The composition of bone

Okay!! Weʼve pretty much covered it all!

Now comes the part where you have to write stuff down. Donʼt skip it, okay?! I mean it. It could mean the difference between success and failure.

The following are 20 questions that I want you to answer by writing them out in either a journal, or some loose paper - something that you can easily go back and reference.

These questions also recap everything that you need to do, so that after youʼve written them all out, youʼll have a perfect map of how you are going to to get from where you are now, to where you want to be.

Writing down a plan for success sounds annoying and lame - I know, because Iʼm totally the type of person who buys ebooks, and never actually does the exercises where they tell you to write things down. But you actually get way more of the result you were looking for if you do make the effort.

The reason you really need to do this is because you are going to have times of

weakness when your brain is screaming at you, and you canʼt seem to remember where youʼre going or how to get there. You need this to refer to in those crazy moments when everything is spinning out of control. Those times when your brain is saying “Hey you.

Just one little squeeze. Just one. You know you want it. Come on baby.”

Your brain is super tricky! It knows you so well and itʼs going to come up with the BEST lines about why you should give in. And youʼre going to be tempted to believe it.

But now that you know that, you can go “NO, BRAIN! NO!” and then go read what you wrote down, and you know you can believe that, because you wrote it when you were of sane mind.

Here they are. Now go forth and writeth:

1. Define exactly which behaviours you want to eliminate. Is it obsessive staring? Is it squeezing every pore on your face? Write it down at the top of your page.

2. Write down your motivation for doing this. Why are these compulsions making you upset? Is it because of the way you feel after youʼve picked your skin? You hate the way your skin always looks worse instead of better after youʼve

squeezed it? Is it because you know that by touching your skin all the time, you are simply reminding yourself of the acne that youʼd like to forget? Is it because popping and picking your skin is creating more acne? Write down why you want to go through this process and why itʼs worth it.

3. Define rules for healthy interactions with your skin. What does a healthy

interaction with your skin look like to you? So for example you might say: “I will only look in the mirror once per day for no more than a few seconds. I will not squeeze my skin or pop any pimples, unless itʼs an ʻAʼ.” Tailor this to your specific situation and write it down.

4. Write down how you want to feel in the end once youʼve gone through with this.

Write about how you will feel when your skin is more clear, itʼs not ravaged from

your fingers, or you are able to be more carefree since you arenʼt looking at your skin and touching it all the time.

5. Write down the challenges you think youʼre going to face during this transition.

Be honest about it, but positive that you will overcome them. By accepting and acknowledging the challenges and anxieties that may come along, you wonʼt be surprised and will be able to stay stronger when youʼre faced with them.

6. What do you feel are some of the limiting beliefs, fears, and anxieties that are behind your skin compulsions? Have a good think about this and write them down. Then go through the limiting beliefs exercises to change and eliminate the beliefs youʼve identified.

7. Write down some ways in which you are going to work on fostering more self love. Write a list of ten things that you can do for yourself that really make you feel awesome.

8. Write down the ways in which you will get your anger and emotions out, instead of taking them out on your skin. Will you choose to journal? Exercise? Scream it out while youʼre home alone?

9. Decide if your habits are mostly conscious or unconscious. Choose if you are going to use Habit Reversal Training (HRT), or Exposure and Response Prevention (ERP).

10. If your habits are mostly unconscious and you are going to start with HRT, start observing your habits and write down every time you catch yourself doing them.

As per the Self Monitoring exercise, write down the place it usually happens, time of day, habits that precede it, what sensations you enjoy, what emotions precede it, which thoughts precede it, and if it usually happens in the presence of

a certain person, or when youʼre alone?

11. Write down a few practical ways that you can avoid situations in which you tend to perform the behaviour. Can you avoid the bathroom? A certain person that sets you off?

12. Write down the techniques you will use to help you stop the behaviour once you have the urge. Can you start journalling as soon as you feel the urge? Can you pick up a jump rope and jump for five minutes?

13. Write down the techniques you will use to prevent the behaviour. Will you get your nails done, or wear makeup? Will you wear gloves in high risk situations?

Will you take down your mirrors?

14. Write down which competing response will you use to replace the compulsive behaviour. Will you make fists with your hands? Sit on them? “Glue” them to your lap? Flick your finger against your other hand?

15. If you are doing ERP, expose yourself to the urge, and then donʼt do it. Accept that you have the feeling and that itʼs uncomfortable, but still donʼt do it. Use the techniques you wrote down in questions 12, 13, and 14 to help you to not

perform the habit once you have the urge.

16. Alternatively, you can choose to do modified ERP and gradually build up your tolerance to resisting the urge. This is where you choose to delay the picking/

popping/touching/staring for a predetermined amount of time, after which you are free to go ahead and do it. The amount of time will be increased as you get stronger. If you are going to do modified ERP, choose the amount of time that you will delay giving into your compulsion, and how much time you will increase it by.

17. Write down ways you are going to support yourself during this process and the first two weeks (the most challenging part!). Perhaps a nutritious diet, lots of sleep, and spending lots of time out of the house and with friends will make you feel supported.

18. Write down ways in which you are going to support your long term success so that you never go back to your skin compulsions. Are you going to accept unpleasant feelings and uncertainty more readily knowing that they canʼt hurt you? Will you take up meditation? Exercise? Doing things you donʼt like promptly, like taking out the garbage?

19. Write down what you are going to do if you fall off the wagon and have a relapse? Are you going to give up and keep picking just because you had an accident? Or are you going to stop as soon as you slip up and take it as an opportunity to learn more about your triggers?

20. Track your successes. Every time you felt the urge to pick or look at your skin, and decided to do something else instead, thatʼs a success. Write it down. It might seem silly, but as I said, it could be the difference between success and failure. When you can see your successes, it will give you confidence that you really can do this.

Wrap Up

So weʼve come to the end of the book, and I hope that you feel more equipped now to deal with these compulsions that have been taking over your life. Remember that no matter how insignificant you feel your problem sounds, if it is causing you stress in any way, than you deserve to have the help you need to get better and live the life that you want!

Donʼt forget that there are qualified therapists all over the place who can help you if you do feel you need professional help in order to move through this. It might be difficult to get to the true emotional issues behind the behaviour, and a professional can help.

Apparently it can be sometimes difficult to find a therapist who really truly “gets” skin picking though, so if I can recommend someone, I would say to get ahold of the author of ʻSkin Deepʼ, Dr. Grossbart. He is one of the leading experts in this area and he offers counseling sessions over the phone and Skype so that you can speak to him from anywhere and remain relatively anonymous. Again, his website: http://grossbart.com/

Lots of love my darling,