Decoupling for body-focused repetitive behaviors

Decoupling [1] is a self-help technique developed for body-focused and related behaviors (DSM-5) such as trichotillomania, onychophagia (nail biting) and skin picking. The affected person is instructed to modify the original dysfunctional behavioral path by performing a counter-movement shortly before completing the self-injurious behavior (e.g. biting nails). This is intended to trigger an irritation, which enables the person to detect and stop the compulsive behavior at an early stage. A systematic review from 2012 confirmed the efficacy of decoupling [2], which was corroborated by Lee et al. [3] in 2019.

A manual on technique for reduction has been produced in five languages by the University Medical Center Hamburg-Eppendorf's neuropsychology unit.

References
  1. Moritz, Steffen; Rufer, Michael (2011). "Movement decoupling: A self-help intervention for the treatment of trichotillomania". Journal of Behavior Therapy and Experimental Psychiatry. 42 (1): 74–80. doi:10.1016/j.jbtep.2010.07.001. PMID 20674888.
  2. Sarris, Jerome; Camfield, David; Berk, Michael (2012). "Complementary medicine, self-help, and lifestyle interventions for Obsessive Compulsive Disorder (OCD) and the OCD spectrum: A systematic review". Journal of Affective Disorders. 138 (3): 213–221. doi:10.1016/j.jad.2011.04.051. PMID 21620478.
  3. Lee, Melissa T.; Mpavaenda, Davis N.; Fineberg, Naomi A. (2019-04-24). "Habit Reversal Therapy in Obsessive Compulsive Related Disorders: A Systematic Review of the Evidence and CONSORT Evaluation of Randomized Controlled Trials". Frontiers in Behavioral Neuroscience. 13: 79. doi:10.3389/fnbeh.2019.00079. ISSN 1662-5153. PMC 6491945. PMID 31105537.
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