Psychiatry & Psychology--General/Nail Biting

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Question
Dr. Elmore,

I am a graduate student with 42/48 hours in a counseling program and 18/33 in a counseling psychology program, and I need help!  I can work well with other people, but when it comes to applying what I know to me, it's a different story.

I bite my nails... I've bitten them as long as I've had teeth (and I'm 30 years old, now).  I've tried polishes, diaries, rubber bands, distractions, band-aids, counseling... and so far nothing has worked.

I've had so many infections that it's absolutely ridiculous, and last night while watching a movie I managed to completely remove a nail from the bed in its entirety... I started biting because it felt dry and 'odd.' and just kept going because it didn't feel right... before long, I realized that the white moon of the nail was completely separated.

This is just out of control and it's to the point now where it might actually be seriously dangerous.  I'm taking 100mg of Zoloft for general anxiety and social phobia... I've read plenty of research that says SSRIs help mitigate the biting by 30-60% and can only imagine what havoc would befall my nails if I weren't taking the medication.

Do you have any suggestions?

Thanks,

Brian

Answer
Brian,

You are doing the right thing by availing yourself of this medication for your, nail biting.

You would also benefit from cognitive behavioral therapy for OCD behaviors.

Remember too that you are probably at the peak of stress in your young life and that even if you did nothing at all this terrible habit will fade as you get settled in your adult life.

I have had a handlebar mustache since I was 17.  I pulled on it so badly when I was in graduate school that I shaved it off and all my friends just laughed at me because I looked ridiculous without it.  I was teaching undergraduates in Research Methodology at the time and a couple of students stayed after class one day to ask study questions.  Just before she left one of them said, can I ask you a question?  Why do you do this all the time?"  She mimicked me yanking on my sideburns!  So I grew the mustache back.  If I had shaved my head I probably would have pulled my eyebrows.

You have these new forms of treatment and will probably do very well with them.  It is important to know that your nervous habit is based in the reality of this time of your life, and while "bad," it is certainly not as bad or dangerous as many other nervous habits.

Good luck.

Dr. Elmore

Psychiatry & Psychology--General

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Andrew M. Elmore, Ph.D.

Expertise

I can answer questions about: Stress. Headaches. Stress-related Disorders. Anxiety/Panic Disorder. Depression. Psychopathology. Cognitive Behavioral Therapy. Personal Problem Solving. Life in General. Relationships: Love, Friendship, Business Partner, Coworker, Family,Child/Parent. What makes us tick. The use of psycho-pharmacological agents in combination with psychological treatment. How to deal with evil people in your life. How to improve your outlook under duress. How to control stress. How to control mood. How to control headaches. I cannot answer: Questions about Eating Disorders. Questions about computers.

Experience

30 years in private practice as a psychologist in Manhattan. Dealing with people from almost every conceivable ethnic and socioeconomic backgrounds, and as many character types as exist in this country. Dealing with patients from 8 years old to 90 years old. Pioneer in biofeedback and the treatment of stress-related disorders. Assistant Clinical Professor of Psychiatry at the Mount Sinai School of Medicine since 1982. Treatment of stress-related, anxiety and depressive disorders with biofeedback and cognitive behavioral therapy. Developed personal problem solving, an extremely precise form of psychotherapy. Relationship therapy for couples, families, parent/child issues, business partners, coworkers, employers, and dealing with psychopathic individuals in your life.

Organizations
American Psychological Association. Association for Applied Psychophysiology and Biofeedback. Biofeedback Certification Institute of America. New York Academy of Sciences.

Publications
The journal, Psychophysiology. The book, Expanding Dimensions of Consciousness. The journal, Headache. The journal, Biofeedback and Self-Regulation. The journal Psychiatry Digest. The book, The TMJ Book. The book, Dental Phobia. The network, CNN. Parade Magazine. The newspaper, Newsday. The Manhattan TV station, WCBS. The national news program, The CBS Evening News. The newspaper, The New York Post. The national TV program, The Phil Donohue Show. The magazine, The New Yorker. The magazine, Glamor. The magazine, Redbook. The magazine, Health. The magazine, Bottom Line Personal. Web MD. The website, Healthology. The magazine, Newsweek.

Education/Credentials
Ph.D. SUNY at Stony Brook, 1979. B.A., magna cum laude with Honors in Psychology, Illinois Wesleyan University, 1974.

Awards and Honors
Who’s Who in Medicine and Healthcare, First, Second and Third Editions, 1997-2000. Appointed to the Training Faculty of the Biofeedback Certification Institute of America (BCIA), 1993. Senior Fellow BCIA. New York Academy of Sciences, 1987. Who’s Who in the East, 1983-present. Who’s Who in Frontier Science and Technology, First Edition. Citation Paper Author. Eleventh Annual Meeting of the Biofeedback Society of America, Colorado Springs, Colorado, 1980. Biofeedback Society of America Scholar, 1979. Co-author, USVA Grant, “Variables Affecting the Experience of Pain in Migraine,” USVA Medical Center, Northport, New York, 1977-1979. Biomedical Research Fellow, Department of Biomedical Engineering, SUNY at Stony Brook, Stony Brook, New York, 1978. NIMH Predoctoral Fellowship, 1976. BA, Magna cum laude, with Honors in Psychology, 1974. Danforth Fellowship Nominee, Illinois Wesleyan University, Bloomington, Illinois, 1973.

Past/Present Clients
Most of my clients are my private patients. However I have provided many seminars, lectures and workshops for: Columbia University. The Mount Sinai School of Medicine. The Metropolitan Museum of Art. The Museum of Natural History. The UJA Federation. The university, CW Post. The College of New Rochelle. Equinox Fitness. Travelers Insurance. AutoOne Insurance. Chubb Insurance. Metropolitan Life. Allstate Insurance. State Farm Insurance. Encompass Insurance. The public relations firm, Porter Novelli. The investment firm, Capital Re:. The Estee Lauder corporation. The law firm of Irwin Abrams. The National Insurance Crime Bureau. GEICO Insruance. Beth Israel Hospital.

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