Decoupling [1] is a behavioral self-help intervention developed for body-focused and related behaviors (DSM-5) such as trichotillomania, onychophagia (nail biting) and skin picking. The user is instructed to modify the original dysfunctional behavioral path by performing a counter-movement shortly before completing the self-injurious behavior (e.g. biting nails, picking skin, pulling hair, etc.). This is intended to trigger an irritation, which enables the person to detect and stop the compulsive behavior at an early stage. A systematic review from 2012 confirmed the efficacy of decoupling,[2] which was corroborated by Lee et al. [3] in 2019.
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