Body-focused repetitive behaviors: the specifics of the examination and tactics of cognitive behavioral therapy.

Abstract

The article describes clinical manifestations of repetitive traumatic behavior directed (focused) on the body or skin picking disorder. The spectrum of forms of repetitive traumatic behavior directed at the body is detailed. A diagnostic algorithm and a psychological approach to the assessment and initial treatment of psychosocial stressors in this group of patients are proposed. The general tactics of treatment are presented, and emphasis is placed on the specifics of cognitive behavioral therapy (CBT) for repetitive traumatic behavior directed at one's own body, as well as its effectiveness and limitations. It is shown that the «classical» CBT protocol (for example, habit change training, habituation, attention management, stimulus control) is an insufficient tactic of psychotherapeutic treatment, because it is unable to help the patient cope with internal experiences and emotional dysregulation. In this regard, it is recommended to use a multimodal protocol with an emphasis on metacognitive features of perception of the situation, regulation of impulsivity, maladaptive perfectionism and minimization of empirical avoidance of one's own experiences.