People over the years have asked me to help them with all sorts of different habits, and they’re often reassured when I can tell them that they won’t be the first person I’ve seen who’s struggling with their particular problem. In Cliff’s* case though whilst I’d seen plenty of people doing what he was talking about he was the first person to ask me to help them stop.
In fact research has shown that 9 out of 10 of us will admit to the same habit that Cliff had when we’re sure our answer is in confidence, but otherwise most of us will deny that we do it. If we see other people doing it we’ll disapprove, and if we’re spotted doing it we’ll be ashamed. What habit am I talking about? Nose-picking, or to give it its technical name rhinotillexomania.
Strictly speaking nose-picking only becomes rhinotillexomania when it becomes a constant or repetitive habit that can be regarded in the same way as an obsessive-compulsive disorder (OCD). Whilst Cliff wasn’t at this stage he also had the habits of pulling hairs out of his nose (a form of trichotillomania) and mucophagy – I’ll let you look that one up.
In fact what might seem a fairly minor habit was causing Cliff some real problems. Firstly there were his frequent nosebleeds, which his GP had diagnosed as being caused by his constant nose-picking. Secondly his nose was becoming more and more irritated, catching him up in a cycle of nose-picking triggering the irritation and the irritation triggering the nose-picking. Finally there was the effect on his relationships – people at work had complained about his constant nose picking, and it had caused upset when he’d done it at social occasions, including meals and dates.
Cliff did try to justify his habit by referring to some medical opinion that says that it can help to boost the immune system as it responds to and attacks weakened bacteria. However he quickly conceded that this was a justification after the event, and played no part in his reasons for his nose-picking. In fact his constantly irritated and bleeding nose was at greater risk of infection, especially from whatever might be on his fingers, and infection in the “danger triangle” (the corners of the mouth to the bridge of the nose) can lead to brain infection.
So when Cliff asked me for help I wanted to be able to help him, but I was truthful in saying that he was the first person who’d asked my help with nose-picking. Talking to him though it became clear that I’d tackled all of the triggers and behaviours with other people – soothing the irritation to stop the trigger for nose-picking; helping people control unconscious habits with their hands; and helping people with unconscious repetitive eating.
We used a number of different techniques to help Cliff get past his habit. To help with the irritation we used a similar technique to people with psoriasis to teach him to hold the outside of his nose and feel the inside go cold and numb. To help with the nose-picking we used the same route as with nail-biting (onychophagia), and made his hands moving near his nose progressively more uncomfortable; and for the mucophagy (really, you’ll have to look it up) Cliff chose to see himself as another person would, and use those reactions to stop him.
Cliff’s habit was ingrained over decades, and whilst he still sometimes reverts to it when he’s really stressed by and large he no longer does it. People at work have noticed the difference, and so has Cliff on the last couple of evenings out with friends.
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*Cliff’s real identity has been protected, and he is happy to share his story.