CSP – my incredibly unsexy stim

Please note that in this post I discuss a stim that could be construed as a type of self harm. If this could be triggering for you, please approach with caution. 

So, the last few weeks have been a serene and peaceful time filled with birdsong and bunnies and holding hands and rainbows and me lying about how serene and peaceful everything has been.

I may also have been lying about birdsong and bunnies and hand-holdings and rainbows, but there has definitely been quiet weeping in the corner.

The last few weeks have been horrifically stressful, on a personal, national and international stage. I am loathe to go into further details at this point – we could find ourselves going around in increasingly dingy circles as we remind ourselves of the awfulness and uncertainty that pervades the air like a noxious gas. I would, however, like to talk about one of my own particular, personal responses to this prolongued exposure.

Most of my stims are adorable. I place this squarely at the feet of the fact that, quite frankly, I think I am an adorable person. They come in a range, from foot tapping, knee jiggling and hair fiddling to scarf flicking, fidget-toy playing and carrying around an assigned anti-anxiety soft toy. However, I’ve found myself being drawn back into one of my only so-called ‘bad stims’ – the only one (aside from chewing my tongue, which was something I did as I was much younger) that actually causes me some sort of physical harm.


I’ve never talked about this particular stim before, or considered it as a ‘stim’ in the same way I class my other stims. It’s one of those ‘ew gross’ actions that you try to keep hidden from the rest of the world. I’ll go to exorbitant details about my other stims, and how they help me to cope, or how to re-channel them into something more appropriate for a particular circumstance. This one is my ‘dirty little secret’. With the turbulence I’m currently caught in, both emotionally and politically, I decided to finally look this issue square in the face, and, in the process, do some learning for myself.

It’s not something I had ever looked into before. It was always something I had done with no understanding of the hows, whys or whats of doing it. So I decided to take the first logical step in understanding this elusive and ouch-making ‘bad stim’ – I consulted the Google.

‘Compulsive skin picking (CSP) is characterised by the repetitive picking of the skin to an extent where damage is caused…Individuals affected by CSP may start by picking at normal blemishes such as freckles or moles, pre-existing existing scabs, sores or even acne blemishes. They may also pick at imagined skin defects that nobody else can see. CSP can also be known as ‘dermatillomania’ or ‘neurotic excoriation’. It is often categorised as an impulse control disorder under the Obsessive Compulsive Disorder (OCD) Spectrum as the skin picking is often repetitive, ritualistic and tension reducing.’
 – Anxiety UK

And there it is.

My particular brand of CSP is centered around spots. I fulfilled many stereotypes of the ‘greasy awkward teenager’, one of these being relatively severe acne that afflicted me throughout my adolescence. My mum had a habit of cornering me to squeeze some of the more prominent ones, sometimes pouncing on me the moment I got home from school, and as I got older I taught myself how to effectively do this on my own. From that point, as they say, I was hooked.

As my acne cleared up with miraculously little scarring, my need to squeeze did not abate. Instead, any vaguely widened pore became a target. Although for a while the focus of this was on my face, I soon migrated to my upper arms and chest – these areas are more easily covered, so I can pick away without the sense of embarrassment that having a perpetually potholed face can bring. In fact, I would often find myself squeezing healthy pores, which consequently led to damage and infection that produced actual spots for me to attack.

This particular tidbit from AnxietyUK struck a very tender nerve :

‘While CSP can be the result of a conscious response to feelings of anxiety and depression it can also be an unconscious reaction. Sufferers can enter a trance like state and pick at the skin without being fully aware of their behaviour, only to be confronted by the results of what they have done afterwards.’

This is an almost perfect summation of my squeeze-sessions. It will start with a quick pinch to try and relieve some tension, and the next thing I know I have been standing there for up to forty-five minutes and the skin of my arms and chest is red and pitted. And, to top it all off nicely, my dogs are looking at me disapprovingly; my foray into minor self-mutilation has delayed their bedtime and they are thusly most unhappy.

This moment of recognition reminds me of the first time I looked up what it meant to be ‘autistic’ – seeing myself described in actual words, given a name, diagnostics, structure, everything that I had ever wanted to understand myself.

Although very few of the sites I have explored have addressed autism and stimming, I can’t help but feel there is a connection. One of my searches took me to an all-too-brief informal discussion on the topic on Wrong Planet, which seemed to suggest that there are other autistic people experiencing this and counting it amongst their stims.  After all, my CSP links to my anxiety, and my anxiety is inextricably intertwined with my autism. Would anxiety dominate my life in such a way if I were neurotypical? That’s like asking me what would change about my life if I were to have blue eyes instead of green-brown-hazel-no-one-quite-knows-exactly eyes. I don’t know, because it’s a part of me, and I have never known any different. My autism is intrinsic to my being. Maybe my anxiety is too.

So, what can be done about it?

(my skin-picking, not my autism – my autism is wonderful and beautiful and irritating and head-scratching and fabulous and heaven help anyone who looks to take it from me)

The long and short of it is that I am only at the beginning of acknowledging that there is a connection between these things. I do not have any answers. Several sources in my internet-trawlings have suggested consulting a doctor; whilst I haven’t done this yet, as the GP is absolutely not one of my favourite places, it may be something I consider in the future.

One thing that I have found helps soothe the urges (something that my doctor probably wouldn’t even think of prescribing) is watch ‘pimple-popping’ videos on the internet. It sounds like an odd hobby, but I have spent many hours browsing for satisfying compilations – these bring the relief of squeezing, without the damage of doing it to myself. One of my favourite channels is Dr Sandra Lee, a dermatologist who styles herself as ‘Dr Pimple Popper’; not only is her work clean and professionally done, but she has a calm and friendly manner which is very different to the sometimes traumatic screaming and retching you find on ‘home-made’ popping videos.

(There has recently been some criticism in her comment section, not just about her techniques but about whether she overstepped a line in her interaction with one patient. I’m not here to pass any judgement on that, as I have no interest in getting involved in that particular brand of YouTube-Comment-Section-Drama; it is just a warning that if anyone is interested in her videos and, like me, is upset or repelled by conflict, it may be best to follow the age old internet adage and do not read the comments.)

So, at the beginning of this post, I promised you rainbows and bunnies and birdsong. Instead, I gave you spots and dermatillomania and pimple-popping videos. As disappointing as this is, it has been incredibly freeing to talk about, and incredibly insightful to research and acknowledge it properly for the very first time. And that’s an incredibly important step – a step that is definitely worth all the rainbows and bunnies in the world*.

*please do not engage the author in arguments about the comparative worth of bunnies and rainbows to this blog post, as she is the author and thusly reserves the right to misuse her omnipotent authorliness in any way she sees fit. So nyer. 


If anyone else has any such experiences, or any ways in which they have managed to hold back the urge to pick, pop or squeeze, please do let me know. If anyone recognises these urges in themselves, and is feeling unsure or worries, the NHS has a page on Compulsive Skin Picking (or Dermatillomania) which includes suggestions for what to do next. Please be aware, I have only just started on this journey myself, so am unable to pass judgement on whether any of the solutions offered in any of the links included in this post are helpful

Author: QueerlyAutistic
Erin Ekins is a queer autistic writer, speaker and attempter of activism. She has an interest in all areas of autistic social justice, but has a particular passion for improving understanding and acceptance of the intersection of autism and queerness. She runs the blog queerlyautistic.com and is the author of the upcoming book 'Queerly Autistic: The Ultimate Guide for LGBTQIA+ Teens on the Spectrum'. By day, she works in campaigning and influencing at a disability related charity, but, by night, she is inhabits a busy space between angry internet person and overly-excited fangirl.

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