The problem with picking: Permittance, escape and shame in problematic skin picking

Anderson, Susan

Abstract

Problematic skin picking is a poorly understood experience characterised by a drive to repeatedly pick the skin and related psychosocial impact. Researchers have sought to understand and conceptualise this picking through noting its common characteristics, such as qualities of the drive to pick, similarities to other presentations, and its emotional context and sequelae. Qualitative research is lacking in this field, and participants’ voices, insight and meanings are rarely represented. This thesis seeks to explore the lived, subjective experience of people who engage in problematic skin picking, using semi-structured interviews. Participants were given a choice of interview modality in the hope that individual needs and preferences around visibility and exposure might be accommodated. Seventeen interviews were analysed using thematic analysis. The analysis discusses the problem of picking through three overarching themes. These cover the internal ‘voice’ and cognitions that drove and permitted participants’ picking, the phenomenology of ‘zoning out’ and the relief that it offered, and participants’ distress relating to how they felt their picking may be seen or interpreted. Through these overarching themes, the problem of picking is presented as not just one of picking behaviour, but one of contextual emotion and of emotional and social response. This thesis demonstrates the complexity of individual picking sense-making and presents the need to understand individual formulations in order to respond with therapeutic efficacy. It contributes depth and novel ideas to the understanding of picking phenomenology and of the processes that drive and perpetuate picking behaviour. It identifies distress as a central consideration in therapeutic intervention.

• Thesis Type: Thesis
• Deposit Date: Mar 27, 2021
• Publicly Available Date: Jan 24, 2022
• Public URL: https://uwe-repository.worktribe.com/output/7239383
• Award Date: Jan 24, 2022