What is the root of a compulsion? Example: nailbiting

January 19, 2015 7:13 PM

There are tons of suggestions on how to stop nail-biting on metafilter, but they all seem to coincide with the idea that to stop a compulsive habit, one must replace it with another habit.

Example: If you want to stop nail biting, bite carrots or chew gum instead. But these don't get to the root of the problem because once you get rid of the gum or carrots, there your nails are again. I'm using nail biting as an example, but it could be anything. If you're just replacing one compulsion with another, then you're just alleviating the symptom rather than curing the compulsion isn't that so? So how does one get to the root of a compulsive habit thereby eliminating the need to replace it with something else? Or have scientists not figured out how to do this yet?

posted by rancher to Health & Fitness (13 answers total)

I bit my nails daily for about 25 years then stopped cold turkey one day. I was told to stop doing it by many medical professionals, but the one day I chipped a tooth while biting a nail was the last time I ever touched my teeth to my nails ever again.

I'm not suggesting you keep doing a thing until it harms you, but if you know you are doing harm and could stop it today and prevent a harmful side-effect, might that be enough to reduce or eliminate the behavior? If someone would have told me I'd break a tooth someday, I'm pretty sure I would have stopped or at least cut down significantly.
posted by mathowie at 7:34 PM on January 19, 2015

I agree. Why replace one habit with another? Why not simply extinguish the habit altogether? That's what I did when I stopped smoking years ago. No gum or anything else as a substitute. Just. Stop.

But the true mystery is, where did that determination come from? I don't know. But I do think there's an inverse relationship between the strength of the initial resolution and the ease of implementation. It's almost if--once you firmly slam shut that door, bar it with chains and padlocks and plates of steel--then you find it easy never to toy with opening it again. But if you just click the door shut or leave it a bit ajar, then you have to keep on revisiting your decision again and again until, finally one day, your willpower is exhausted, you push open the door and walk on through. Seems to me that substituting gum for nail-biting is like keeping the door ajar.

There is some research on how to increase the strength of the initial resolution: Make your decision public, ask others to help you, and promise to pay out a serious amount of money if you fail. But that just pushes the question back one step. How do you get to the point where you're willing to to that?
posted by mono blanco at 7:40 PM on January 19, 2015 [1 favorite]

how does one get to the root of a compulsive habit thereby eliminating the need to replace it with something else? Or have scientists not figured out how to do this yet?

No, doctors are pretty good with medicine and/or therapy that can help with compulsive behaviors depending on what exactly is causing or encouraging the compulsion. I pick at my nails and toes (a "body focused repetitive behavior") a lot less when I am not anxious. My anxiety can be managed with diet, exercise and occasionally with medication. Some people have a lot of luck with CBT that helps redirect the brain from comfort-habits that can include some of these compulsions. ACT is another therapy that works for some people by helping with mindfulness and not acting on compulsive feelings. There are also medications and therapies for OCD-types of obsessive behaviors if it's gotten to that level.

At some level things only are problems if they are problems. So biting your nails might be a problem because you don't like how your nails look or (on preview) you fuck up your teeth. The same things are not issues with carrots or gum. There may be some people who are upset just by having compulsive behavior feelings and not acting on them (and I am not talking about people with diagnosed OCD or other similar medical issues but people who just feel ootchy) but by and large finding appropriate ways to sublimate and/or express them is most of the issue and that can be addressed by behavior modification of the kind you mention.
posted by jessamyn at 7:40 PM on January 19, 2015 [6 favorites]

Not sure if this is exactly the same thing, but: I gave up smoking a pack a day by using patches. While using the patches, I could concentrate on PART of the whole smoking problem (eg: taking breaks from work, being able to drink coffee/drive a car/whatever without immediately lighting up etc). If that part of the compulsion hadn't been alleviated by patches, dealing with the other part of the behaviour would've been much harder.

It's not that I didn't end up dealing with both the nictotine cravings, and also the habits, but I could approach each issue (mostly) seperately.

So for your nails/carrots thing: perhaps while I'm gnawing on a carrot, rather than my nails, I'm getting used to the scenario that I don't chew my nails, without needing to deal (just now) with the idea that I don't just chew things all the time.

Also, I think this:

So how does one get to the root of a compulsive habit thereby eliminating the need to replace it with something else?

...is a bit of a false dichotomy. You can get to the root of the compulsive habit with, or without, the process of replacing it with something else. I'm not saying that just going straight for your ultimate goal can't be done, just that it needn't. Those people who can just say to themselves "That's it, no more nail chewing," and be finished with it, thus obviating any replacement, aren't even worrying about this stuff. They're probably painting their nails right now. The only people who've thought about this replacement approach are those who have not, on first go, sorted this out through simple willpower.
posted by pompomtom at 7:41 PM on January 19, 2015 [4 favorites]

They're probably painting their nails right now

The only way I ever stop biting my nails is by painting them. That's an alternative strategy to substitution: creating an impediment that interrupts the compulsive habit.
posted by ottereroticist at 7:57 PM on January 19, 2015 [3 favorites]

I stopped biting my nails by painting them religiously for a couple of years, and what's interesting to me is how eventually it stopped being a replacement compulsion. The cognitive process for me basically went something like urge to bite nails exists but is blocked by nice painted nails -> urge to bite nails co-exists with urge to paint nails but is also blocked -> urge to bite nails is extinguished, only urge to paint nails remains -> urge to paint nails as a compulsion is largely extinguished, although I do tend to keep mine painted because I like how it looks and I have weak nails that aren't helped by basically banging away at a keyboard all day for a living. What stands out to me is that once I'd spent enough time completely blocked from biting my nails, I stopped wanting to, and how once I got really good at painting my nails and it became effectively automatic and something I could do on auto-pilot without sperging out about it, I stopped having a compulsive urge towards it. I don't know what that suggests about the cognitive process, exactly.
posted by The Master and Margarita Mix at 7:58 PM on January 19, 2015 [6 favorites]

I don't know if this will help answer your question but when I quit biting my nails I made a deal with myself that I could continue to bite my nails but not in the specific way I always bit them. I would catch the side of the nail in between two of my bottom teeth and slowly tear the nail off. Other methods did not "scratch that itch" for me and I stopped that habit. Sometimes I make deals with myself that just don't work at all, I don't know why it did that time.
I also bite and pick at my lips but none of my deals have worked for that one, though sometimes I can quit for a week or two by wearing bandaids on my bottom lip while I'm at home.
Somehow you have to figure out how to short circuit the satisfaction you get from the compulsion.
posted by BoscosMom at 8:09 PM on January 19, 2015

My mother and my grandmother and I all have OCD in varying degrees, and nail biting, hair pulling, and (unfortunately for me) skin fussing are subconscious self soothing mechanisms that manifest when my OCD gets triggered. When I take anxiety medicine, my need to do those things disappears. How's I get a temporary cure? By seeing a doctor and a therapist who helped me learn how to track triggers and treat those.
posted by Hermione Granger at 8:50 PM on January 19, 2015

If you just sit on the floor without any distractions (no phone, no internet, no other people, no hunger, no self talk, no radio, no music, no chewing gum... just you) for at least an hour, you will probably discover what the root of the problem really is. More probably you will jump right out of that situation within 10 minutes and continue with the nail biting. Good luck!
posted by hz37 at 12:46 AM on January 20, 2015 [1 favorite]

So how does one get to the root of a compulsive habit thereby eliminating the need to replace it with something else? Or have scientists not figured out how to do this yet?

Dealing with the effects of a thing isn't the same thing as understanding its cause(s). Nail-biting may be one manifestation of a genetic predisposition to anxiety (aka, maybe, partly, responsiveness to one's environment), among other things, but gene therapy's not on the table (as far as I know). What's addressed are some of the known contributors to maintenance of the behaviour (thoughts, environmental cues, etc.). Ways of addressing it can involve "top-down" things, like applying relaxation techniques to sort of generally calm down, CBT, medication, etc., or "bottom-up" things, like getting regular manicures to get rid of those impossible-to-ignore raggedy bits, or both.

(I chipped two teeth this year from nail-biting, and I think I'm done. I did happen to be warned, but the force was strong in this one.)
posted by cotton dress sock at 6:29 AM on January 20, 2015

This article on attention control talks about how “focus of attention physically determines which synapses in your brain get stronger, and which areas of your cortex physically grow in size. The implications of this provide direct guidance for alteration of behaviors and motivational patterns.”

It also describes a cognitive behavioral therapy technique to practice stopping a habit, without just replacing it with another habit:

You notice that you are biting your nails. You immediately focus your attention on what you are doing, and you stop doing it. No rage, no blaming yourself, no negative emotions. You just stop, and you focus all the attention you can on the act of stopping. You move your arm down, focusing your attention on the act of movement, on the feeling of your arm going down, away from your mouth. That’s it. You can go back to whatever you were doing.

Five minutes later, you notice yourself biting your nails again. You calmly repeat the procedure again.

By doing this, you are training yourself to perform a new behavior – the “stop and put the hand down” behavior – which is itself triggered by the nail-biting behavior.

posted by mbrubeck at 8:15 AM on January 20, 2015 [2 favorites]

I do think there's an inverse relationship between the strength of the initial resolution and the ease of implementation. It's almost if--once you firmly slam shut that door, bar it with chains and padlocks and plates of steel--then you find it easy never to toy with opening it again. But if you just click the door shut or leave it a bit ajar, then you have to keep on revisiting your decision again and again until, finally one day, your willpower is exhausted, you push open the door and walk on through.

I have observed the same pattern. It's the key reason why I initially found intermittent fasting so much more easily achievable than any form of restricted eating.

The unfortunate flip side is that once I did allow myself once to make an excuse to eat on what should have been a fasting day, my chains and padlocks and plates of steel seem to have cracked and I have well and truly exhausted the willpower I was using to try to re-establish them.

So I've now reached the point where trying to work around this kind of bullshit compulsive self-sabotaging perfectionism on my own is shitting me to tears, and my first appointment ever with a therapist is in two weeks. I will be quite interested to find out whether "getting to the root of the problem" is in fact a useful thing to spend time on, or whether it will (as I suspect) come down to learning a handful of proven techniques and then doing them.
posted by flabdablet at 9:15 AM on January 20, 2015

I have been a compulsive nail-biter for almost my entire life, and its really hard to give up, because its an unconscious habit (I can't bite my nails without realising it, and only notice once its too late), plus you can't cut off access to your nails like you can with cigarettes or drugs. I assume the root cause of a habit like nail-biting to be a mixture of general anxiety, and just pure habit. I have given up biting my nails exactly twice in my life, both times I was pregnant. I did not consciously attempt to quite, I just noticed one day that I had long fingernails and realised I hadn't been biting them. I find it simultaneously fascinating that some change in general mental state must have triggered this, as well as depressing because I have no idea how to replicate that without being pregnant all the time.
posted by Joh at 2:53 PM on January 20, 2015