Character Background
The character is a young adult woman named Shaylynn, who is currently attending college. Her family consists of herself, her mother and her father. According to the character, she has always experienced a high level of nervousness. She did not have many friends and experienced trouble communicating with others, primarily due to anxiety. Attending school, Shaylynn spent much of her time preparing for college, attending various extracurricular activities and catching up on her studies. The character’s parents, while supportive, were described as placing too high of a standard on Shaylynn. She reports feeling like “she is never good enough” and considers her parents to be rather harsh. As a result of stress experienced both at home and in school, Shaylynn developed a habit of picking at and pinching her skin. The picking was centered primarily on the elbow area, gradually causing scabs and bleeding to occur.
The process of picking or pinching the skin allowed Shaylynn to become distracted from the source of anxiety and brought her relief. She did not inform her parents or any other parties about the habit. Upon being discovered by her mother and father, Shaylynn felt great embarrassment and shame. From that point on, she gradually stopped picking her skin until college. In her higher education, Shaylynn experienced the liberation of living on her own and the joys of love. These things, however, also brought her the insecurity and distress of separation. As a result of feeling crushed after breaking up with her girlfriend, being stressed about her studies and suffering from bad self-perception, Shaylynn started to pick her skin again. The extent of the skin damage was more severe this time. After a period of picking her skin, Shaylynn decided to sign in for therapy, after which her picking habit subsided. She has also found a new, loving relationship.
Primary Diagnosis
The primary diagnosis for Shaylynn is Excoriation disorder or skin-picking disorder. It is characterized by a desire to pick at one’s skin. This diagnosis is consistent with the character’s habit of picking her skin, which was severe enough to form scabs, patches and bleeding spots on her body. Furthermore, this disorder is accompanied and often preceded by feelings of anxiety and tension. Both of these feelings have been prevalent in Shylynn’s life, emerging from family pressure, academic expectation and self-image. She has often cited feeling anxious before picking her skin, which gave her relief. Furthermore, skin-picking disorder is characterized by the tendency of sufferers to obsess over their skin or experience periods of increased focus. Similar events can be seen in the character’s life, where she would almost fully ignores the situation around her, focusing on the process of examining and picking at her skin.
Differential Diagnosis
Another potential disorder that falls in line with Shaylynn’s symptoms is obsessive-compulsive disorder. Much like the skin-picking disorder, it is also characterized by a high level of focus on a specific behavior, which may be undesirable for the person. This diagnosis was dismissed because skin-picking disorder fits more of the specific criteria exhibited while also being a part of the OCD spectrum.
Treatment Recommendations
Seeking therapy for both anxiety and skin picking is the correct course of action for Shaylynn, as it will allow her to better process her issues. Furthermore, joining a support group or another type of community can bring her a sense of being understood, as she previously reported thinking she is the only one with this problem. In addition, Shaylynn would benefit from using objects or stim toys to relieve her stress and shift the attention from her skin-picking habits.