Consultant Psychiatrist


Habit reversal







Our 12 year old patient was delighted when her previously troublesome chronic atopic eczema quickly cleared using habit reversal for habitual scratching using The Combined Approach. We asked her what part of the treatment programme had been most important for her.

“Becoming aware of what I was doing!” she replied. She had been using her tally counter to count her scratching for five weeks – during the first week without habit reversal, then with habit reversal and optimal topical treatment for four more weeks.

Habit formation

When she had first come with her mother to meet us, we had explained how any habit starts. If anything is repeated often enough, it can become a habit: then doing it becomes what is called “second nature” to us. 

We learn something, and once learnt, it becomes a habit and it can happen automatically, without thinking, sometimes prompted by times, situations, activities or frames of mind. We do not notice what is happening – neither do those around us, if they too get used to what is happening. 

This way of getting into a habit of doing something is a really useful trick our mind is able to help us with. With regular practice we get good at doing something – and then we discover we can do it even while we are thinking about something else: clever!  

This is great for good habits. But if a habit is causing problems, it may need unlearning. This is where habit reversal comes in.

And the first thing with habit reversal is to bring the habit back into awareness. Only then can we learn a good replacement – and this can happen quite quickly, if the results please us.

Find out more about The Combined Approach to atopic eczema at



Dr Christopher Bridgett (DrB) is a specialist in Adult General Psychiatry who has also worked in Dermatology since being first introduced to Psychodermatology by Arthur Rook in 1971. Together with dermatologists Richard Staughton (London) and Peter Norén (Uppsala) he co-authored Atopic Skin Disease - A Manual for Practitioners, which sets out a behavioural approach for the successful management of atopic eczema. Now retired from both NHS and private practice, he continues to teach and advise at Chelsea & Westminster Hospital, London and runs an online community for both practitioners and patients interested in The Combined Approach to the treatment of atopic eczema:

2 Responses to Habit reversal for atopic eczema

  1. Nice article!

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