struggling with my dermatillomania

I few years ago, I did self-harm a few times, and then I got super into spirituality, and about a year ago, I remembered I did self-harm and ever since haven't been able to shake the guilt off... Constantly, every day, my mind would make me feel guilty about it and think about it all day. It's like my brain knew the thought that I could/ have cut myself scared me, so it kept bringing it up. My family had no idea I had ever done this, so my OCD told me I was a liar for not telling them about every day. I was afraid that they wouldn't love me anymore and send me to a mental hospital if I told them. About 2-3 months ago, I had gotten so fed up with having these thoughts every day and confessed to my mom what I had done, and her reaction was great. And I thought I'd never have thoughts about when I did self-harm again because I finally confessed. I was wrong. Even with people telling me that it's okay, I did that, I can't shake the guilt I had around this event, and even more so the fear/guilt around my own thoughts... My therapist and I talk about how the problem isn't the thoughts but what the OCD does to them. I try to create positive neural pathways, but that just makes me more stressed about it. There are things I'm supposed to tell myself when I feel negative, but I think I get that confused and tell myself those things every time I have thoughts about what I did. Which is feeding into a mental compulsion (replacing every "bad" thought with a "good" one. What works for me is (if I can) do nothing and have the thoughts... It's been hard to get better because I have had no idea what's been happening to me and felt like for the last year I was going crazy... I always thought OCD was cleaning stuff and physical compulsions . Everything that happened to me happened in my head. On the worst days when my OCD is really bad, every single time I was conscious and aware, I was thinking about the fact that I did self-harm. I would lie in bed all day trying to figure out my thoughts because I thought if I watched TV, I would be avoiding important things. I thought I had to figure out all my thoughts. I would ruminate, replay, and second-guess all. day. long. It was hard to recognize it was OCD because I thought I had done something seriously bad and wrong, and that I must deserve these thoughts. I think the trick is that you feel like you must have positive thoughts, and the most distressing thing wasn't necessarily the fact that I did self-harm, but the fact that I couldn't stop thinking about it. I find the best thing you can do is just have all your thoughts in your head and try not to separate them from good and bad, if you can. It's nice to have people who understand!!!! More to come, about the journey. My favorite thing to say when I'm stuck is "that sly devil... OCD. Silly OCD is getting to me right now, but it won't last forever. That sneaky guy tricked me again" Love you!!!

So... I few years ago, I did self-harm a few times, and then I got super into spirituality, and about a year ago, I remembered I did self-harm and ever since haven't been able to shake the guilt off... Constantly, every day, my mind would make me feel guilty about it and think about it all day. It's like my brain knew the thought that I could/ have cut myself scared me, so it kept bringing it up. My family had no idea I had ever done this, so my OCD told me I was a liar for not telling them about every day. I was afraid that they wouldn't love me anymore and send me to a mental hospital if I told them. About 2-3 months ago, I had gotten so fed up with having these thoughts every day and confessed to my mom what I had done, and her reaction was great. And I thought I'd never have thoughts about when I did self-harm again because I finally confessed. I was wrong. Even with people telling me that it's okay, I did that, I can't shake the guilt I had around this event, and even more so the fear/guilt around my own thoughts... My therapist and I talk about how the problem isn't the thoughts but what the OCD does to them. I try to create positive neural pathways, but that just makes me more stressed about it. There are things I'm supposed to tell myself when I feel negative, but I think I get that confused and tell myself those things every time I have thoughts about what I did. Which is feeding into a mental compulsion (replacing every "bad" thought with a "good" one. What works for me is (if I can) do nothing and have the thoughts... It's been hard to get better because I have had no idea what's been happening to me and felt like for the last year I was going crazy... I always thought OCD was cleaning stuff and physical compulsions . Everything that happened to me happened in my head. On the worst days when my OCD is really bad, every single time I was conscious and aware, I was thinking about the fact that I did self-harm. I would lie in bed all day trying to figure out my thoughts because I thought if I watched TV, I would be avoiding important things. I thought I had to figure out all my thoughts. I would ruminate, replay, and second-guess all. day. long. It was hard to do any of the things I loved; OCD took the joy out of it. It was hard to recognize it was OCD because I thought I had done something seriously bad and wrong, and that I must deserve these thoughts. I think the trick is that you feel like you must have positive thoughts, and the most distressing thing wasn't necessarily the fact that I did self-harm, but the fact that I couldn't stop thinking about it. I find the best thing you can do is just have all your thoughts in your head and try not to separate them from good and bad, if you can. It's nice to have people who understand!!!! More to come, about the journey. My favorite thing to say when I'm stuck is "that sly devil... OCD. Silly OCD is getting to me right now, but it won't last forever. That sneaky guy tricked me again." Love you!!!

Hiiii, I’m Sara 💖 and I have Severe OCD 🧠, Severe Excoriation Disorder ✋, ADHD ⚡, GAD 😰, and Major Depressive Disorder 🌧️. I love using emojis if you haven’t noticed lol. To keep this as straightforward as possible I want to focus on the OCD and dermatillomania part today. I hope this can help some people 💬 and maybe give others a better understanding of what it’s like to live with these two issues! ☺️ I have always struggled with skin picking, especially on my face 😔, and it has made my acne worse and caused scarring. 🤕 I did not realize until my therapist told me that it can be connected to OCD. Sometimes I do not even notice I am doing it, and other times I am aware but cannot stop. 😓 For me, the OCD side is often tied to perfectionism or needing that just right feeling. 🫠 From thoroughly washing my face and hands, overusing or meticulously applying products to make sure the “ritual” is done perfectly takes both time and money. To having picking episodes which causes scars to heal slower⏳ and to also leave me with a “pepperoni face” 🍕 from all the red and raw wounds or with widespread hyperpigmentation that lingers for months. Oof 😅 ERP IS A LIFE SAVER!!! 🛟 Addressing that OCD pattern is a big part of ERP, Exposure and Response Prevention 🚪. ERP helps you face the discomfort without picking or fixing, so over time your brain learns the urge does not need to be acted on. 😤 Behold~ another technique, HRT! Habit Reversal Training can still be part of treatment, but timing matters ⏰. If OCD is the main driver, starting HRT too early, especially if it leans on avoiding triggers, can unintentionally strengthen the OCD cycle 🔄. That is why ERP often comes first, and HRT is added later once the compulsion has weakened. 🤗 Skincare time! Oooo la la la 🤭 For wound care 🩹, I keep it simple. When the skin is still open, I use a gentle cleanser 🫧, a moisturizer 💧, and Aquaphor directly on the wound, then keep it covered to protect it from bacteria 🦠 and UV exposure 🌞. Once the wound has closed and turned pink 🌸, I use a gentle cleanser, a moisturizer, a scar cream, and SPF daily to prevent discoloration and help the scar fade. Fidget toys 🪀 do not work for everyone (Ik people who love it 😍), but ERP paired with steady skin care has made the biggest difference for me ✨. If possible, I recommend seeing a dermatologist 🩺 to help heal your skin and give you tools for long term care, and ask directly if they understand skin picking and OCD and will keep that diagnosis in mind while treating you. Progress is absolutely not linear 📉📈. You will have times when you pick or have an episode, even when your skin has been looking great. 😥 That does not mean failure ❌. In OCD, compulsions are rewarded in the moment because anxiety drops after you do them, so the brain learns that the behavior works 🤥. ERP builds new learning that competes with the old habit rather than erasing it, which means stress, hormones, sleep loss, or strong cues can still light up the old pathway at times ⚡. The goal of therapy and strategies is not to create a life with zero urges 🚫, but to help you navigate 🧭 life with OCD by reducing how often urges show up, how intense they feel, and how quickly you recover when they happen. Most important part EVERR 😮‍💨🥰 The most important part of this process is practicing self compassion 💕 and remembering that no one is perfect 🌼. Every lapse is information you can use for the next step forward! 🫂 Thanks for listening to my Ted talk! 😄 (edited) (edited)