Angela Hartlin has a long history with excoriation (skin-picking) disorder (also called dermatillomania). You may be familiar with her story, but if not, the disorder had a grip on her life from a young age. During her teens and into her early twenties, she’d pick her skin up to eight hours a night, and, for a long time, she didn’t think recovery for her body-focused repetitive behaviour (BFRB) was possible.

“I knew my case was severe,” she says. “I thought I was too complicated and damaged for help.”

It wasn’t just these emotional barriers that made her think recovery from her skin picking wasn’t possible, however. As a Nova Scotian, there isn’t a lot of help for BFRBs like skin picking out that way in general and there’s no specialized help. She says she’d accepted that her severe skin picking struggles would just be the way things were.

That is until the television show The Doctors reached out with the offer to come on the show and meet someone who could help. That someone was Karen Pickett, LMFT, who took Hartlin through a combination of Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT), both of which are popular and effective treatment methods for BFRBs.

As she went through the treatment process with Pickett, it changed Hartlin’s perspective on skin picking recovery.

“Getting results made me believe!” she notes. “The deepest desires of my teenage self came true.”

After working with Pickett, she says her legs and face were clear of red spots and picking for the first time since she was in her pre-teen and early teen years.

Addressing and managing her skin picking meant coming at it from multiple angles. She used CBT logging sheets to track her skin picking and identify triggers, used body-scanning and breathing techniques to address her anxiety, challenged cognitive distortions, and learned about the connection between emotions and biology. Each of these has helped her find the recovery that she craved growing up.

That’s not to say her recovery came without its challenges. Apart from the initial barriers she faced, once she was full swing in her recovery process, a series of different things threatened to derail it. From trauma to chronic physical pain to sleep deprivation to becoming a mom just weeks before the first lockdown for the COVID-19 pandemic, things were anything but smooth.

Despite all that, Hartlin says, “I am proud that I never regressed back to ‘pick sessions’ again.”

She says although her recovery wavers, she’s about 85%-95% better than she was before therapy because now she has the tools to address and walk away from skin picking urges. Another thing that keeps her going through all this is thinking about what others would give for the opportunity she had.

“So many people would have taken my place to enjoy a trip to Los Angeles and meet a highly acclaimed BFRB expert on television. No matter how many times I slip up, I try again because I have skills that others didn’t get the chance to learn because I was given this opportunity.”

It’s true, Hartlin had an extraordinary opportunity that many with BFRBs will never know. With those extraordinary factors, it may seem like BFRB recovery is only in reach for a lucky few, but that’s not the case.

Instead of looking at her story as that of someone who went on a television show, look at it from the perspective of someone who struggled greatly and what able find the tools to succeed. Hartlin’s story is a reminder that even if you feel too broken or come up against great challenges, BFRB recovery is possible.

You might not have an opportunity like she did to go on a television show, but there are steps you can take to start your own BFRB recovery, such as going through the Canadian BFRB Support Network’s list of treatment providers or the TLC Foundation for BFRBs’ database. If you’re not ready for that leap or there are things preventing you from connecting with a professional, there are other ways to approach recovery.

“Being in the larger BFRB community has helped reduce the shame associated with my picking and appearance,” Hartlin says.

She adds that support groups are a great chance to share your experiences while learning tools and skills from others on how to manage your BFRB. Getting involved with BFRB organizations like CBSN also helps.

“You are not alone and don’t have to suffer in silence.”

Angela Hartlin is a Canadian mental health advocate. She’s the author of the book FOREVER MARKED: A Dermatillomania Diary and the subject of the documentary Scars of Shame. Her upcoming book with Karen Picket, LMFT, EMRACING DERMATILLOMANIA: Through Pain & Recovery, will share her learnings and step-by-step process to recovery. Hartlin also runs skinpickingsupport.com.