Can't stop biting your nails or pulling your hair? Let's learn about Habit Reversal Training (HRT)!

We have all kinds of habits in our lives, right? Some are good, some are not so good. For example, some people have a habit of not closing the kitchen cupboard if it is left open. It is a little annoying, but it is not very harmful. But there are some habits that can have a big impact on our lives and our health. Just think, habits like biting our nails, chewing our skin, and pulling our hair. These are things that we do without even realizing it. These kinds of habits can interfere with your daily activities, cause mental stress, and even cause physical harm. So if you also have a habit that is difficult to stop and need help to get rid of it, the treatment method we are talking about today called Habit Reversal Training (HRT) will be very useful for you.

Simply put, what is Habit Reversal Training (HRT)?

Habit Reversal Training, or HRT for short, is a behavioral therapy that identifies your bad, unwanted habit and replaces it with a harmless activity. To put it simply, what we do is train our brain to say "stop" to the bad habit and do something else at the same time.

It's like a pothole on a road. We always fall into it when we walk down that road. What HRT does is, when we're about to fall into that pothole, it recognizes it and teaches us another way, another way, to get past the pothole. Over time, when we get to the pothole, we get used to taking the new path without even realizing it. The old habit disappears.

This method was first introduced by two psychologists in the 1970s. Since then, a lot of research has proven its effectiveness.

What types of habits are used for HRT treatment?

This treatment method helps stop many body-focused repetitive behaviors that children and adults have. Let's take a look at what these habits are.

If you need help stopping this habit, it's best to see someone who has experience with HRT, such as a counselor.

How does this HRT treatment work?

During this treatment, you work with a counselor. There are several key steps involved. Let's briefly talk about each one.

1. Awareness Training

This is the first and most important step. What we are doing here is making yourself aware of when you develop that bad habit and how you do it. It's like putting a CCTV camera on your body and showing yourself what you are doing. There are a few more small steps to this as well.

• Response Description: First, you and your counselor will talk about the habit in detail. Let's say your habit is nail biting. "When I'm watching TV, I unconsciously put my hand in my mouth. Then I bite my index fingernail between my teeth. Sometimes I chew the gum around it." Describe everything from the smallest things like this.
• Response Detection: Next, every time you do that habit, you have to recognize it, "Oh... I'm doing this now." When you recognize it while you're with the counselor, he will encourage you. If you're doing it without even realizing it, he will point it out to you. Even at home, when you start biting your nails, you can tell yourself, "Okay, I'm doing this now."
• Early Warning Training: Once you have become more aware of when you are engaging in a habit, we next look at the thoughts, feelings, and movements that come to mind when you are about to engage in the habit. For example, if you are biting your nails, your hand may be moving toward your mouth before you bite. Or you may feel a little pressure or boredom. We learn to recognize these "early warning signs." We also look at when you are most likely to engage in the habit. It could be when an exam is coming up, when someone is scolding you, or when you are just sitting around.

2. Competing Response Training

Now we know what our bad habit is, when it happens, and what the early signs are. The second step is to do something else that will make it impossible for us to do that bad habit when we feel like doing it. This is called a 'Competing Response'.

When choosing this countermeasure, you need to consider several things.

• That should make it impossible to do that old bad habit.
• You should be able to stay in that action for at least a minute.
• It should be a normal action that doesn't seem strange to others.
• It should be something that can be done anywhere, without any equipment.

What can be done to counteract nail biting?

• Hold the handle with both hands tightly together and keep it aside. Then you won't be able to put it in your mouth.
• Clasp your hands together.
• If you are in a chair, sit on your hands.
• Tie your hands.

Once you have chosen a counter-action that suits you, you practice it with your instructor. Whenever you feel like biting your nails, you do the chosen action (e.g., clenching your fists).

3. Obtaining social support (Intensive Training)

This is the third step. This is also called 'Motivation and Compliance'. Simply put, it involves involving people close to you, such as your family and friends, in your journey.

For example, when you see your mom, dad, sibling, or best friend doing the opposite action (squeezing your wrists), they praise you. They say something like, "Wow... great! You're doing that really well." That's a big boost for you.

Also, if you forget and start biting your nails, they will not be harsh, but will lovingly remind you to "get your hands dirty." This social support will further strengthen your new habit.

Other things that help besides HRT

In addition to the three main steps mentioned above, two other training methods can be added to this treatment.

Relaxation Training

Often, these bad habits are more likely to occur when we are under stress. So, by practicing ways to calm our minds, we can reduce the urge to engage in that bad habit. Your counselor may teach you things like:

• Mindfulness
• Meditation
• Deep breathing exercise
• Progressive muscle relaxation
• Things like listening to music, reading books, and physical exercise.

Generalization Training

What you do here is practice the new 'opposite action' you've learned in different places, at different times. You need to practice this everywhere, not just at home, like on the bus, in class, at work. As you continue to do this, the new action will become a habit without you even realizing it, and the old bad habit will be completely suppressed.

Is this treatment really effective?

Yes. Overall, many studies have shown that HRT is a very effective way to reduce a number of habits.

However, we need to understand one thing. In more complex conditions, such as nicotine dependence or Obsessive-Compulsive Disorder (OCD) , HRT alone is not a complete treatment. In such cases, medication or other psychological treatments may be needed in addition to HRT. You can discuss with your doctor what treatment plan is best for you.

How long does HRT treatment take?

There is no set time frame for this. It depends on factors such as the complexity of your routine and how committed you are to it. In addition to meeting with the counselor, the "homework" part you do at home is also very important.

Some people can successfully quit the habit in a few months. Others may take a year or more. People with long-term conditions, such as tic disorders or dermatotillomania, may need to attend "maintenance" sessions periodically throughout their lives, even after initial HRT treatment.

When should I see a doctor?

If you've tried HRT and it's not working, talk to your doctor or a counselor again. Maybe another treatment option might be better for you.

Also, if the habit resurfaces after you've broken it with HRT, don't worry. Meeting with the counselor again and attending a few follow-up sessions can get you back on track.

For decades, HRT has helped countless people overcome their troubling habits. If you need help, don't be afraid to see your doctor or a mental health professional. They're not there to judge you, they're there to help you.

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