How to Overcome Onychophagia
Compulsive nail biters tend to hide their hands and avoid social contact as much as possible. They feel depressed and shamed by their disorder which then causes major problems with their work, relationships, and daily life. Like all other obsessive-compulsive spectrum disorders, this one also requires treatment.
Antidepressants or SSRIs, typically used to treat other obsessive compulsive spectrum disorders, can bring about improvement in nail-biting behavior. However, they may take up to several weeks before they begin to work and so are not particularly effective unless accompanied by psychotherapy.
Cognitive-behavior therapy is the most effective psychotherapeutic treatment option used for compulsive nail biting and it involves habit reversal training.
The first part of HRT is self-monitoring and it aims to help the individual become aware of the problem itself. For this purpose, self-monitoring sheets are given to the patient and he/she is asked to keep a log of when the episodes occur,how long they last, how strong the urge was to bite the nails, and what they were doing that may have triggered the compulsive behavior.
The second stage involves learning progressive muscle relaxation, typically by listening to taped instructions. The technique aims to improve the focus of the individual and to reduce his/her tension.
Once the progressive muscle relaxation is learnt, the individual is taught diaphragmatic breathing to help them achieve a relaxed state. It also helps the individual to become more aware and alert to the sensations that he/she is experiencing at a given point in time.
HRT also involves stimulus control which aims at identifying and avoiding or changing the circumstances or moods that cause the nail biting OCD.
Another therapeutic technique known as Competing Response aims to provide an alternative to nail-biting. So, the individual may be encouraged to keep their hands busy by performing other activities such as knitting or beading or satisfy their urge to chew with chewing gums.