Consultant Psychiatrist


“Behaviour” commonly means what we see people doing. As a behaviour modification technique, habit reversal can be used to tackle nail biting, thumb sucking or scratching that have become troublesome habits.

Habits start as conscious behaviours associated with specific triggers. With sufficient repetition the behaviour can later occur relatively unconsciously, or automatically, and the triggers can multiply – by association with other related factors. Thus, a habit is formed.

Not only can an action become a habit. The process can apply to feelings and thoughts – also seen in psychology as behaviours – just as it works with actions. If an experience is repeated sufficiently and is associated with a typical emotional response, and a particular train of thought, a habitual attitude can emerge. If this is then a problem, the principles of habit reversal can be used to tackle it.

It is easy to understand how living with longstanding troublesome eczema can make anyone pessimistic. Repeated previous experiences of unsatisfactory clinic visits and treatment failures are commonly reported by chronic atopic eczema sufferers, and these experiences do not encourage optimism. Along with pessimism also comes passivity, a sense of helplessness, created by the repeated experience of failure.

Fortunately for most with chronic atopic eczema we have found that the habit of passive pessimism can be reversed by following The Combined Approach. The active nature of the treatment programme requires repeated practice of positive behaviours to which the skin responds favourably in a relatively short period of time. The experience is therefore quickly rewarding: active optimism soon emerges and is established as a new habit, and the benefits of living without eczema maintain the new positive attitude.


One Response to Habit reversal for passive pessimism

  1. This writing I am having to share with intermittent scratching and rubbing. I have read with interest the idea that chronic atopic eczema could well be linked to the mind. I have always believed the deterioration of my eczema about 6 years ago was linked to stress at both work and at home. A recent change in the way I work hasn’t improved the eczema situation ( It is at its worst now !) but when I see a dermatologist ( I am trying to see two) I shall certainly mention a combination of behaviour therapy and some topical medication because I know some of my scratching is habit rather than a way of relieving the itch.

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