Introduction

Decoupling is a behavioural self-help intervention for body-focused and related behaviours (DSM-5) such as trichotillomania, onychophagia (nail biting), skin picking and lip-cheek biting.

Outline

The user is instructed to modify the original dysfunctional behavioural path by performing a counter-movement shortly before completing the self-injurious behaviour (e.g. biting nails, picking skin, pulling hair). This is intended to trigger an irritation, which enables the person to detect and stop the compulsive behaviour at an early stage.

A systematic review from 2012 suggested some efficacy of decoupling, which was corroborated by Lee et al. in 2019.

Whether or not the technique is superior to other behavioural interventions such as habit reversal training awaits to be tested. Decoupling is a variant of habit reversal training.

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