A critic’s picks

I’m going to dive right in to something I’ve been contemplating writing about for a long time but haven’t had the courage. Because it’s embarrassing and gross. And I tend to only want to write about embarrassing, gross things in past tense with a dollop of self-deprecating humor once I’ve safely moved on.

But this is a present-tense thing I’m struggling with and it’s not over yet. I know some others caught in this cycle too and they know the cyclical frustration and ecstasy involved in it.

I’m a skin picker. Have been all my life. Lately it’s worse than ever and I’ve finally had that moment where I’ve decided that I have to fix it, have to do whatever it takes to stop, because it’s spiraling and it’s stressful, and I know it’s indicative of a deeper problem.

I’m putting this after a jump because I think it might get long. And gross.

2009. This is actually fairly mild compared to some other bouts.

Picker’s Paradise: A Timeline

For as long as I can remember, I have had a constant urge to bite my nails. I would nibble them down to the quick and then keep going. They would bleed and scab up and I would bite and rip off the scabs and the process would start all over. My fingers would throb with pain and sometimes I could barely use my hands, but I couldn’t stop. Half the time I didn’t even know I was doing it. My family would scold me for biting and it would hurt my feelings sometimes because I wasn’t even trying to bite. They told me it was a nervous habit and tried to recommend all kinds of remedies (including foul-tasting nail polish) to relieve me of it. My hands just found their way to my mouth without my conscious brain getting involved and if someone said “stop biting!” to me, I would realize how badly I wanted to bite and then the urge to bite was overwhelming.

As an adolescent and teen, I discovered these bumps on my upper arms that I thought were pimples. I was so incredibly embarrassed by them that I refused to wear sleeveless shirts. In retrospect they weren’t that big of a deal and I should have worn sleeveless shirts as long as possible before I grew fatty mom wings on my underarms, but you know how small problems seem supersized to the adolescent. I was convinced that these bumps needed to be eradicated. So I set about trying to pop them every night. I found over time that my favorite tool to do so, because I had no fingernails to use, was a mechanical pencil — the kind with the little metal bit right where the lead comes out. I could press it into my skin and make the bad stuff ooze out of each pore. Doing so felt victorious and I would do so until my arms were red and swollen with circular indentations where the pencil had been pressed. Which only made me more ashamed, of course. But it felt necessary, like if I didn’t fight that battle that the bumps would win. Plus, once I got started picking at them, I couldn’t stop.

My face fared better for the most part. My dad had horrible teenage acne so I really lucked out by having fairly clear skin throughout my school years when others were struggling with those hard red lumps on their faces that looked so painful. I did like to lean in to the mirror, however, and keep tabs on my nose pores every day. I got blackheads on and around my nose that were small and fairly unobtrusive. But once I saw them, I couldn’t stop thinking about them and how they didn’t belong there. I needed to get that crap out of me. Of course, I had gnawed-up fingers and pushing them against anything was very painful. So I would just open up one of those metal hair barrettes and use the rounded clasp end to press at an angle into my pores, releasing little blooms of pus and infection.

I felt like I was doing important work, cleaning up my dirty pores. I didn’t understand, though, why a day later they would be clogged back up. So I just had to keep evicting that mess day after day.

At some point in high school I expanded my (arguably) normal habit of tweezing stray eyebrow hairs and began overtweezing the brow area adjacent to my nose. I also — for some reason I have absolutely no recollection of — began tweezing a patch of hair right in the center of the hairline along my forehead, at the base of my part. I guess I thought it looked funny, or maybe there were broken hairs there causing weird flyaways. I could be sort of obsessive about my hair lying flat in those days. So I just removed the rogue hairs at the source. When I got an ingrown underarm hair, I tweezed it out. And then figured I could prevent ingrown hairs by going ahead and tweezing all the other hairs under there that I could get to. (I was wrong.)

In college, I got so sick of being a nail biter and how it made people look at me that I stopped biting my nails. Just sort of went cold turkey. I always had one longish pinky fingernail (I have no idea why, and no I did not use it for a cocaine habit) and one day I decided to see if I could get the others to catch up. It took a couple of weeks but I felt emancipated from the longest-running bad habit I had ever had. And I didn’t even have to take up smoking to do it.

Breaking free of nail biting created a new problem, however. As my nails grew out and strengthened, they became tools for me to use to indulge my need to pick. If I felt a little flake of skin or cuticle that was about to slough off, I would do my body the favor of going ahead and taking care of it and pulling it off. Often I pulled too much or created an imbalance between the thickness of my cuticle on one side of my nail vs. the other side. So I would pick at the thick side and pull it off to even it up. I would run my fingers over my fingernails to feel for these little opportunities and set about pulling and picking at my skin until, sometimes, I would feel a sudden wetness on my fingers and realize that I had pulled something from a little too deep and I was bleeding everywhere. Then I would have to wrap up my fingers in tissue and wait for the bleeding to stop. Sometimes I’d accidentally get blood on my clothes or on the paper I was writing on. But those spots would scab up and create future picking opportunities.

My poor thumbs got the brunt of my abuse. I would peel the skin back slowly and when it came off clean in a large sheet, it would give me this sick little thrill. I would sometimes get the skin peeled back down to the first knuckle, on the bottom or sides of my thumb. The spots where that skin had been removed would be so red and painful that when I would bend my thumb, it would sting like fire. When I washed my hands or got anything slightly salty or acidic on them, it would bring me nearly to tears.

I broke my brow/hairline tweezing habit a few years ago. My eyebrows looked a little awkward for several weeks as the new hair grew in, but now my brows look so much better. The hairline issue was a little trickier. I had to have short, straight bangs cut all the way across so that the new hair could grow in underneath them. Otherwise it would have been completely obvious that a patch of new hair was growing in at the base of my part. Taking the tweezers to my armpits is something I still have to fight the urge to do. I still sometimes lose.

The past couple of years, I have focused my most intense picking on my upper arms, using my fingernails to dig in, which leaves moon-shaped scabs that turn dark as the redness leaves and they try to heal. My right arm tends to get most of my attention, as its affected area is larger and therefore there’s more damage I can do. It’s an awful cycle, and the area I pick has spread up onto my shoulder, where there are fingernail-shaped scars in tiny rows. My skin tends to darken after injury, which is why a mosquito bite that I scratch can leave a dark and slow-to-fade circle on me for five years. Last summer I noticed a few bumps on forearms and compulsively squeezed them, delighted when they popped. They left behind very dark marks that have yet to begin to fade. I tried to put concealer on them at first but now I just sort of have to live with them until they go away.

I’ve relapsed a bit on the nail biting. I will go a while without biting (painting my nails helps encourage this) and sometimes even leave my cuticles alone. But then sometimes I will get one tiny hangnail and the urge to get it off with my teeth is too much. I will bite that nail down to the quick, sometimes accidentally while trying to achieve a smooth nail edge. And then once one nail is bitten, I find a reason to bite another. Then another. And I start to think of my bitten and unbitten nails as a ratio. Four out of ten nails are still OK, I’ll tell myself. That’s not a bad ratio. But sometimes I bite them all down and then keep going on the soft flesh in the nail bed, gnawing at it like some kind of dog trying to get at food through a fence. Then the pain of what I’ve done sets in. Mentally first: Why did you do this, you idiot? You knew better. Then physically: The throb and ache of ten injured fingers. The inability to tightly grasp anything or put my hand into my purse without wincing at all the things my raw fingers have to scrape against to get to my keys. The sting of soap. They way people look at chewed-up fingers and calculate what that must mean about the person who has them.

Picking and Not Grinning

In the past couple of years, I have educated myself a little bit about what is going on with me.

I have a few interconnected issues: Some Keratosis Pilaris (the upper-arm bumps) mixed with dermatillomania, with some mild trichotillomania thrown in.

Arm bumps: Keratosis Pilaris is fairly common, and it’s hereditary. It’s the little bumps on the upper arm and upper thigh, formed when keratin, a skin protein, plugs a hair follicle. I know lots of people with it and most of them just ignore it and it is fairly innocuous. The people who do not ignore it and who pick at it exacerbate it to the point where it is much more prominent than it would otherwise be, drawing even more attention to an area they were already sensitive about.

Skin picking, nail biting/nail and cuticle decimation: Dermatillomania is currently classified as a sub-category of obsessive-compulsive disorder in the DSM-V. It’s defined as “repetitive and compulsive picking of skin which results in tissue damage.”

Hair plucking: Trichotillomania is recognized is the DSM-V as an impulse-control disorder in which a person cannot control the desire to pull out his or her own hair.

The trichotillomania I may or may not have is extremely mild compared to the dermatillomania, so I am somewhat hesitant to even use the technical term for it or even identify as someone who suffers from it. Still, I have done some damage to my skin because of vigorous plucking, and I did have to work to get over the urge to excessively pluck hair in spots I would instantly feel ashamed of plucking. So I think it belongs somewhere on the spectrum.

These are the clinical names of my tormentors.

Just the other day I was at work having an actual conversation with one of my team members, giving him some instruction on how to proceed through an issue. Down by my sides, my middle fingernail was busily scraping and picking at a scabbed cuticle on my thumb. Suddenly something felt slippery and I looked down and I was bleeding everywhere, and I had to excuse myself to go get a tissue to wrap around my injury. I went through two or three tissues before the bleeding stopped. It was humiliating, and I didn’t even really know that I was doing it.

Just stop

Throughout my life, my closest family members who have noticed the nail biting and the cuticle picking have admonished me to stop. Any time someone would ask me why I would hurt myself in this way and I would respond that I didn’t even know, they would ask, “Well, why don’t you just stop?” And, yeah, obviously I would do that if it were that easy. But people who don’t have this constant hum of compulsion animating their subconscious don’t understand the need to bite/pick the same way I don’t have any understanding of the need to smoke a cigarette. I just don’t fucking get it and I never will.

I recently discovered Stop Picking on Me, a site for pickers that attempts to help them admit to their addiction and begin healing and overcoming it by silencing their critical, violent selves and overcoming the self-loathing that is at the root of the problem by working on developing healthy stress coping mechanisms.

It’s no secret or surprise to anyone who knows me that the past few years of my life have been stressful. I tend to carry the weight of the world on my shoulders sometimes, even when no one else expects me to. I battle depression and anxiety and mania and feelings of worthlessness like every other person with bipolar in the family. I might tweet or blog sad or angry things periodically sometimes but I do most of my suffering in private in my own head. And when it gets really bad, I take it out on myself (sometimes without even realizing it) because ultimately I blame myself for all the shitty things in my life. I pick when I get deep in thought or when I feel rejected, which happens a fucking lot. When I have a problem to work through (basically every day) there is nothing more satisfying than zoning out and “working” through my skin problems while I let my brain mull solutions to my real problems. Obviously I am spinning my wheels in every possible way.

It’s not self harm in the same way that cutting is. Picking is more about control and falling into a bad habit that might have started out in a way that was meant to be constructive but that becomes a compulsion where you are constantly trying to solve a problem you don’t think your body can. Flaked cuticle? Let me fix that. Bump on my chin? Let me fix that? Clogged pore? Let me fix that. My stupid body made this problem so it can’t be trusted to fix it so I will hurt myself in the service of making myself better. It is like a scavenger hunt, finding all the tiny flaws on your body you can “fix.”

All the while I am just making it worse. It’s almost wonderfully poetic, in a way that is only really beautiful in art but not in real life.

Here’s a fun cycle:

When I bite my nails off, I can’t pick at my arms. So my fingers hurt like bastards but my arms get a break. Once those nails come back in, though, I’m back in the saddle and my nails look OK but my arms are constantly under attack. The circle of life?

I went to a dermatologist the other day to see about my arms. He basically told me there’s nothing he can do for me and that I need to get a shrink. And then I paid him $50 for the 40-minute wait and the five-minute conversation. And that was my answer: No one can help me but me. Well, OK, a psychiatrist could probably help me but I am way too broke for that. I have to fix this myself.

Part of the healing process involves admitting to the problem. That is this post. Here is my confession, so now we can all stop feeling weird about all those times you (yes, you!) looked at my arms and wondered what the fuck. It’s interesting and sweet how polite everyone is about this problem. No one really asks me what’s up because they know I am sensitive and I’d get all bent out of shape at the thought of someone looking at me and wondering why I am disfigured. But I still know people are looking because I see them. I feel them looking.

I don’t know why this problem got started when I was younger. I grew up in a stable home with loving parents, but I was a pushover. Always sensitive, always wanting to please, always hyperperfectionist. Adults told me I was my own biggest critic. I wonder how I let that part of me get away from me and develop into a self-saboteur rather than a natural check on mediocrity.

I’m not happy with where I am right now in a lot of ways and I increasingly take that out on myself in ways that sort of surprise and horrify me. I have a long way to go before I will heal completely and I feel pretty lost right now. I mean, I’m telling the fucking internet my dark, gross secret. Why? I don’t know. Why not?

Right now as I am writing this — and this has taken me several days — I can’t stop running my fingers over this one spot on my right pointer finger where the skin is rough from trying to heal where I had ripped it off a few days ago. I want to get my teeth on it and yank but I won’t. I have to start stopping some time and this has to be the time. It might last a finger, it might last a day, it might last a year. But I have to take the first step.