“You get good at becoming secretive, at hiding it.” Shame and loneliness: the mental health impacts of skin picking disorder

Purpose The purpose of this paper is to report on a study into the lived experience of skin picking disorder (SPD) and to explore the psychological impact of the disorder. Design/methodology/approach Researchers employed a qualitative phenomenological approach, using Interpretative phenomenological analysis (IPA). Findings The study found that the sense of shame, common among participants, led to self-stigma, hiding, concealing and avoidance. Shame of SPD also interplayed with and compounded the shame of loneliness. Research limitations/implications Limitations included a lack of a longitudinal component to the work. This is deemed important, as both the SPD and the experience of loneliness can shift over time as circumstances change, and individuals develop strategies for coping or, conversely, experience a worsening of the condition and the shame, loneliness and social isolation it can induce. Practical implications This study draws attention to the complex nature of both SPD and loneliness. It highlights how those living with the disorder are reluctant to seek help, resulting in low rates of treatment access and distrust in health providers. Social implications As SPD is little understood, it can be erroneously deemed a “choice”; seldom discussed as a condition, it can lead to exclusion and withdrawal. The sense of shame of both appearance and behaviour interplays with and compounds the shame of loneliness and can force the individual into a further cycle of withdrawal and isolation. Originality/value While research suggests SPD should be acknowledged as a public health issue, research and literature is still relatively limited, and there are no qualitative phenomenological studies as yet that report on the lived experience of SPD.