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The problem with picking: Permittance, escape and shame in problematic skin picking
Author(s) -
Anderson Suzy,
Clarke Victoria,
Thomas Zoe
Publication year - 2023
Publication title -
psychology and psychotherapy: theory, research and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.102
H-Index - 62
eISSN - 2044-8341
pISSN - 1476-0835
DOI - 10.1111/papt.12427
Subject(s) - shame , distress , psychology , feeling , qualitative research , psychosocial , thematic analysis , phenomenology (philosophy) , cognition , interpretative phenomenological analysis , perspective (graphical) , psychotherapist , social psychology , clinical psychology , psychiatry , social science , philosophy , epistemology , sociology , artificial intelligence , computer science
Objectives Problematic skin picking (SP) is a poorly understood experience characterised by a drive to pick the skin and related psychosocial impact. In the DSM‐5, problematic SP is classified as ‘excoriation (skin picking) disorder’. The aim of this article is to present a rare qualitative perspective on the lived experience of problematic SP, prioritising participants' voices and sense‐making. Design An in‐depth qualitative study of individuals who self‐identified as picking their skin problematically and experienced related distress. Methods Seventeen UK‐based participants were recruited online and interviewed about their SP. Participants were given choice of interview modality, including instant messenger platforms, telephone, email and Skype , to maximise comfort and improve the accessibility of the study. Transcripts were analysed using thematic analysis. Results Three themes offering novel insight into the phenomenology of participants' SP are highlighted and explored: (1) how cognitions and circumstances drove and permitted SP, (2) how participants ‘zoned out’ while SP and the escape or relief that this attentional experience offered and (3) participants' feelings of shame and distress in how they felt their SP may appear to others. Conclusions This study contributes in‐depth and novel ideas to the understanding of SP phenomenology and identifies how environmental factors, cognitions, contextual distress and shame may be considerations in therapeutic intervention. It presents the complexity of SP sense‐making and demonstrates the need for individual formulation.