How do I stop biting my nails?

Wouldn't you like to know?

Treatment reflects aetiology. Such is the mantra of the clinical psychologist. Actually, we don't know any clinical psychologists who ever say things like that, but we think it's true anyway: Often, knowledge about the cause of a problem enables us to find a solution. Now, given that the research suggests explanatory pluralism when it comes to nail biting, we should expect a similar diversity in treatment options. The research has generally focused on three treatment traditions:

1. Drug therapy
2. Aversion therapy
3. Other cognitive-behavioural therapy.

Because nail biting has been linked to mood and anxiety disorders (e.g., depression, obsessive-compulsive disorder), drugs usually used to treat these disorders have sometimes been adopted to treat chronic nail biting as well. Clomipramine, a popular drug for obsessive-compulsive disorder, has been shown to be effective against nail biting. However, the potential side effects - nausea, diarrhoea, and drowsiness, among the milder but more common ones - are pretty nasty. More recently N-Acetyl Cysteine, a naturally occurring amino acid, has also been shown to be effective. However, it's early days yet for research in this field. No drug has been approved by the U.S. Food and Drug Administration for nail biting thus far. Also, these drugs don't work for everyone - presumably only those whose nail biting habits are partially caused by underlying neurophysiological problems. Furthermore, they only work if you keep taking the drugs. For these reasons, we think drugs should be the last resort. SAY NO TO DRUGS!



Anyway, perhaps the most common advice given to nail biters is, "Paint some bitter stuff on your nails." On the face of it, this isn't bad advice. The bitterness increases awareness which, for motivated individuals, will help them reduce their nail biting. Furthermore, the bitterness also acts as punishment which, according to behavioural principles, should also reduce nail biting behaviour. Other people take this aversion therapy one step further by recommending self-administered shocking devices. The problem with aversion therapy is that people generally hate it. And so people drop out fairly readily. Furthermore, it is a truism in behaviour modification research that reinforcement works better than punishment.

In light of that, many researchers have looked into reinforcing more adaptive behaviours to interfere with nail biting behaviour. A nail biter might, for example, be taught to chew gum or trim his nails with a nail clipper, instead of biting them. These so-called competing response or habit-reversal treatments have been shown to be successful, and relatively inexpensive.

Finally, we think that nail biters should try what we call a socially-supported, self-help programme. Because it's a self-help programme, this is much cheaper than any of the other treatment options. Furthermore, because it's based on principles gleaned from the research literature, it should be effective in reducing nail biting behaviour.

To find out more about treatment options and our recommended first line of action, read the full PsychoBabble report, coming soon!