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Compulsive and impulsive behaviours are recurring urges or actions that feel difficult to control and can lead to distress or impairment in daily life. These behaviours may bring short-term relief (a sense of calm, release, or satisfaction), but they often create longer-term consequences—emotionally, socially, and sometimes physically.
When these patterns start affecting your relationships, work, school, or self-esteem, therapy can help you understand what is driving the behaviour and build practical strategies to reduce it without relying on shame or willpower alone.
At The Cohen Clinic, we provide therapy for adults in Toronto who experience patterns such as hair pulling, skin picking, and nail biting, including behaviours that escalate under stress, anxiety, or trauma-related activation.
These behaviours often follow a predictable cycle: an internal urge or tension builds, the behaviour happens, and there is brief relief—followed by regret, shame, or frustration. Over time, the relief can reinforce the pattern, making it feel harder to stop.
Some compulsive/impulsive behaviours fall under a group called body-focused repetitive behaviours (BFRBs), which can include hair pulling, skin picking, and nail biting.
Trichotillomania (hair-pulling disorder) involves recurrent urges to pull hair (commonly from the scalp, eyebrows, or eyelashes) and repeated attempts to stop or reduce the behaviour. It can lead to noticeable hair loss and significant distress.
Skin-picking disorder (also called excoriation disorder or dermatillomania) involves repeated picking at the skin that causes lesions, scarring, or infections. Many people feel tension beforehand and relief after, even when they want to stop.
Nail biting can range from an occasional habit to a persistent behaviour that damages nails and surrounding skin. In some people, nail biting is part of a broader BFRB pattern.
Therapy can help you break the cycle by focusing on triggers, urge patterns, and practical replacement strategies—without relying on punishment or self-criticism.
CBT helps identify the thoughts and emotions that fuel urges and builds alternative coping responses for stress, anxiety, boredom, perfectionism, or trauma-related activation.
HRT is a common treatment approach for BFRBs. It focuses on increasing awareness of the behaviour and teaching alternative responses (often called “competing responses”) so urges can pass without acting on them.
ERP can be helpful when behaviours are driven by anxiety, discomfort, or rigid “must do” internal rules. It involves gradually facing triggers while reducing the response pattern, so the urge weakens over time.
Therapy can also help with:
At The Cohen Clinic, we offer a supportive, non-judgmental space to work on compulsive and impulsive behaviour patterns. Your treatment plan is tailored to your goals—whether you want fewer episodes, less damage, reduced shame, or stronger tools for managing urges in daily life.
If compulsive or impulsive behaviours are affecting your confidence, relationships, or day-to-day functioning, support is available. Therapy can help you understand the pattern, reduce urges, and build healthier coping strategies.
At The Cohen Clinic, we’re here to support you.
Book an Appointment today to begin your therapy journey.
