I, I kind of got resigned. Like, I'm just like, the infection's gonna show up. You put Polysporin on it, you hope for the best. But one day the infection got like, really bad. Like, it was on my right hand and I didn't know what to do. I, like, I continued going to work. I'm like, not much I can do about it. So my hand was infected, but then after about a week or so, it was just really painful. I, like, I just, I need to go see someone. And so I, I actually went to work that day, but on my lunch break, I'm like, it hurts so much. So I like walked across the street to this like, drop in clinic, shout out to Canadian healthcare. And I showed it to my doctor, this doctor, and he's like, oh, okay. You know, like, the infection's pretty bad. Like, here, I'll give you some antibiotics. He's like, it's a good thing you came in. Honestly, if you let it go a few more days, the infection might have gotten into your bones. Like, you might have not have been able to do anything. Like, you might have lost your hand. And I'm like, oh, okay. Thank again. Appreciate it. Thanks. And then he asked like, you know, how did your hand get cut? How did it get infected? I do this thing. It's like kind of OCD related. I pick my skin. And the doctor's like, you should probably stop that. No, like, great, thanks. So after that, that was like five, six years into my journey. Yeah, it's not like I stopped. Like, I continued to pick my skin after that. Like, and I think that's the extent to which, again, something like willpower, something like shame, something like fear. I don't want to do it, but I can't not do it. So that's kind of what I want to share in that story. Getting back to the shame of it, it's like I don't know. That's kind of what I think about, like, how close the behavior's been. And again, the, the shame of like, oh, it's such a moral failing, Jason, you should just stop. The doctor told you to just stop. Yeah, that's not the way, you know.
- [58:18]
A
Well, and then it just adds more of that pressure which can become such a, a big reinforcer. It's not that stress is always the reinforcer, but stress adds nothing good to any party. And so, yeah, it's tough. And I was just thinking about, I was curious as you were going into that story. I was like, I wonder what the doctor's gonna say, because I feel like doctors gotta see this more regularly and they miss it. Whether it's with, you know, skin picking, nail tearing, the dermatologist with hair probably, and different things. People getting assessed for alopecia or different stuff, maybe using really strong steroidal medications and really kind of just missing a big part of this is, is the BFRB and not understanding that. And so if the doctors don't even understand it and you don't understand it and it feels shameful to talk about and you can see how this becomes pretty tough. But you know who generally does get a front row seat to this, in addition to the lived experience person, is the family. They generally know. Yeah, they've done that forever. Yeah, oh, yeah. They, you know, fill in the blank. And so, Lisa, do you have any ideas in terms of, you know, like Jason was describing with going to the doctor, and you'll even hear this in the addictions realm, you'll hear, well, they'll bottom out bad enough at some point that it'll teach them. And again, it's very much like that. If they're hungry enough, they'll eat. If you don't want to lose your hand, you'll stop picking. And then it's not as cut and dry and as easy as that. And so do you have ideas, Lisa, in terms of how people can grieve what has happened, but also facilitate some of that warmth and understanding of how this is functioning for them and also how to not get really inundated in that shame?
- [60:13]
C
So, you know, there's like a three step process and we're going to. I'm kidding. There's nothing.
- [60:17]
A
Uh, I was like, good, we solved problems today. Here we go. Just give it to the doctors. They can hand it out.
- [60:24]
C
Right, Exactly. If only. Right. And, and I think this space around. I'm in a very fortunate position in my role as a therapist. So, like People are coming to me and saying, like, hey, I want to work on this thing.
- [60:37]
B
Like, cool.
- [60:38]
C
We've got to know, albeit we do a lot of motivational interviewing, because interest waxes and wanes. Right. And so, like, over and over, I can create that space in our relationship to help support them. Right. So I know people coming in want to work on it. Aces. Right. And so a lot of it is coming from that place that we don't shame ourselves into being better. Right. How do we start to slowly shift that relationship? I'll have them watch a little fuel light, or we'll talk about this change in the relationship. And I get a lot of, like, cool, cool, cool, cool, cool. That would be great. I'm not going to get there. Like, all right, let's. You know, we could just, like, hold it for what it is right now. That's a direction we're moving towards. And, Jis, I'm not sure if you would want to share about it, but, like, it's not like you walk into this warm, friendly relationship and you're like, well, achievement unlocked. Right. I never get frustrated again. Right. Like, holding the space for the waxing and waning in that part of the experience, too.
- [61:30]
B
Yeah. I think there's sort of this related to the golden ticket thinking. It's like, yeah, the BFRB is just a part of me. Like, let's cut it out. Like, let's. There's sort of this, like, cancerous, like, if I just cut it off, remove it from my life, and then it's a problem solved and I'll never have to deal with it again. But, like, no, Like, I think that's, like, the part of the grief to really internalize. Like, no, this is with you forever. Like, I. I don't know how to explain it in a different way. And, you know, people, like, they hear that and they're like, okay, yeah, that makes sense. But then three years later, they're like, I have a new understanding of what that means. And. And I think that's kind of what I think about. About being on the journey is. Yeah. It is sort of this, like, surrendering. It is sort of this humility of this. BFRB is, like, ancient, you know, like, it's, like, intergenerational. Like, you know, this is. This is not a. This is not a. Oh, I got a flat tire. That's a bummer, right? I'll put in a spare. Let's keep driving. It's like, no. Like, this is kind of, like, coded in our genetic DNA. This is like a Fundamental way of me being in this world and interacting with other people. And, like, I'm a sensitive being. You know, I am a soft person, and the world can be very harsh. And, yeah, like, I think that it is like a. There's like the. The level one depth of, like, yeah, I got it. I have all the strategies. This makes sense. And then there's the level, like, 13 depth of, like, whoa, Like, I don't know anything.
- [63:12]
A
One of the things I appreciate the description of looking at it and saying, it's not the same as going, this is a cancer. Rather, this is a part of me. Right. The cancer is like this foreign invasion that is unnatural to you. This is part of you. And so being able to, again, redefine or recontextualize that relationship. And that this part of you is actually trying to give you information. You don't have to like how it's giving you the information, but understanding how it's giving you the information. Similar to kind of that analogy you use with the sidekick in the Disney movies. It's like, okay, I'm gonna learn how to read you. And then once. Once there's no longer that language barrier, then it's not gonna be so difficult for us to be able to speak, and we're gonna be able to communicate more effectively. And I still might not like what you have to say sometimes. But you know what? Getting to that place can be so freeing. Absolutely. And there's a lot of hope for it to get there. But if you've been in that space where either Lisa or Jason have said, like, no, that's not where we're like, hold on to knowing that that is a blip on the journey. It's not the destination you haven't arrived at. There's no looking back. I'm never going to be any different. It only can get worse from here. This is a blip on the journey. And really understanding how to use that bfrb, really, even as a compass to get where you're going is. Is huge and can be really, really empowering as well.
- [64:55]
C
Yeah, I know. One of the earlier questions you asked is like, how do you make space for all of it? Right. And it's going through all these ways. Like, we used to think grief proceeded in a very linear fashion, and it doesn't. Right. We can't control how we respond to things. And so making the space in session, seek out support. Like Picking Me foundation, run by Lauren out of Chicago. Habit Awareness Community, run by Anya and Ellen. Right. Like any of these groups, any of the supports. Listen to a podcast like Fidget, right? You're just getting this infusion, whether you're the person with a BFRB or a loved one is like, oh, that's what this is getting, like, over and over. Kind of deprogramming. This idea of it's a moral failing or it's easy to just stop. Or like, well, just use the no pick nail polish or no bite nail polish that you got and, like, you'll be fine. Right. Like, we're. We're practicing a different way of having that language, right?
- [65:50]
A
Yeah, yeah, no, I. I like that a lot. So in terms of then looking at just more broadly the community, I would love to hear more on that if you're up for it. Jason.
- [66:03]
B
Yeah. Building community with BFRBs, I think so. The community is really important because when I met other people with BFRBs, that was like the. This, like, place to normalize. Just, like, how much of a challenge it was, like, with no judgment. Because I think there is this. With other people who maybe don't get it, the solution seems so simple. You know, it's like, I just did this. You should just be able to do this. But the energy is so different in community. It's like, yeah, I tried that and it didn't work for me. I hope it works for you. But, yeah, and just being in a space where people can respond and interact with you like that, that's amazing. Earlier, I gave the story about the mom who, like, wanted to just intentionally shame their child out of the behavior. And again, I, I want to say this. Like, I have no judgment on the mom. Like, it's like, I totally get why she thinks that way. And again, I don't disagree with that as a thought process. And in the same way, I met this person who compulsively pulled their hair at trichotillomania, and she came to me and this was her line of thinking. She's like, you know, Jason, I'm going to shave my head. I've been shaving my head for. For many years, but I'm sick and tired of this hair pulling thing. This time I'm going to shave my head. I have my wig. But now I have this timeline. I have this, like, one year in the year it's gonna take for my hair to regrow. That's the year I'm gonna kick my habit, you know, that's the year I'm gonna learn how to not pull my hair. And by the time all my hair is grown back, I'll be cured, right? And, oh, it's just like, I like totally get it. Like, I get that line of thinking. And also I am skeptical or simple. It's like, I don't. That's a lot of pressure you're putting on yourself. I don't know if that's gonna work. And it's not because I don't believe in you.
- [68:10]
A
It's just, yeah, it's a minefield waiting to happen. It's, you know, literally all or nothing. Taking that hair and then being very, very aware of when it starts coming in, that you can just see the potential for someone feeling really overcome by their shame and failure if and when they do pick. Yeah, I mean, it's interesting. One of the first times I talked about BFRBS on the show was with Dr. Suzanne Mountain Onom and had just heard her at a conference and had reached out and asked if she'd be on the show. And she was talking about this idea that if I don't do something and it needs to be extreme or my loved one is gonna be bullied, let's say a kid in school that might have a bald spot or might have a sore scab or scar, even infections, et cetera. And one of the points she made was, and I found this helpful Even outside of BFRBs, in terms of conceptualizing, we can't prevent that from happening. They can't prevent themselves from being bullied, let alone us. Preventing them from being bullied and putting that kind of pressure on ourselves is so immense. But what to do if and when they are being bullied, ways to cope with it, strategies to help manage those tricky situations. That is so much more helpful than preventing the bad thing from ever happening because a. You can't, you can't prevent somebody, especially in, you know, kids. Kids can be dicks. I just, you know, I'm just saying.
- [69:46]
C
It so I don't work with them.
- [69:49]
A
And you know, it's because I. One of the things I was thinking about, I have a son in middle school and you know, bullying just, you know, even if you're really well liked kid, you're going to get bullied at some point. But how do we want to respond to it? You know, there are lots of responses we can have and some of them might feel really good in the immediate aftermath, but it also might lead to more complications. And we talk about it and I was just thinking, I wonder if this could work. Even as we think about BFRBs. When I talk to him about it, I encourage him to think of it like an uno game. There's usually a lot of different cards you can play, but what is the point? Why are you playing the card you are? Were you just like, I had a lot of cards and it's the beginning of the hand and it doesn't really matter. Are you thinking about, I need to save this for when we're all down to just a couple cards left. And then there's going to be some natural consequences to using your draw four or your wild now versus later, right? And so with BFRBs, too, being able to go, okay, my brain is going to have this need and my body is going to have this need. And so there are different ways. And sometimes it's going to be picking or polling or my bfrb, whatever that might be, and insert yours fam. And that might be the card that's played. But were there other options? Did we realize that we needed a blue card and there was another option, or we could trade it for the number. And this is getting pretty zoomed into, I guess, an Uno and analogy. But I think about it and just realizing, like, there are different tools and sometimes there's multiple options that you can do, but certain ones are going to leave you feeling later on and other ones are going to help you feel empowered to play the best hand you can. And even then, sometimes it's luck. There's no guarantee, right? Because you don't know what other cards are being played in life. And so thinking even of BFRBs in that way of sometimes there's multiple ways to meet the need, right now, we're in the habit of meeting the need this way because that is accessible, it travels with you. It's something we have access to. And so being able to understand again, that communication and being able to feel empowered that I can choose to play different cards or I can choose to play this one, I can. And feeling some hope in that is huge.
- [72:19]
C
Nicole, what I love about that deep dive into Uno, right, It's not like the reminder of I do enjoy a good card game, right? It's not just the, like, I've got multiple choices in my hand. There's a whole game that's being played here, right? It's zooming out of this moment that feels so intolerable and so painful and I don't know what to do with it, right? Like, oh, wait, there's so much more here too. If we can get just a little bit of space, yeah, we can see the situation for what it is a little bit more and just get a bit more grounding in what's going on, even when it sucks.
- [72:52]
A
Yeah, I like that because there's. You can play more than one hand, and also, sometimes you're gonna win and sometimes you're gonna lose. And we're not sitting there, like, beating ourselves up at night, hopefully, about losing the UNO game. We're just like, yeah, I see how that happened. I understand it. And am I ever gonna play again? Probably. Especially if you're a therapist listening, you're probably gonna play a game of uno if you've worked with kids at all. So. But, yeah, I mean, it is helpful to see not only within the hand you're playing, but just the hand in retrospect of the bigger game. And again, we don't know what other people's hands or what life's other circumstances are gonna throw at us, and that's okay. That doesn't mean we can't play the game. It means it might not go the way we anticipate, or we might do really well with it. But it's. It's a little bit of that trial and error as well, and going, okay, is this working for me? Is this not because, you know, you were talking earlier, Jason, about if somebody's like, this worked for me, and you can be like, hey, it didn't work for me, but hopeful that it works for you. There's also that piece to BFRB that makes it unique in. In that sometimes our needs are going to change. So that might have helped last time, but this time it won't because your need was different and it all looked very similar, but it was a different need. So even finding a tool that works for you doesn't mean it's going to work every single time. You got to understand what is the underlying need. And what's helpful is when you don't have to guess, but you start to understand that communication. It's kind of like your dad with that low fuel light of. He had a good kind of system set up with his odometer to try and kind of help compensate for it. But ultimately, it doesn't mean he's never, ever going to run out of fuel or that there might be some things that he needs to reconsider at some point in time. So I think that is. It's a helpful analogy for thinking about it. And I'm glad you brought that up.
- [74:55]
B
Yeah, I mean, my mind's going in, like, eight different directions based on just what you said, but one memory I have is I attended this, like, peer support group, like, virtually on Zoom. I think it might have been Lauren's Picking me foundation, definitely. You should check out that organization. And I remember being in this. It's kind of this, like, confidential online zoom space that's free. You can, you know, people can show up all around the world, all ages, all genders. And I remember it was one of my first meetings and. And I was in this group and there was a little kid showing up. Like, I think they were like 10 or 12. Honestly, I don't know how they found the group, but, like, amazing. And they were sharing. They were like, hi, everyone. Like, blah, blah, I'm calling in. I'm 12 years old. I picked my skin. I'm really ashamed of it. Like, I get bullied at school. I do get bullied at school about it. I'm really scared. I don't know what to do. I just found the. My mom helped me find this online community, like, six months ago. Oh, my gosh. You know, like, everyone around the room's like, oh, like, feel for you, kid. Dang, we're here for you. And then this woman chimed in. She. She came off mute and she was like, hey, thank you for sharing. Thank you for being here. You are 12. I am 62. I am 50 years older than you. You know, you learned you had this skin picking thing a few months ago. I only Learned what a BFRB was last week. You know, you are 12. You're. You're scared because you're starting your journey. I'm 62. I'm scared. I'm starting this journey. And if anything, she's like, I'm proud of you. You are so much farther ahead than where I am because I am just coming to learn this now. And I think that is, like, the power of community, and that is the power of, like, be mindful of, like, where people are on their journey, what challenges they're showing up with. You know, like, if you're in school, maybe your math test is causing you to pick your skin. Okay, great. And maybe that's like getting a math tutor. But when you're 62 and you're stressed and you're picking your skin, it's not because of the math test anymore.
- [77:05]
A
Right.
- [77:06]
B
You know, it's totally something else.
- [77:08]
A
Right.
- [77:09]
B
But yeah, like, I think that's just this earlier thread that we were having about the Uno game of it's a long journey and the mentality isn't, okay, I'm going to shave my head and in one year, this is my magical year of curing my bfrb and I'll be solved. It's like, no, it's like a, it's a journey of a lifetime. You go on every single day. And that's, it's, that's almost like the timescale of it. And I find that helpful, like, you know, kind of linking in, thinking about wanting like more tangible strategies. Like, I feel like maybe if you're a therapist supporting a client, like, I think that kind of like timescale perspective is helpful to sort of reduce the minute to minute urgency of like, hey, this week we talked about all these strategies. Next week you're going to try them out and we're going to cure it. You know, and then the next week comes and you're like, how did it go? And I relapse. And it's like, oh, no, that energy is different from how did it go. It's like I relapse. It's like, yeah, that makes sense. The thing's gonna help.
- [78:13]
A
Yeah, no, it's such a good point. It's such a good point. I'm thinking of a client too, where, you know, some of those gains are hard to feel. But when we looked at, okay, some of the, the goals that you wanted to be able to do were to reduce this or you did it less. Wow, look, look at you. You did that. You did that. It still brings up a lot of pain, I think, for, for people when, especially when they're earlier on in that journey, but maybe have been in that journey for decades, like you're saying, right? But having that self compassion of like, oh my gosh, you know what though, realistically, I'm not gonna ever be able to just stop, stop. And that was a win for me and being able to celebrate that win. And that's why also having a therapist that understands BFRBS is going to be huge in helping with that process. Right, Lisa? Because so many people, even if they've been living with it for decades, you might go like, how did you not know you had a thing you've been picking for decades? Well, there's a lot of ways that we don't know that this is even a thing that we can get more industry and hope around. So could you speak to that maybe a little bit, Lisa?
- [79:26]
C
Oh, totally. One of my favorite things to do is speaking about doing trainings around like every doctor I see for anything. Like, have we heard about bfrbs? I could be in the middle of seeing my gyno, my eye doctor, an esthetician, my primate. Right. Like, I'm talking to everybody about it. So that we do spread awareness. Yeah. Right. And usually I get a like, huh, that's interesting. Or like, oh, I know someone who at the eye doctor didn't have any eyebrows. Right. But didn't know what to say. Like, here's the cool thing, you don't have to fix it. Right. And it could be that they, you know, we just have something for IOCDF or other kind of promotional materials for awareness building groups. Should people be interested. Right. Because the idea around. Let's spread awareness. Let's talk about this this again. Broader scope of the the UNO games, like for the listener. I have snarky cross stitches in my office a lot and one of them that is not up right now is afgo, which is another effing growth opportunity over and over and over again. That could be for the person who's whose BFRB played broke down. All right, what do we take from it again? Like Jason was talking about, it shifts from like, oh man, we. You're really solid on that to like, okay, yep, that happens. All right, what do we want to do? Not to just watertight fix it, but to try next time. Take that thing UNO gain. Take that same plan and put in the hands of a loved one who's like, oh, I stumbled into that conversation in a really lousy way. Or is like, hey, I heard this podcast episode. I thought you might be curious. Or the loved one with a BFRB is like, hey, it would really help if you handed me that fidget that I like and it works a couple of times and the next time. So I was like, right, we don't have the perfect way of coping with our own stuff of supporting someone else. But we have so many opportunities to keep. Right. And that is so valuable to keep in perspective too.
- [81:19]
A
I like afgo. I. I might have.
- [81:22]
C
Oh, it's one of my favorites.
- [81:23]
A
I might borrow that one. And I love to say ingest quite a bit. Like, yes, let's cross stitch that on a pillow. So the fact that you actually have cross stitches, I can see them, y'.
- [81:34]
C
All.
- [81:34]
A
There's on your office walls. Afgo, that is. That is so good.
- [81:39]
C
It just like the low fuel, right? It's shifting the relationship to that experience. It's not a failure. Like, my clients will like, if they say failure, I'll like, like, there's a twit. Like, I heard what I said. I didn't mean failure. I meant like we're trying again. Right. And yet the semantics of that are important or the all or nothing that signals is important and so we can hold those experiences more lightly. Yeah, right now we can do something different.
- [82:04]
A
That's what we call the F word in our home.
- [82:06]
B
Failure.
- [82:07]
A
Yeah, like, you use the F word and that's, you know, quarter in the jar.
- [82:12]
B
Another place that I draw inspiration from is, like, kind of thinking about people in, like, the. The queer community, you know, like, people navigating their sexuality. And in many ways, like, I feel like it's. It's a similar experience, like, kind of navigating neurodivergence. It's like there's a process of coming out and there's a process of denial and there's a process of like, ah, I. I don't want. I don't want to be gay. Like, that it makes life so much harder. Like, it's so much more complicated. Why can't I just be straight? Like, it's just easier. Like, I just wish I could be straight. And then, you know, you. You go on like, oh, okay, like, I can't change this. And here it is what it is. But then getting to this point, I was talking to a gay friend once, and he. He said to me, he's like, you know, Jason, the process of coming out, it's like, it's not a one and done. It's a continual. You always have to do it. Like, it's okay. I came out to my mom and, you know, it was tough for her at the start, but now she got it and blah, blah, blah. And then Kate's ready to tell dad. Now you come up to your dad and blah, blah, blah. And then you come up to your friends, and then you come up to your co workers, and then you come up to your boss and then you blah, blah, blah. And then 30 years later, there's some uncle at a wedding that you haven't seen, and then they ask like, oh, so are you dating any girls? And it's like, oh, my gosh, I have to come up to this guy too now. Like, what the heck? You felt like, the journey doesn't stop. And in the same way, like, I think that's the BFRB journey too. And the, like, the. The multitude of growth opportunities that there are available, it's just like, yeah, every single interaction in life, like, it is a lens upon which you experience the world. Like, you know, if you're in the queer community, everything is channeled through your experience of your sexuality. And it's just how you are a being in. In relation to the world. And I think similar. You know, in a. In a weird way, it's same when you struggle with your Mental health like that. It's like, okay, everything is sort of filtered through this lens of like, yeah, I have a bfrb. I'm constantly managing. Is this going to cause me to pick? Do I have a bad picking episode? Who knows? If they see me picking, are they going to be like, stop that or I need to have a conversation with this person now. Like, hey, have a bfrb. This is what it means, you know. Yeah, it can be exhausting in that way. But that's why it's important to have the right pace to approach the situation. Like you can't bang it out urgently. Just like come out to your whole family and one Thanksgiving weekend and expect it to be done.
- [84:58]
A
Yeah, well. And having, knowing that you have safety and being able to do that in that pacing as well. You know, I think about that process and I appreciate you speaking to that is similar for those in the autistic community trying to unmask around different people and really kind of be their authentic self. But it is this constant pressure to feel like I need to express, explain why and within different intersections. And I think it's such a helpful analogy of just thinking about how something core, no matter how you identify being able to be like, okay, how do I integrate this? But you also have to recognize that societally certain things are not going to be safe or accepted and you want to make sure that you are with safe people that are going to also meet you with loving kindness and curiosity as well. And so being able to share something about BFRB being part of who you are, it's, it's, it's foundational and it's part of how your brain just processes information. Your brain is your brain and your brain gives you lots of beautiful things and in ways as you described, even in the Low Fuel Light video, you can even learn to appreciate what BFRB is telling you and how it's communicating needs back to you. I wonder too, Jason, if you'd be willing, as you were sharing with the family earlier that you are Chinese Canadian, were there some cultural pieces that you experienced? I know it can be different within family, but also just within ethnic culture. Would you mind me asking how that cultural piece has impacted you and your understanding of your bfrb?
- [86:46]
B
Yeah, I mean, Nicole, this is another two hour conversation, but to give like a high level some initial thoughts. I guess that's what I'll say. Here's, here's some initial thoughts. Yeah, it, it is like kind of what I was just saying about like the sexuality piece of like it is a filter upon which you funnel. You channel your whole experience. Like, in the same way. My BFRB is that in the same way I'm, like, Chinese Canadian also. It just runs through that, like, immediately when people meet me. It's what they recognize. Like, oh, Jason, you're, you know, you're Asian. And they interact with me differently because of that. And I think my. You know, I've had to fight against that. That upset me. Oh, people underestimate me. They assume, blah, blah, blah. And so I need to work hard now. I need to overachieve. Am I good at math? Do people seem mad at me? Blah, blah, blah. You know, all of that, the. The. The kind of societal pressures of that and almost channeling that through my BFRB is like, okay, well, yeah, maybe, like, people have these assumptions of me and that make me upset, but I feel, like, repressed. Like, I don't have the. The. The language or the power. The. The social capital to kind of, like, be authentic in that way. And so I feel like that is one way my BFRB shows up is like, it is my way of kind of, like, coping. And just like, yeah, this is my experience. And it's. I'm not gonna say it's bad, but it has its challenges. And so one way that I kind of express that is through my skin picking, not having, like, the language. I think being, like, second gen, like, an immigrant kid, I don't always have, like, the closest relationship with my parents. Like, it's just. There's a language gap, and they don't really know me. Like, there's an emotional distance that is neither of our faults. It's just we've had different experiences. Like, they've had to go through the process of immigration. That's crazy. That's something I will never understand.
- [88:58]
A
Right.
- [88:59]
B
But I had to go through the process of assimilation. Like, I had to, like, learn how to fit in with all the white kids, and they're like ham and cheese sandwiches. Like, my parents didn't need to learn how to do that, but I did. And so to me, in a way. But the emotional distance, now my parents, you know, there's like, a loneliness there. I don't know. Again, there's just so many elements. Yeah. Of that. That kind of, like, channel through my skin picking. And it is a way of coping and dealing and, like. Yeah. Just kind of being in the world, I guess. Yeah.
- [89:31]
A
Yeah.
- [89:31]
C
Well.
- [89:32]
A
And going back then, to understanding how the BFRB is meeting the need, that's really an important need to understand, like, to be like, hey, I want to just be. I feel like sometimes I have to fight to exist, just to assimilate or be a part of the crowd, even to fade into this crowd. Because as a kid who wants to stand out, right? They're all like, don't look at me, right? And so having your BFRB be something that could be a source of comfort, could be a source of, you're here, of regulation for nerves, for, you know, fill in the blank and realizing that it is helping you feel visible, feel a sense of belonging, helping keep you afloat in this really difficult landscape. I think that's a huge point and I really appreciate you speaking to it because I think a lot of people, I mean people listen from all over the world, but whether you're immigrating between two other countries or coming here to us or parents did that, 0.51, you know, second generation, all these different things. It's like, yes, you have your culture, but then you realize like your family's culture is so different than your culture and then your, if you have kids someday, your kids culture is going to be so different. Just in the process of assimilating to this new environment. And so it is, it's a very complex thing to understand how BFRBs are meeting our needs, but it's also really sacred in a way to find out how BFRBs are meeting our needs and to not shame the need. Like this need are important. Those needs are there for a reason. And so I think I really appreciate that.
- [91:23]
C
Beautifully said.
- [91:24]
A
So real quick as we wrap up here, this has been wonderful. And yes, I think there's many things that could be full episodes, but I know we were going to think about maybe some practical things that family members, loved ones can say when they encounter now with this information really present for us all, if you walk in and you see somebody engaging in their bfrb, say it's cheek chewing or pulling at their lips or picking skin or pulling hair. What are some strategies that people can say to their loved ones who are battling a bfrb? To be supportive and for it to be more productive and heard than to feel stigmatizing or shaming.
- [92:12]
B
Yeah, I mean, yeah, we're gonna keep on riding this UNO thing, but I'm glad. I find, yeah, I find a helpful separation is to be like, there's the speaking to the person in the moment. Like you and me talking right now. Nicole, Lisa, like we're kind of lucid, we're, we're clear minded. We can have this conversation. But when the, the urge to pick sets in, it It's a different reality, you know, it's a different part of the brain and that's not a problem solving brain. So when a parent comes into the room and is like stop, like it maybe it's like, ah, like what can.
- [92:52]
C
I do to help you stop right now?
- [92:54]
B
I don't know right now. Like this part of my brain, I don't even know then. And I'm certainly not going to figure it out in the moment when you catch me red handed.
- [93:03]
C
Right.
- [93:04]
B
So I think again, this is another whole conversation but making space for when we approach someone, it's like, hey, I noticed the other night that I saw you picking. Next time I see you do that, could we maybe brainstorm like what I what would be helpful for you in that moment? The time to have that conversation is not in the middle of the picking episode. And I think that's sort of one line of separation is like come up with your game plan beforehand. Yelling at me to stop doesn't help. Maybe it could be a gentle squeeze. Maybe you could hand me the fidget. Maybe what would be helpful is just ignore it. I'm going through my own thing. I need to figure it out for myself. Just go to the other room. It's a combination of all those clippings. But you're gonna figure it out like between the two people. Yeah.
- [93:54]
A
Yeah.
- [93:54]
C
I love that idea of asking permission to have the conversation. Yeah.
- [93:58]
A
Right.
- [93:58]
C
Hey, could we talk about this? Yeah. And maybe not now, but later. All simple and not at that moment. And the idea of like you don't come up with a perfect plan. Like I'll often have loved ones working with college students. Like parents will join a session and we'll talk about like what's something you could say or do and it's not going to hit the mark every time. Even we both agree, eyes on of like the kid and the parent of like, yeah, that's what I want you to do. It doesn't mean it's perfect. Right. And yet the space of here are things you can do, including thank you for paying for my treatment or I don't want to work on this right now. Leave me alone. Right. Okay, then that's the parent recognizing it's not telling them. Okay, you don't get to say anything. They're telling you, I don't want to work on this with you. And so something I heard once about parenting was instead of thinking they're giving me a hard time, they're having a hard time. This is a hard time.
- [94:50]
A
Yeah.
- [94:50]
C
And so here's where we're at right now. Can we keep those lines of communication?
- [94:54]
A
Yeah.
- [94:55]
C
Because it is hard.
- [94:56]
A
Yeah. I already know you guys are going to cringe as I tell you this example, but I had, and I can't even remember client personalized. Somebody came up to me and said, yeah, you know, this person was struggling with pulling eyelashes and all sorts of hair. But like, at this point all the eyelashes are gone and they were kind of emerging towards teenagehood. And so the mom was like, well, if you don't do that, I'll get you this really nice mascara. See, they are, they're cringing. They'll get you this really nice mascara that this influencer uses and they get ready together and they show it in the video and stuff. And I too was like. And it was one of those things of, you know, first of all, could that person at that point do that? No, they don't want to have no eyelashes either. But now, B, they're going to feel shame and they're going to feel even more pressure. And every time they get into their value driven like, let's get ready for work together videos, they're going to be reminded of how much they are mad at themselves for pulling their eyelashes. And so again, we can often see the intent to be helpful. But here's the beautiful part. You don't have to be a mind reader. Isn't that great news? You don't so so much of this anticipating what's going to be incentivizing or motivating or whatever. Maybe just ask your loved one. And again, not in the moment, but when brains are calm and we can use kind of more of our wise mind and no response and say what would be helpful. Sometimes the kid or the partner is already like, oh shit, you walked in and you caught me. I already know this. Right? So that was reinforcing enough. They don't want anything else said. Hey, that's fair. That's fair. They're learning to monitor. They're learning to see what they need. And then maybe later they can go, you know, what I would really like is because I'm afraid I'm failing you, if you just came over and gave me a little squeeze on the shoulder. Because then I know, like we're in this together that you're supporting me. But it's not the lecture, it's the loving reminder of, you know, we're going to get through this. And boy, doesn't that feel and sit differently even to me as we're, as we're talking than experiencing the alternative. So really being able to ask them what they need, not having to be the mind reader. And thank God, because we've got enough on our own plates, we don't have to imagine what other people secretly need or feel or this or that.
- [97:34]
C
Let's just.
- [97:35]
A
Let's talk.
- [97:36]
C
Afgos for all.
- [97:37]
A
Afgos for all. I love it. Okay, well, thank you so much to both of you for just. I feel like the time went so fast, but it was wonderful to hear and to talk with you guys about different strategies, different dynamics that can happen for folks within BFRBs and for their family members, but most of all, for hope that there's a lot of hope and there can actually be beautiful warmth. And if you do listen to that video again, going to be linked over on this episode's blog@ocdfamilypodcast.com, you'll hear the warmth in Jason's voice even. It's just. It's striking and it's empowering. And thank you for everything both of you are doing for the broader community to raise awareness, education and hope.
- [98:25]
B
Yeah, thanks, Nicole. It's so fun. Again, there's like eight hours more of discussion to be had. So just for anyone listening out there, thank you for the opportunity and yeah, like, good luck on your journey. Just wishing you the best.
- [98:40]
A
Yes, you've got this.
- [98:42]
C
So happy to be here. So enjoyed this conversation. And one thing to note is Jason, I actually training partners along with two of our colleagues, Katherine and Pam. So we love working with therapists who are learning how to work with BFRBs. We can always learn and grow. And so anytime I get to hang with Jason, I'm stoked. Like, Nicole, you're a delight. Right? So this is great.
- [99:01]
A
I love it. Yes, thank you both.
- [99:04]
C
So great to see.
- [99:04]
A
Thanks, Nicole, in terms of thoughts. Alrighty. A huge thanks to Jason and Lisa for sharing and being so open and helping us really understand the nuance and the reality of BFRBs. And if you're curious to learn more about them or to catch that Low Fuel light video again, the links are going to be over on OCD family podcast.com just look for this episode's blog. But as we enter into our Intrusive Thought segment, which is my application segment of each show, I just want to remind us that little tagline that I've said if you've been around for a hot minute now, fam, you've heard me say it before, but it rings true. Whether we're talking about OCD or this ocrd when in doubt, let's zoom out. Lisa I might have to cross stitch that on my own pillow. But seriously, we can love the heart and intention around what we're doing. We also can be curious and learn about the function of why our actions, our behaviors are functioning the way they are. And when we zoom out, we can see the forest through the trees. We can see how this is digging into maybe our functioning or our enjoyment and value driven, driven activities. And if we don't know how to make sense of that, that's okay. Help is available. But have you ever heard of the sign? And maybe you've seen it around different maybe child care facilities or schools where it's like, hey, a dysregulated parent or a dysregulated adult cannot regulate a dysregulated child. Why is that? Because we're all like, meh, things are hard. So whether you're thinking about for your loved one or maybe even just for yourself, this is hard. Maybe where we need to start is by zooming out and taking a breath. What do we need to regulate ourselves? And is our need as simple as maybe just needing a drink of water or getting that math tutor? Or is our need to feel present and able to live authentically in our own skin? Whether that's with a bfrb, with our identity, with our ethnicity, any intersection, let's be curious together and let's remember that we don't have to do it alone. Whether it's that 12 year old going, you know what, I'm scared but I'm here. Or the 62 year old going, gosh, I'm proud of you. And maybe even a little jealous that you get to have this insight and awareness even at 12. Don't get me wrong, it doesn't mean it's an easy ride for that 12 year old. But knowing is half the battle. Recognizing is half the battle. Add some curiosity to that and we have a really good recipe for hope. So thanks again Jason and Lisa. And hey, I hope this was helpful learning for you family because we are better together. Thank you for joining me and our OCD Family community. If you enjoyed what you heard today, please like and subscribe to the OCD Family Podcast wherever you enjoy. Enjoy your podcast. Did you find this content helpful? Please consider leaving a review. The more people that know they're not alone, the better. For more information regarding today's podcast, please visit OCD familypodcast.com and remember to join the email list while you're there. It will provide you with the most up to date information, resources and the download on the family chatter. Oh yeah, nothing says family like Jason. Like Lisa and me talking BFRBs. That's right, I went there and you can too@ocdfamilypodcast.com hey practitioners, if you're looking to deepen your understanding of obsessive compulsive related disorders, check out the OCD Training School's amazing course catalog on emetophobia, what to do when you have co occurring eating disorders and OCD, and process based therapy for BFRBs. Plus tons of OCD trainings and self help courses. Add that many of the trainings are apa, aswb and NBCC CE eligible with both live and on demand options. I mean say less. So head on over to ocdfamilypodcast.com courses to learn more because when you use my special link, you will be supporting the POD at no extra cost to you. So let's get to learning family because we are better together.