Skin Picking: The Freedom to Finally Stop – Advance Praise!!!!

Lead by Lizabeth Wesely-Casella; Body by Annette Pasternak, Ph.D.

Skin Picking: The Freedom to Finally Stop – Advance Praise!!!!



Today is a very special treat for me as I am able to share something special with you, my BFRB, Trichotillomania and Dermatillomania sisters and brothers.  I’ve been given the honor of sharing an advance peek of the amazing new book by Annette Pasternak, Ph.D. titled Skin Picking: The Freedom to Finally Stop which is on sale TODAY at Amazon for just $4.99!

When Annette approached me and offered to let me read some advance copy I was beside myself with pride, and then I was hopeful that she’d choose me to spread some of these great words in your direction.

With the advent of 2014 I’ve made it a priority to find more resources, support and the highest quality information to share with you about pulling, picking and shame so getting to start this year on a collaborative foot with Annette, I just know we’re all in for something good!


Annette Pasternak, Ph.D. is a certified Holistic Health Coach, Yoga teacher and Brain Gym® Instructor/Consultant in Los Angeles. Formerly a research scientist, college professor and high school chemistry teacher who struggled for more than two decades with chronic skin picking, Annette is now dedicated to helping others, worldwide, break free from its tenacious grip. Contact Annette through her website at


A key to stopping picking for many of my coaching clients is using a simple yogic breathing technique that I will teach you in this chapter. Pranayama, loosely translated from Sanskrit as “breath control,” is an ancient yogic practice to calm and steady the mind. Used strategically it can be one of our most important tools to stop picking. Pranayama helps to increase our awareness, improves our mood and overall energy level, yet quickly and powerfully calms us when we are overstimulated. Skin pickers tend to have nervous minds, and are easily overloaded sensorially. Not only is the practice of pranayama one of the best ways of calming ourselves when we are agitated and feeling strong urges to pick, it is also excellent as a preventative measure to do regularly once or twice per day. It has been shown in scientific studies to be effective for anxiety and even for acute panic attacks[i] and post-traumatic stress disorder (PTSD)[ii]. It is a healthy simple practice with such profound effects that I wish it would be taught to children in elementary school.

The manner in which we breathe reflects our state of mind. When we are stressed, we breathe shallow quick breaths; when we are relaxed, we breathe long slow deep breaths. Conversely, the manner in which we breathe also greatly affects our state of mind. So in order to relax the mind (and body), all that is necessary is to slow and deepen the breath.[iii] Purposely breathing slowly and deeply is a simple example of pranayama.

In yoga, pranayama is practiced in a cross-legged position, but you can do it in a chair if you are more comfortable. You can even do it standing, if needed, for example, in a crowded subway. The wonderful thing about this technique is that you can do it anywhere to calm down, and nobody will even notice. If you are sitting, sit tall, but comfortably.

The basic methods of pranayama are done by breathing only through the nose, for both the inhale and exhale. The first key to deep breathing in general is to start with an exhale in which you squeeze out as much air as possible; to do this you contract your abdomen in towards your back, squeezing the abdominal muscles in. The next inhale will automatically be deeper. As you inhale, the abdominal expands outward from your body. After the abdomen expands you can expand the ribcage as well to bring in even more breath. Abdominal breathing engages the parasympathetic nervous system, allowing us to get out of a “fight or flight” stress response and relax.

Before going on to the exercise below, be sure you have mastered the simple deep abdominal breathing. Babies naturally breathe as above, but through stress or the desire to hide what we may consider a fat stomach, many of us have acquired a habit of shallow breathing into our chest only, and as we breath in, our abdomen moves inward as the chest moves up and out, and as we exhale our abdomen puffs outward. This pattern is backwards from the natural abdominal breathing explained above. If you are breathing in this reverse manner habitually, even working to change that habit should have a tremendous effect on your energy level and state of mind.

When you are comfortable with deep abdominal breathing (which may be right away or you may want to practice a few rounds a day for a week or so), continue with the following exercise – a counted deep slow breathing with a breath retention and an exhalation that is twice as long as the inhalation.

This ultra-relaxing type of breathing is supercharged in the following three ways to calm you down FAST:

  1. Abdominal expansion – When you puff your belly out on the inhale, proprioceptor nerve cells in the diaphragm, the muscle you use to breathe deeply, send a signal to the brain to relax.
  2. Breath retention – Holding the breath for a few seconds signals the brain to slow down bodily functions like the heart beat and muscle tension, thus relaxing us.
  3. Longer exhales – Slow exhales further relax us.[iv] We also breathe only through the nose, which also forces the breath to be slower and thus, more relaxing. 

Before you begin, notice how your body feels and your state of mental agitation or calm. To begin the exercise (after first squeezing all the air out of the lungs), inhale for a count of four seconds, then retain the breath for a count of eight, and finally exhale for a count of eight. That’s 4-8-8. Then repeat. To begin with, do four repetitions. Notice how you feel afterwards. Remarkably calmer? And in only a minute or so! Also, notice the strength of any urges you felt to pick. Have they lessened? 

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in which I lead you through this exercise (plus you get a free report and more).

If you can discipline yourself to do it, beginning and/or ending the day with this exercise can go a long way, with the calm alertness you feel spilling over into the rest of the day or night. You can work your way up from four rounds to seven, eight or even ten rounds. If you tend to get antsy in the evening, doing the breathing right before dinner might be a good practice for you. Or you can practice it whenever you have a spare minute, sitting at a stoplight, waiting in line, or whenever.

Another great way to use this breathing is when you are having urges to pick, and are in danger of picking. Clasp your hands in your lap (or sit on them if you need to) and make yourself breathe instead. When you are done, if you still feel the urge to pick, you may need to breathe some more. Commonly, my clients tell me something like “The urge went away, but came back a half hour later.” Well, that was a victory! But you know what? You might need to do it again, or do more than four rounds. If you, like many of us, are resistant to “wasting” more time breathing, think of how much time you waste picking, and know that any time invested in calming techniques like this breathing exercise is time well spent.

I know you may be resistant to doing the breathing exercises regularly or especially when you feel like picking. When your body is in that tense state of being about to pick, it is hard to sit still and simply breathe. Yet when you do it, it is extremely effective.

Often the hardest part when you are in that “about to pick” state is remembering to use the tools that help you. Here is the strategy for that: Whenever you remember, whether it is before you would pick, in the middle of picking, or just after a session of picking, do the breathing exercise. Have the intention that you are going to couple breathing and picking together, and you will begin to remember it more easily. The ideal, of course, is to do the exercise before any picking happens, so it will calm you down and prevent you from picking, at least for a while. However, in order to get you to this point, do it after any picking too. Your mind will begin to associate picking with the breathing exercise, and before you know it you will be remembering to breathe before you pick, and eventually it will become a good habit you will use all the time. Eventually you will not need to pick, and you will not need to use the breathing exercise as often, although you may still choose to do it as a healthy, calming daily practice.

[i] Clark, D.M., Salkovskis, P.M., Chalkley, A.J.  “Respiratory control as a treatment for panic attacks,” J Behav There Exp Psychiatry 16(1):23-30 (1985)

[ii] Descilo, T. et al. “Effects of a yoga breath intervention alone and in combination with an exposure therapy for post-traumatic stress disorder and depression in survivors of the 2004 South-East Asia tsunami,” Acta Psychiatr Scand 121(4):289-300 (2010)

[iii] McCaul, K.D., Solomon, S., Holmes, D.S. “Effects of paced respiration and expectations on physiological and psychological responses to threat,” J Pers Soc Psychol 37(4):564-571 (1979)

[iv] Cappo, B.M. and Holmes, D.S. “The utility of prolonged respiratory exhalation for reducing physiological and psychological arousal in non-threatening and threatening situations,” J. Psychosomat. Res 28:265-273 (1984)

1 Comment

  1. 365 tips to stop skin picking, hair pulling and other BFRBs | Stop Skin Picking Coach
    365 tips to stop skin picking, hair pulling and other BFRBs | Stop Skin Picking Coach12-16-2014

    […] Pranayama is easy and can help you stop anxiety, panic, picking or pulling. Learn how and why – an excerpt from my […]

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