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Anxiety is the sole cause of BFRBs.

Almost everyone with a BFRB reports pulling/picking at least some of the time when they are feeling anxious or stressed, however a host of other emotions, beliefs, sensations, and habitual triggers are also reported. The goal of therapy is to understand the internal and external triggers that lead a person to engage in their BFRB, as well as the internal and external events that reinforce them (make them more likely to happen again in the future). For some people with a BFRB, anxiety management skills are a key focus of treatment, while for others it is not a part of treatment at all. The key to good treatment is understanding what is driving the behavior for that person, and then offering interventions to address those unique drivers. Treatment for BFRBs is tailor-made to the individual and should be customized to the needs of the presenting person.