Pathological skin picking, or dermatillomania, is a body-focused repetitive behavior that remains underexplored in psychological research, particularly with respect to subjective lived experience. Existing studies predominantly emphasize neurobiological and behavioral accounts, while the affective meanings and personal narratives surrounding the symptom have been insufficiently addressed.
From a psychoanalytic perspective, self-inflicting behaviors such as skin picking may be understood as unconscious attempts to regulate overwhelming affect. When symbolization fails, unrepresented pain is enacted on the body. In this sense, skin picking may function both as an expression of unmet psychic needs and as a somatic means of regulation in the absence of symbolic mediation.
The present preliminary study aimed to capture how individuals themselves describe skin picking, using secondary data from publicly available YouTube videos in which people shared their experiences in search of community. A qualitative approach was chosen to allow access to authentic, unfiltered accounts that may be difficult to elicit in clinical settings, thereby offering unique insight into the lived experience of the symptom. Thematic analysis was selected for its flexibility in identifying and interpreting recurring patterns across narratives while remaining grounded in participants' language. Six videos were selected for relevance, featuring women aged 25-50.
Three overarching themes were identified: (1) Affective and Experiential Cycle: Including trance-like states, numbness, craving, satisfaction, guilt, and shame; (2) Social Perceptions and Stigma: Including secrecy, misunderstanding, bullying, and the search for recognition; and (3) Impact on Life and Coping Strategies: Including sensory triggers, avoidance, functional disruption, and paradoxical relief.
By foregrounding subjective experience and situating it within a psychoanalytic frame, this study addresses a gap in the literature and provides a foundation for subsequent qualitative inquiry. These findings may inform the design of semi-structured interview questions, thereby contributing to a deeper clinical understanding of skin picking.