Exploring Interoception and Affective Touch: A Fresh Look at Skin-Picking Disorder

Update The Intricate Link Between Skin-Picking Disorder and Interoception For many, skin serves merely as the body's boundary, a protective layer separating us from the external world. Yet, for those battling body-focused repetitive behaviors (BFRBs) such as skin-picking disorder (SPD), the skin transforms into a battleground of emotional conflict. SPD, part of the obsessive–compulsive spectrum, involves compulsive picking that damages skin and causes significant emotional distress, affecting an estimated 2-5% of the global population. This article explores the intricacies of interoception—our ability to perceive internal bodily signals—and how it connects to SPD, while highlighting the role of affective touch in emotional regulation. What is Interoception? Interoception encompasses the physiological signals that our bodies generate, including sensations like heartbeat, tension, and discomfort. Recent research suggests that these internal signals play a crucial role in emotional regulation. People with SPD often feel profound urges or discomfort before an episode of skin-picking, experiencing relief afterward. This dynamic invites investigations into how interoception might contribute to these behaviors and their management. Emerging Evidence from Recent Research A systematic review by Kłosowska et al. (2025) highlights the nascent yet compelling evidence linking interoceptive processes and skin-picking disorder. The review reports findings from nine studies involving 1,338 participants, predominantly women aged between 23 and 34. Notably, individuals with SPD exhibited significantly lower cardiac interoceptive accuracy compared to healthy controls, highlighting potential disturbances in how they perceive their internal bodily states. These disruptions suggest a connection to the emotional turmoil often accompanying SPD. Affective Touch: Calming the Storm? The concept of affective touch, specifically C-tactile touch, emerges as a fascinating frontier in understanding SPD. Research indicates that this type of touch can have calming effects, which could aid in emotional regulation. In experiments, individuals with SPD rated affective touch as less pleasant and more arousing, relating it to a heightened urge to engage in skin-picking. This dual response underscores the complexity of touch and sensory experiences in coping strategies for people with SPD. Implications for Treatment and Self-Care While current evidence is preliminary, it opens potential pathways for therapeutic strategies. Clinicians may find it beneficial to assess bodily cues and sensations alongside traditional mental health evaluations. This exploration could enhance self-awareness in clients with SPD, helping them identify triggers and implement tailored coping mechanisms designed to address their emotional regulation challenges. Additionally, therapies emphasizing gentle sensory experiences might integrate concepts derived from affective touch research, paving the way for innovative treatment options. Addressing Common Misunderstandings About SPD Despite being often dismissed as mere ‘bad habits’, skin-picking behaviors are much more complex. They are linked to deeper emotional struggles and deserve recognition and empathy. Understanding the underlying factors, including disruption in interoceptive processes, is crucial for effective support and intervention. The Road Ahead: Future Directions in Research The findings from the systematic review indicate a crucial need for further investigation into interoception’s role in skin-picking disorders. As researchers continue to delve deeper, we may uncover valuable insights that can lead to effective interventions tailored to those struggling with SPD. Emphasis should be placed on developing an expanded framework that examines sensory processing, emotional regulation, and their intersection with bodily behaviors. A Call to Empathy and Understanding While the body’s role in BFRBs remains underexplored, what is becoming clear is the importance of approaching these behaviors with sensitivity. Providing support that emphasizes understanding personal experiences can foster better treatment outcomes and help individuals feel safe and connected. As these insights unfold, it is essential for those affected by skin-picking disorder not to hesitate in seeking help. Empathy, compassion, and informed discussions can create a safer space for healing. In closing, as research progresses, we anticipate significant advancements in how interoception and affective touch therapies can guide effective treatments for skin-picking disorder. The journey from understanding to healing is ongoing, but by harnessing these concepts, we can transform lives and alleviate distress.