I have compulsively picked my skin since I was 13. I am not sure if that’s new information on this blog or not, although it is a bit more serious than a lot of the content, so apologies for that change in pace. I want to write about my experience with something new I’m trying here, though, because when I first turned to the internet for help kicking this disorder, all I found were anecdotal stories on blogs. And still today, with awareness building and BFRBs gaining steam and support (see: bfrb.org, an average google search, the DSM-officialness of “excorciation disorder”), a lot of what’s out there is still anecdotal and frankly, somewhat limited. People are often somewhat crummy about communicating, particularly around disorder(s) that can carry a lot of shame, and from the limited-attention-span portal of their smartphones. And so: I’m trying this new thing, the HabitAware Keen wearable, and I heard about it casually, in a forum, but also had a bunch of questions I wanted answered casually and nobody had an opinion out there. I’m going to try to fill that gap, through a multi-post reflection/review here.
The Keen is a wearable designed for and targeting the BFRB community. It’s a “smart” bracelet that you train to detect certain body movements, and then it vibrates when it senses those movements are happening. The point is to create awareness right at the perfect moment to retrain the impulse, allowing you to realize you’re doing the behavior (picking/about to pick, in my case) and make a different choice.
Keen caught my eye because the first wearable I heard about people using for picking shocked you. Which, frankly, sounds awful. I imagine I’d have to bully myself into putting on the bracelet(s) in the morning, which for me (and I imagine for many) is a recipe for disaster. While I often want to take a tough-love, punishment-oriented approach to getting myself to do (or not do) things a certain way, I’ve found that kindness, along with very stable consistency, is actually most effective. Even for the worst you-can’t-make-me stuff. …The short idea here is that I really doubted shocking would work, because I didn’t think I could get myself to use the devices in a way that made me feel good about eliminating or reducing the habit. Keen’s vibration seemed a lot better.
That said, I came to Keen just as skeptical. I was (and am, still) skeptical for a few reasons:
- Not all of my picking is subconscious. Sometimes I choose to do it, sometimes I find myself doing it and choose to continue. The whole premise of “make a different choice” seems shaky, because I can always fall back on acknowledging the vibration as that choice-making-point and still choose to pick.
- Keen seems first for hair pulling, and then possibly for nail biting, and then for skin picking. I have doubts about the effectiveness of the device for a behavior I do literally everywhere on my body but my feet, which is a lot more skin to cover (ha) than just areas with hair or my mouth. Keen was built by a trichster (hair puller) and her husband, so it really was first for hair pulling. I say then for nail biting, because a lot of HabitAware’s content online demonstrates via nail biting. I can’t really fault them for it, because I imagine nail biting is one of the easiest things to demo to wide audience that may not really “get” BFRBs, and it (guessing, but it seems likely) might be one of the easiest behaviors to train on the device as well. All of this, though, made me skeptical about what it really could do for picking. I thought about the movements associated when I pick. Many of them are far ranging (running a hand up the length of my arms) or incredibly localized (my arm/wrist doesn’t move really, but fingers do) or involve 2 hands (that classic “pinching the pimple” type movement. I read Keen’s materials, and a device can learn up to 4 movements — that’s a start for me, but it’s not going to cover everything. They also talk some about buying two devices if both hands need monitoring (I paid attention for a few days, and both my hands do), but it doesn’t seem like 2 Keens can work together yet — I can train left for 4 movements and right for 4 movements. But I’d really love one movement to span both hands. Finally, I was also just generally curious and a bit skeptical about precisely how the movements are calculated and detected. Given that people were talking success in their reviews, the algorithm had to be decent, but (particularly working in tech) I knew that how I trained the devices would have a big impact on their effectiveness, so I wanted to really understand how they worked before making the plunge. Because…
- They’re expensive. $150 a pop, and, as mentioned, 2 would be ideal for me. $150 is really reasonable for a wearable, but it’s a lot for something you’re holding a lot of doubts about.
- And finally, I was/am skeptical because nothing has ever really worked. I’ve been in therapy on and off for 15 years. Picking has sometimes been a central focus, other times not. It often feels, anymore, like I’ve tried all the tricks in the book. My most recent approach has mostly been acceptance… this is a thing I do, and it doesn’t need to shatter my world or pull a lot of shame. Sometimes, that’s okay, and picking is okay, and it really is nice not to beat up on myself for it. Other times, acceptance feels like defeat. Accepting the behavior doesn’t make it go away — heck, it doesn’t even really lessen it (even if it can lessen my distress about the behavior). Working towards accepting picking has helped me root out some of that all-or-none perfectionist thinking around it; I no longer am convinced that anything short of never picking again is failure, and that’s awesome. But I would still like to pick less. If nothing else, picking can make it difficult to tell if something’s actually not healing (so my skin-cancerous self should get it checked out) or if I just won’t let it. There are other pieces, though, too. I don’t care so much about the appearance of my skin all summer long anymore, but I do care about having to stand up in a wedding or having to explain the whole mess to a new doctor. I would like to pick less, and while there have been ups and downs, after 15 years, kicking picking feels highly unlikely.
But somehow, I am trying these things now. And I look ridiculous — I already wore a FitBit, so now I have 3 devices across 2 wrists — so it wasn’t a fashion choice. What happened to make me take the plunge?
- I am standing up in a friend’s wedding in a little less than a month. Because my own wedding is in June, I had been saying I’d have to pay attention to where I picked come spring, but it suddenly clicked that I need certain regions of my body cleaned up a lot sooner. Which is tough, particularly with the stress of the holidays.
- Honestly, something that had nothing to do with picking — I realized HabitAware is also based in the Twin Cities, and that I had met the trichster founder at a tech event. When I was on the HabitAware website, I saw her name and thought it looked familiar — in particular because I had looked up this woman’s other venture (which she had told me about when we met) after I got home that night, so she had made an impact. I went back through my stack of collected business cards, looked up her LinkedIn, and sure enough, same woman, different venture. And suddenly buying Keens was something that could maybe help, but even if it didn’t work out, I’d be supporting a local woman in tech. There was some hope around the devices being helpful, but a silver lining if they weren’t, instead of $300 down the drain.
Because I am local, my bracelets arrived super quick. So quick, in fact, that I had received the first email in the email series that ordering a device puts you on, but not the second. The second was about training the devices, and I received it roughly 6 hours after I trained them.
I charged the devices overnight upon getting them. (The instructions in the box said at least 2 hours before training, but it wound up being overnight.) I trained them in the morning. You train them by downloading the app, letting bluetooth find the devices, and then following some prompts on the screen.
Because I sometimes have trouble with my phone and FitBit, I was nervous about the bluetooth connection, but both devices popped right up. I clicked the first one listed, it buzzed one device so I knew which one it was. I specified it was on the left, and went through the training sequence. I trained it for the back of my head — my scalp and shoulders have been subconscious targets at work lately — and it was fast and easy and effective. I tested it out as part of the training sequence, and then I sat there and tested it a few more times. It buzzed. Reliably. It was amazing. I was super impressed.
I leapt into training the second one excitedly, but that didn’t go as well. The pre-training screen tells you to do the action for 15 seconds, the training screen says 20-25, and I knew from training the first brand that the screen itself would change when it got the movement. …But I did the movement for 2 minutes and nothing changed. Heck, my phone fell asleep and I had to wake it up (with my other hand). So I exited out of the training, and the main screen didn’t see that device anymore! The main screen does prompt you, if you don’t see a device, to plug in that device and then unplug it and try again. So I did that. And I repeated this whole not-working-device-disappears cycle about 5 times. I was getting super frustrated. By the 3rd time or so, I could see an uncompleted training in my device’s settings, but I just deleted that (I didn’t know which attempt it had been). I took my FitBit off in case it was interfering, and put it and the other Keen in another room — no luck. Finally, I wondered if maybe the area I was training was part of the problem. I had been trying to train for my shoulder of the same arm, a sort of “scratching the back” type motion, under an “Other” option (the first step in training has you specify a region). I tried training my shoulder opposite of my arm, no go. I switched to chin, and got through the training. But then the device was buzzing nearly constantly! And I was not doing the motion, my hand was just sitting there in my lap. So I deleted that motion and tried for back of the head, since that worked on the other device. Success, for the most part. Close enough to try for the day, anyway, particularly since I was frustrated at this point. I think that had I not been coming at this at least 50% from the let’s-experiment-with-technology standpoint, I would have given up a lot sooner.
So I was set to go for the day! (You’re told to start with just one area.) Things I noticed:
- These things have a LOT of potential to actually be really helpful. This could be a game changer, for sure. They definitely made me aware of things I wasn’t aware of, or of the chance that I could start picking. For example, I’d actually scratch an itch on my head and get a vibration — and this is good, because even though I might not even being checking out my skin yet, scratching often turns into picking. Other times, I would actually be looking to pick, either totally aware or partly aware, and — this is the simplest little feature but really matters — the bracelet continues to send you vibrations. I can’t tell you the number of times someone would say to me, “Hey, you’re picking” and I would shrug it off or do it anyway or even get mad — people checking your behavior have emotions and often stop checking your behavior based on the emotions you present them with in return. The device doesn’t care. It just keeps pulsing “STILL —- DOING —- IT” until I actually move my hand. And it’ll pick right back up if I move my hand right back.
- Getting the right false-positive balance is going to be key. My left motion almost wasn’t sensitive enough, while my right was vibrating basically every time I raised my arm anywhere near (or above) my head. There are settings to adjust this kind of stuff, and I need to play with them. (I also probably need to retrain even these first attempts, now that I’ve learned more about training the devices. I think I could do it better and get better results from that alone.) This’ll be important — I noticed, for example, that when I was eating and watching TV, I was getting a bunch of false positives eating, and then when I started picking, I wasn’t as sensitive to the vibrations after I’d just had so many that didn’t matter. You can also snooze Keen for a bit, but I haven’t tried that yet.
- I need a substitute for my brain if this is going to work. Picking is especially bad for me as I get tired. Last night, sitting in bed, my hand would go to my head, the bracelet’d buzz, and I’d go, “Oh, yup, I’m doing it” and press the button. I was literally talking aloud to the device, and my partner, next to me, said, “I feel like if somebody wanted to understand this disorder, we could just like record this and show them. You acknowledge it and then your hand goes right back.” The Keen provides the opportunity to disrupt the pattern, but I need to insert something in there to really do the disrupting. Right now, I’m leaning towards self-compassion phrases, as I generally have a lot of success with these. Many people would insert a physical fiddle, but that doesn’t do too much for me. HabitAware will put you through a breathing exercise — I might try that, but I’d like something quicker if possible. I pick all day long, and could easily chew up a work day even with just a minute-long breathing exercise.
Two areas for improvement:
- When you train a device, you first pick the region you’re targeting. There are a lot more head regions than body regions (somewhat confirming my bias-towards-hair-pulling thoughts), but both the Head options and the Body options have “Other” choices. Later in the day, I wondered (and couldn’t remember) if I had chosen the Body other for shoulder or the Head other, and if maybe the opposite would give me better results. It wasn’t clear to me if the device is starting with sort of a pre-set understanding based on the region you’ve chosen, or if choosing a region is just to give the motion a name in the app.
- The bands have nice L and R markers. But I can’t really charge the devices while they’re in the bands — I can pop them half out to get at the charging port and keep them with the bands, but with a kitten in the house, reliably keeping them in the right band when they’re not actually snapped in seems shaky. I’ll probably just mark L and R on the actual device with a marker or sticker.
So that’s the backstory through Day 1! Today is Day 2. I’ll check in soon!