Body Focused Repetitive Behaviours (BFRBs) with Professor Clare Mackay

Jan 15, 2026

In this engaging conversation, Professor Clare Mackay, a neuroscience expert from Oxford with over 30 years of experience, dives into body-focused repetitive behaviors (BFRBs) like hair pulling and nail biting. She explores the connection between these behaviors and primate grooming, revealing their soothing effects. Clare shares her personal journey with BFRBs, comparing urges to an itch that demands scratching, and discusses the evolution of social touch. Offering insights on management, she emphasizes compassion and support, especially for parents navigating these challenges.

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INSIGHT

BFRBs Are Grooming Gone Awry

BFRBs (picking, pulling, biting) are evolutionarily rooted in normal primate grooming and self-soothing behaviour.
They become problematic only when they cause distress or physical harm.

ANECDOTE

Clare's Own Onset At Age 12

Clare Mackay began nail biting early and started hair pulling at age 12 during bullying and parental separation.
She links onset to social isolation and family stress during adolescence.

INSIGHT

Pulling Happens In Ritualised Episodes

Grooming episodes are ritualised chains of movements similar to animal grooming sequences.
The behaviour often won't stop until a feeling of completion is reached, explaining resistance to interruption.

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Welcome back to Series 11 and episode 3. What are BFRBs? It's picking, biting or pulling, skin, nails or hair or Body Focused Repetitive Behaviours.

Here I’m in conversation with Professor Clare Mackay, Professor of Neuroscience at the University of Oxford.

Professor Mackay has spent over thirty years studying the structure and function of the human brain. In 2023 she turned her attention to a disorder she’d been living with for most of her life: hair pulling, which comes under the umbrella of BFRBS.

BFRBs are often done unconsciously at first and, as we’ll learn, are a throw back to primate grooming behaviour gone a bit awry. Most of us do have some BFRBs, we may pick the skin around our nails, or bite our nails or even become fixated with plucking that stray hair, but it’s when it goes into overdrive that it can become a problem.

In this episode we find out about a fascinating neuron which surrounds every hair follicle called the CT fibre, which, when stimulated (stroked etc) by someone we trust releases endorphins. This is why we love having our hair or skin stroked or touched (or those fabulous head massages!).

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Produced by Hester Cant. Art work by Lo Cole. Music by Toby Dunham.

So, could BFRBs be a misfire with this neuron? We discuss this and talk in depth about what BFRBs are, what they’re not, how to deal with them if you suffer from them and there’s some really useful advice for parents with children with BFRBs.

Clare’s written a fascinating book called Keep your Hair on, which is published on April 2nd 2026.

I hope you enjoy this fascinating episode and with grateful thanks to Emily Tammam for the suggestion.

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