Decoupling is a behavioral self-help intervention developed for body-focused and related behaviors (

DSM-5 The ''Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition'' (DSM-5), is the 2013 update to the ''Diagnostic and Statistical Manual of Mental Disorders'', the taxonomic and diagnostic tool published by the American Psychiatric ...

) such as

trichotillomania Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. A brief positive feeling may occur as hair is remov ...

, onychophagia (

nail biting Nail biting, also known as onychophagy or onychophagia (or even erroneously onyhophagia), is an oral compulsive habit of biting one's fingernails. It is sometimes described as a parafunctional activity, the common use of the mouth for an activit ...

), skin picking and lip-cheek biting. The user is instructed to modify the original dysfunctional behavioral path by performing a counter-movement shortly before completing the

self-injurious behavior Self-harm is intentional behavior that is considered harmful to oneself. This is most commonly regarded as direct injury of one's own skin tissues usually without a suicidal intention. Other terms such as cutting, self-injury and self-mutilati ...

(e.g. biting nails, picking skin, pulling hair). This is intended to trigger an irritation, which enables the person to detect and stop the

compulsive behavior Compulsive behavior is defined as performing an action persistently and repetitively. Compulsive behaviors could be an attempt to make obsessions go away. The act is usually a small, restricted and repetitive behavior, yet not disturbing in a pa ...

at an early stage. A systematic review from 2012 showed the efficacy of decoupling, which was corroborated by Lee et al. {{Cite journal, last1=Lee, first1=Melissa T., last2=Mpavaenda, first2=Davis N., last3=Fineberg, first3=Naomi A., date=2019-04-24, title=Habit Reversal Therapy in Obsessive Compulsive Related Disorders: A Systematic Review of the Evidence and CONSORT Evaluation of Randomized Controlled Trials, journal=Frontiers in Behavioral Neuroscience, volume=13, pages=79, doi=10.3389/fnbeh.2019.00079, issn=1662-5153, pmc=6491945, pmid=31105537, doi-access=free in 2019. Whether or not the technique is superior to other behavioral interventions such as

habit reversal training Habit reversal training (HRT) is a "multicomponent behavioral treatment package originally developed to address a wide variety of repetitive behavior disorders". Behavioral disorders treated with HRT include tics, trichotillomania, nail biting, th ...

awaits to be tested.

References

External links

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Decoupling – A Technique to Reduce Hair Pulling (Trichotillomania) and Nail Biting
, a free manual Psychotherapies Body-focused repetitive behavior