Reforming the Nail Biter: On Loving the “Ten Friends”
by Mary Lamia, Ph.D.
(Originally published at PsychologyToday.com)
You would likely have no difficulty believing me if I told you that a relationship can be healing. However, it may seem strange if I claim that a specific interaction and connection with another person can help children and adults stop biting their nails.
Nail biting, technically known as onychophagia, is quite fascinating, yet there is a striking lack of research on the subject. And some of the research on the subject that does exist is so absurd that it may make you consider biting your nails. Early research on nail-biting behavior characterized it as possibly due to an impaired mother-child relationship (Oguchi & Miura, 1977), as a self-mutilation behavior (Laxenaire, Millet, & Westphal, 1984), or a sign of inward turned hostility (Ellerbroek, 1978). Most commonly, nail biting has been characterized as neurotic symptom of anxiety or a nervous habit (Abe & Masui, 1981; Klatte & Deardorff, 1981; Miltenberger & Fuqua, 1985; Pathak & Mishra, 1985). In an attempt to determine the function of nail biting, a recent study found that, in young adults, nail biting occurred under conditions of working on difficult problems or boredom, which may reflect a particular emotional state (Williams, Rose, & Chisholm, 2007).
Likely there are a plethora of reasons why people bite their nails, and if you have first hand experience as a biter you likely are aware of what it’s all about for you. Regardless of etiology, nail biting is generally regarded as a common habit that should be broken. But therein lies the problem: habits that bring momentary comfort are difficult to relinquish.
If the relational intervention I will be proposing here can help reform a nail biter, it would likely be a more welcome intervention than some of the atrocious procedures nail biters have endured to stop their habit. If you are a nail biter you are likely familiar with any number of aversive techniques. Most common are horrible tasting substances to paint on your nails. However, like a dog that is willing to endure the shock of an electric fence in order to chase a rabbit, the nail biter usually chews right through any evil-tasting stuff. Dreadful as it may sound, pharmaceuticals such as clomipramine and desipramine (tricyclic antidepressants) have been used in the treatment of severe nail biting although using medications was not shown to be efficacious in most cases (Leonard, H.; Lenane, M.; Swedo, S.; & Rettew, D., 1991).
Some studies of procedures that were designed to reduce nail-biting have focused on increasing the biters awareness of the behavior. Non-removable reminders, such as wristbands designated to be a constant cue to the nail biter of his resolve to quit, have been used to control nail-biting but, unfortunately, they were found to be no more effective than aversive techniques (Koritzky, G. & Yechiam, E., 2011). In another study, participants kept self-monitored records of biting responses and for six weeks they were each seen individually by someone who measured their nail lengths (Adesso, V.; Vargas, J.; & Siddall, J., 1979). The researchers found that self-monitoring along with regularly scheduled nail measurements was effective in increasing awareness for control of nail-biting. The psychological impact of having another person regularly measuring one’s nail length was not implicated in the study as a remedial factor, however, I suspect that it accounted for the result. A relationship with another person who is attentive and caring, even when they are simply measuring your nail length and your progress can raise awareness. If this person happens to be someone who loves you, his or her concern may also be comforting. And this is the essence of the procedure I propose to reform the nail-biter.
Now for the procedure: The example I will use is with a child who bites her nails, although some of my graduate students have effectively employed the same technique with adult nail-biting partners. Every evening for a minimum of 30-days, look at each of the child’s fingernails to determine whether or not she had been “good” to them—personifying each of her little fingers as a “friend.” As each fingernail is examined, talk to it using statements where applicable such as, “Oh, I am so sorry that she chewed on you today,” or “I’m so happy that she was nice to you today!” and give each of them a kiss in turn. These are her 10 “friends” and your relationship with them will seemingly be separate from the one you have with your child. Your relationship with the ten “friends” will be remembered when she is tempted to bite her nails, as will the relationship she has with her own fingers that have now been personified. Additionally, the comfort that you provide will help to relieve anxiety or stress that may lead her to bite her nails in the first place.
If you are a nail-biting adult who doesn’t have the option of engaging a partner to help you establish a new relationship with your ten “friends,” then, at the very least, you should talk to them every evening yourself. And give each of them a kiss goodnight.
For information regarding my books about emotions: http://www.marylamia.com
This blog is in no way intended as a substitute for medical or psychological counseling. If expert assistance or counseling is needed, the services of a competent professional should be sought.
Adesso, V.; Vargas, J.; & Siddall, J. (1979). The role of awareness in reducing nail-biting behavior. Behavior Therapy, 10(1), 148-154.
Klatte, K. M., & Deardorff, P. A. (1981). Nail-biting and manifest anxiety of adults. Psychological Reports, 48(1), 82.
Koritzky, G. & Yechiam, E., (2011). On the value of nonremovable reminders for behavior modification: An application to nail-biting (Onychophagia). Behavior Modification, 35(6), 511-530.
Leonard, H.; Lenane, M.; Swedo, S. & Rettew, D. (1991). A double-blind comparison of clomipramine and desipramine treatment of severe onychophagia (nail biting). Archives of General Psychiatry, 48(9), 821-827.
Williams, T.; Rose, R.; Chisholm, S. (2007). What is the function of nail biting: An analog assessment study. Behaviour Research and Therapy. 45(5), 989-995.
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The opinions expressed by the authors are their own and do not reflect the opinions of the Marin County Psychological Association. The information posted on this blog is not intended as, and is not, a substitute for professional mental health services.