Monday, February 6, 2012

Habit reversal: The hyperactive monkey records scratching events

Today, as the first part of an effort to reduce the frequency of obsessive scratching that contributes to my problems with eczema, I counted the number of times that I scratched throughout the day--every motion, whether a light skin brush or a deep nail dig, that I made to relieve an itch or satisfy a nervous compulsion.

My method was hardly high-tech. I made marks on the back of a business card. (Possibly the most practical use I have made of one.) In fact I made so many marks by noontime (254) that I ran out of space and had to start a second one.
A highly scientific data collection method.
These are separate events. Wow, I knew I had an issue with this but I wasn't aware I scratched so often. And that's the point of this stage of the habit-reversal process: to become aware of the scratching, so you can make a conscious effort to recognize the motion and stop it.

Usually, from what I gather, patients use some sort of clicking device instead of making marks. I bet that you could go further and use a smart device that records the time of each scratch. That way you could see when intense bouts of scratching occur through the day, and link them to triggers, and perhaps deal with issues psychologically.

Also best would be an initial step to record scratching events that the patient is not aware are being recorded. All day today I have gone through this thought process:
  1. unconscious urge to scratch
  2. motion to scratch
  3. realization that I'm doing it
  4. stop! Don't do it!
  5. no! It's OK to do it and record it!
  6. scratch. oh yeah.
  7. repeat
Even marking the stuff down is weird. You can see that instead of making marks in some places I have written down numbers. I did this when I couldn't use a pen and had to keep track in my head--like when I was changing the kids' diapers, or riding the subway, or talking to someone in the office.

I'm glad that I only have to do this once at the start and once later on. It's really interfering with getting work done.

Several things are interesting. For example, the number of times I sneakily merge a scratch with a motion that would otherwise seem natural, such as smoothing my hair (or what's left of it). Also, the vast majority of scratch entries so far correspond to nervous touching of my face and head.

What an interesting process. Even better if the psychological training works and I can stop looking like a hyperactive monkey.

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