Decoupling in sensu
The third method is a variant of decoupling. In sensu means “in the imagination.” This is different from the first two methods suggested above because you do the first part of the exercises only in your mind or imagination. At the moment when the unwanted behavior is about to occur in your imagination, e.g., biting your nail or pulling out a hair, your hand (which you were imagining moving toward your head) now performs the new behavior in reality. For example, first imagine moving your hand toward your mouth but then physically push your hand away from you rapidly and spread your fingers (see Figure 5).
In the in sensu method, it’s necessary to practice the new uncoupled behavior with awareness several times a day and during situations when you would typically perform the unwanted behavior. Perform the new behavior sequence five times in a row for at least three minutes each time. Practice several times a day. It’s best to set a smartphone alarm to help you remember to practice (see page 6 for instructions).
Since this procedure is very similar to decoupling, we’ll only illustrate the technique for nail biting. This technique can be easily adapted for other BFRBs.
If possible, go to the place where you frequently perform the behavior or put yourself in a situation that frequently triggers the behavior, such as watching TV. Rest your hands lightly on your thighs. Now, imagine your fingers moving toward your face in a way that’s characteristic of your nail biting. Immediately before reaching the target (your mouth), forcefully push your hand, which you were previously only imagining, away from you in reality and spread your fingers at the end of the movement. The accelerated movement helps to disrupt and eventually overwrite the old movement pattern. After completing the (jerky) target movement, simply return your hands to the neutral position on your thighs. Practice this for a bit. Perform the new (sudden) movement exactly the same way each time because the old behavior pattern is more likely to be broken when a strong alternative pattern takes its place. You can use essentially the same technique for skin picking and hair pulling.