The strong-willed decision “I won’t pick again” never works, and NOT because you are somehow weak and not strong-willed. But because there are certain mechanisms of addictive behavior that are sometimes stronger than our prefrontal cortex. According to modern concepts, neurotransmitter systems occupy an important place in the pathophysiology of both behavioral and chemical addictions. A lack of dopamine leads to a search for substances or activities that release dopamine and create a feeling of pleasure, creating a dopamine loop. Also, small and tolerable physical pain, when repeated many times, becomes pleasure (this is due to the production of opiates, which should neutralize pain). Accordingly, the habit is easily and quickly reinforced, forming strong neural connections. We resort to the same learned way of acting and behavior, which becomes automatic - because the person does not have another, alternative and conscious way of behavior (for example, how else to cope with stress / how else to get pleasure / how else to satisfy the need that I am trying to satisfy with a compulsive action / habit). And the more often a person engages in this behavior, the stronger and stronger the neural connections that form it become. Like a beaten path that people constantly walk on. After all, it’s easier and more convenient than trampling out a new one (which requires resources, strength, motivation). Attempts to quit by force of will are ineffective. The more you forbid it, the faster you will break. In addition, this is a path to the formation of learned helplessness. It is important to give the brain the experience of victory and reward so that motivation appears. That is, create conditions under which you get a small victory. What else prevents you from quitting? Secondary benefits. They are always there and they are rarely realized. But for some reason we need any behavior. Or it was necessary once upon a time. Almost always, dermatillomania allows you to relieve internal tension caused by internal conflict. One of the parties to this conflict is usually not recognized, the conflict is not resolved and the tension grows. With dermatillomania, we can feed, for example, the inner demon (aka the Critic) - symbolic self-punishment. Or an inner perfectionist. Or comfort the vulnerable child within. Or perhaps it gives vent to aggression as a charge that must be somehow discharged, but a person knows how to discharge it only about himself. Or is it a reason to hide from the world. It happens that picking is an unconscious way of atonement for guilt (I am guilty of..., I am punishing myself). Again, these benefits are often impossible to see without therapy; they are hidden in the unconscious and are very individual. What will help in working with dermatillomania? Below are some specific therapeutic steps: Keeping a habit tracker, where you can mark days without picking or set goals to gradually reduce picking, can be helpful here. For example, if the goal of 1 day without picking is not yet realistic for you, set yourself to pick 3 times a day instead of 6. Goals should be feasible and appropriate specifically for you. Think in advance about the list of rewards with which you will thank yourself when you achieve the goal. Remember that ban doesn't work. The brain must understand that picking is possible. But, let's say, not today :) and for this not today he will receive something cool! The principle as with Pavlov's dogs remains unchanged. 2. Describing the emotional experiences in our lives improves physical and mental health. Keeping a diary of emotions will allow you to focus your attention on your inner world and experiences, increase your awareness, see WIDER and deeper yourself, and not just focus on thoughts about picking. Write about pleasures and desires.3. What inspires you? Sources of inspiration for change? What is important is the emotional connection with your desired future, the image of you without a habit, what are you going to? what do you want to become? Draw, describe, immerse yourself in this. 18+