Did your Parents cause your skin picking?
My most recent video is a review of a research paper that I find intriguing, titled "Parental Bonding in Trichotillomania and Skin Picking Disorder."
Parenting Styles and Skin Picking Disorder
Skin picking disorder is a complex condition, and its development and persistence can be influenced by various factors. It appears that one of these factors is parenting styles. Let's delve into the details of this study.
The Research:
This study involved an online survey of 184 adults with either skin picking disorder, trichotillomania (hair-pulling disorder), or both. Participants were asked to complete a survey known as the Parental Bonding Instrument (PBI). This survey aimed to measure two crucial aspects of parenting: parental care and parental protection.
Parental care refers to the expression of affection and nurturing.
Parental protection relates to the encouragement of a child to explore their environment and develop independence.
Combining these two aspects results in four distinct parenting styles:
Optimal Bonding Style: High affection and low control, where children receive emotional nurturing and have the freedom to explore.
Affectionless Control: Low affection and high control, indicating a lack of emotional support and an overprotective attitude.
Affectionate Constraint: High affection but moderate control, implying emotional nurturing coupled with some restrictions.
Absent or Weak Bonding: Low affection and low protection, typically due to neglect.
Surprising Findings:
Now, let's talk about the surprising findings of this research. In the general population, optimal bonding is quite prevalent, with an estimated 40-60% of individuals experiencing this parenting style. However, the results for individuals with body-focused repetitive behaviors (BFRBs), especially skin picking disorder, were quite different from what the researchers expected.
The researchers said they expected the highest concentration of parenting to be in the affectionate constraint category, because of the similarity of BFRBs to obsessive compulsive disorder (OCD). However, contrary to their expectations, the research indicated that affectionate constraint was the least common parenting style among individuals with BFRBs. Instead, the majority of parents of these individuals fell into the category of affectionless control. This style is characterized by parents being emotionally unresponsive and exerting control that inhibits their children's independence. Affectionless control (along with absent or weak bonding) is also a top parental style among those with substance abuse disorders and other addictions, exhibiting one way (there are others) in which skin picking disorder may be better classified as a behavioral addiction than under the umbrella of OCD.
How Parenting Styles Affect Individuals with SPD:
The prevalence of the affectionless control parenting style in families dealing with individuals with skin picking disorder has significant implications. Parents with this style may attempt to control their children's behaviors, including their skin picking, even as they grow into adulthood. However, this controlling behavior can hinder the recovery process and create opposition from the affected individuals, who naturally seek independence and autonomy.
I have over the years received many requests from parents of adult children in their twenties inquiring about coaching for their children. I always ask them to have their children contact me directly if they are interested. If the children would not have the initiative to do even that, they are definitely not ready to do the work required to stop picking. The parents usually understand, but sometimes they do not. I’ve even had parents of children well on their way to thirty years old insist that if they don’t do the work to get their child help, the children won’t do it themselves. That extreme attempt at control sets up a dynamic in which the adult child is still trying to assert their independence, which they will do sometimes in reflexive opposition to whatever the parent wants, even if it is against their own best interests.
On a personal level, as someone who has experienced skin picking disorder, I can see echoes of my own experience in this study. My mother, while not as controlling as the extreme examples mentioned in the previous paragraph, would constantly tell me to stop picking, and was much more consistently angry with me rather than kind and supportive (in general, not just regarding the picking). I haven’t taken the parental bonding survey myself, though I'm sure she would fall into the category of affectionless control.
Conclusion:
This research sheds light on the importance of considering the role of parenting styles in understanding and treating skin picking disorder and other body-focused repetitive behaviors. The findings suggest that the prevalent parenting style in families dealing with skin picking disorder is characterized by a lack of emotional support and overprotectiveness. Recognizing the impact of parenting styles can help guide therapy and interventions for individuals with skin picking disorder, ultimately fostering more caring and nurturing environments and promoting independence.