Personal Nail Biting Case Study

Here is my personal nail biting case study detailing my over forty years of nail biting that I was finally able to stop doing at age 50, almost by accident.

I began biting and picking nails early in life. My earliest specific memory of nail biting was at around age 10 when I had clearly been doing the habit for some time because my mum paid me $10 to quit. I recall that she had already commented numerous times in my young life about not doing my nails or some variation of this request.

As I had no source of income at that point, I quit and happily got the $10. That lasted about 10 days give or take and I started biting and picking again. My mum would check my nails each day and when I fell off the wagon and refused to climb back aboard, I had to issue the first refund in my life. She got her $10 back and I kept biting my nails.

That’s my earliest memory of nail biting. When 2020 started, I entered my 50th year on planet earth and I was still a nail biter. Or was I? More on that below.

Why

I have no idea why I started biting my nails. Or exactly when it started. Neither of my parents bit their nails and neither did my sister although I want to say there was a brief time that my mum may have bitten her nails but that might be a false memory. I can’t remember if there was a trigger that set me off or got me started biting my nails.

My mum told me that I had a pacifier for awhile like most kids and got rid of it at the appropriate time. I was never a thumb sucker she said and she wouldn’t have let me do it regardless but I didn’t do it anyways so that wasn’t a problem. So I don’t think there was anything out of the ordinary in that department.

Summary: I can’t think of any reason that I started biting my nails. I came from a middle class family, there were no family or external stresses I can think of and I didn’t come from a family of nail biters.

Nail Biting Prevalence

There is a wide range of stats describing how common nail biting is. Numerous research studies exist that use different age ranges that sometimes separate males and females but normally add them together. Here in general terms are indicative figures.

Age Group	Prevalence of Nail Biting
<4 years	Not normally noted. Toddlers may bite nails but it appears to be rare.
Children (5-12 years)	20% – 33% of young boys and girls.
Adolescents (13-18 years)	up to 45% of teenage males and females.
Adults (19+ years)	20% – 30% of male and female adults.

Summary: Depending on which study you’re looking at, the prevalence of nail biting varies by age breakdown and sex. Studies appear to agree that nail biting and picking tends to decrease as we age for both males and females.

Nail Biting Breakdown

Habitual nail biting at all ages combined is believed to affect 20% – 30% of the population. Depending on what research you come across, you may read widely varying numbers with slightly different age ranges. Some research shows that from age 10 onwards, more boys than girls bite their nails. While one study may suggest that more adult men bite their nails than adult women, another report will suggest the opposite. One report suggests that adults 18-35 years of age bite nails at a rate of 21.5% and that as we age, the rate goes down.

What typically isn’t researched by age group – which would be interesting and helpful – is how if at all the triggers for nail biting change as we age. I personally found that while I specifically recall picking my nails due to boredom, stress or anxiety when I was younger, as I got older I often caught myself picking nails while watching tv or working when I was otherwise busy, relaxed and certainly not bored.

Despite the various reports, nail biting is relatively under researched in the medical community although nail picking is even less so. One report summarizes quite succinctly both the fact that nail biting isn’t studied very frequently while also being a difficult habit to get a handle on:

Nail biting (NB) has been a less-published area in the literature of both of psychiatry and dermatology.^1,2 Medicine, psychology and dentistry have been unable to resolve the problem of NB.

NCBI

Summary: There is plenty of research available on nail biting but in the bigger picture, it’s relatively scant compared to other habits and areas of study. Research and commentary on nail picking specifically isolated from nail biting appears to be non-existent. Nail picking is lumped in with biting and is treated as the same thing by researchers even though it could be quite different.

In general terms, it appears that 20% – 30% of the general population may bite their nails at any given time although it’s difficult to say what actually defines a nail biter ie. a chronic nail biter is obvious but what about someone who only bites nails once in awhile or during specific, rare circumstances? Are they included too?

Nail Picking Prevalence

What is the prevalence of nail picking specifically? Good question. Nail picking isn’t necessarily discussed except in passing and is lumped in with nail biting which is a shame. Nail biting might actually be more difficult to quit (I was mostly a nail picker but bit my nails too) because you can do it more discreetly and many products like bitter nail polish are only good for nail biters and not pickers.

At this point, no major nail picking research appears to exist but it’s fair to say that nail biters in general most likely at times also pick at their nails. How many people are nail biters predominantly versus nail pickers predominantly would be a very interesting question to have answered. There’s no research that says that the methods to quit each type of nail activity should be the same, or different for that matter.

Summary: Nail picking can be done more inconspicuously and if you can’t bite your nails because of a lack of teeth or because you don’t like putting your fingers in your mouth, it serves as a viable alternative. Also, products that try to help you quit the habit tend to focus on nail biting only ie. bitter nail polish, mouth guard, habit breaking appliances. None of these prevent nail picking.

My Behavior

Oddly, even though I bit and picked nails from a young age until age 50, I really didn’t pay much attention to my actual activity. Up until right before I quit, I never really considered that I was actually more of a person who picked at nails and ripped at them with my other hand rather than biting them consistently. I did both but it was mostly a case of nail picking.

Here is what else I noted:

• I always bit and picked my left hand just enough that I never needed to cut my nails. I don’t remember ever biting a nail so short on my left hand that it hurt.
• I always bit and picked my right hand nails shorter. Always. Plenty of times I bit a nail(s) shorter than I would have liked and my finger hurt for a day or so. It was typically the baby finger and middle finger that got the brunt of the pain.
• I had orthodontic braces for 4+ years and bit and picked nails the entire time. My orthodontist never noticed I bit my nails (nor did any dentist) and never said anything even though braces and nail biting are a dangerous combination. I was never encouraged to stop nail biting by a dental professional once.
• I generally picked and bit my nails at home but occasionally did it when out of the house and even at friends’ house when no one was looking.
• I don’t recall picking or biting nails while eating, chewing gum or otherwise keeping busy with my hands and mouth.
• I never put noticeably dirty fingers in my mouth but that didn’t stop me from picking my nails instead.

Summary: Had I taken more interest in learning about my nail habit behavior sooner perhaps I would have been able to quit sooner. At a minimum I may have been able to reduce the activity by paying more attention to when I did it.

Identifying Your Behavior

Even though I bit my nails for over forty years, I really didn’t know my own behavior. I never really paid much attention to it. Unlike other habits where people generally know how many cigarettes they smoke in a day or how many drinks they consume each time, nail biting isn’t something I ever quantified. Do you know how many times you bite your nails every day and are you aware of every instance? Probably not.

While smoking or drinking is a quantifiable activity based on the number of cigarettes smoked or drinks consumed, nail biting can occur for a few seconds here and a few minutes there throughout the day at various times.

It wasn’t until after I quit nail picking and biting (or at least as I was in the final stage of quitting) that I really paid attention to my actual, specific nail biting activity. I was only really aware of a few things as listed above that defined my nail biting and picking routine. Had I done this sooner I’m certain that it would have helped me quit years ago.

Although quitting might not be easy for you, I have to say what amazed me the most when I quit about 5 months after my 50th birthday was how easy and quick it was to quit. To be specific, it was not easy to quit nail biting and picking full stop. It it was, I’d have done it decades ago. But when I did put the effort forth to quit, it came easy. I literally just stopped doing it one day and minus a few picks of my nails here and there, I went cold turkey. Last time I put my fingers in my mouth? I can’t remember.

What can you do to help yourself quit?

Write down or type out your list of nail biting behaviors like the bullet point list I wrote above in the My Behavior section. Your specific actions might be similar or they could be different to mine. The value in doing this is that you may identify your reason(s) for biting and picking nails and the environment in which it tends to occur. You will also identify if you’re actually a biter, picker or both like I finally did.

Summary: Identifying your specific nail biting and/or nail picking behavior will help you figure out if any of them can be avoided or otherwise dealt with. At a minimum you will help to crystalize specifics that relate to your nail biting that can ultimately help lead you closer to quitting.

Identifying Triggers

Triggers are long believed to be a main cause of nail biting, nail picking, pulling hair, lip biting and other habits. Specifically, a trigger is a reason that causes us to suddenly or chronically start biting and picking at nails as a reaction to the trigger. Common triggers that are often discussed as being reasons for nail biting include:

• Stress
• Anxiety
• Boredom
• Frustration
• Anger
• Perfectionism
• Insecurity
• Hunger
• Nervousness
• Need to keep hands busy
• Just something to do in general terms

Summary: Figuring out your trigger(s) is one of the keys to quitting nail biting as I found out after I quit. Had I known sooner it’s likely I’d have had a better chance to quit. Imagine if you could identify that your trigger – your reason for nail biting – is one that you could avoid or minimize with some different strategies.

Or like me, you discover after a period of time that your reason for nail biting is simply something to do and that you can quit by putting forth an effort to do so. By the time I quit, I think I’d had enough of nail picking and biting basically told myself: It’s my time to quit doing this. I don’t need to do this anymore.

Coping Mechanism

As you can see by the list above there are a number of potential triggers, some of which may occur because of very specific events (stress before a job interview or big test at school), at certain times of the day (boredom at work or at school) or because of things that you may be able to resolve (avoid hunger by eating something).

Researchers have long treated various habits like nail biting and picking as a coping mechanism, as a method for us to deal with whatever situation we’re in at the time. Yet if you look at the last two reasons listed above – the need to something just to keep our hands busy, and just something to do in general terms – these are not only triggers that I personally experienced but are ones that you’d think would be easy to avoid.

Summary: I could have easily picked something up and held it in my hands like a stress ball or even my cellphone to keep my hands busy. And if I needed something to do, I could have found something to keep me occupied. Anything. We could all do this. But I didn’t find an alternative and I’m guessing neither have you (yet) otherwise you wouldn’t be reading this. I just picked and bit nails instead. Perhaps you’re the same.

Controversial Triggers

Several old theories that used to exist regarding reasons for nail biting have now since been discarded. Several new controversial ones have replaced them that some people disagree with:

Oral fixation: This is a belief that nail biters have an oral fixation and satisfy it by sticking our fingers in our mouth and biting our nails accordingly. Sigmund Freud first suggested this “theory” although like some of his other theories, it is no longer looked at seriously although you may hear it referenced from time to time as if it’s still a thing. It isn’t. No one seriously considers this reason anymore and no actual proof of it was ever presented.

Self harm: One controversial reason for nail biting is that we somehow have a desire for self harm and manifest it by biting nails to the point that we bleed and make our fingers hurt. I personally have never felt this desire. In fact I would be mad in the rare instance that I picked or bit a nail and the moment I starting tearing it, knew that I’d taken off too much and that it was going to hurt. I don’t care for pain especially if it’s avoidable so this reason makes no sense to me personally.

Psychiatric Disorders: Research has tried to tie various mental health issues to nail biting but as of yet hasn’t done so successfully. There is a belief that mental health issues can lead to nail biting but not the other way around. Research suggests that around 80% of kids with psychiatric disorders including depression were also nail biters. That’s not to say that mental health issues cause nail biting but that those who have such issues may be more likely to be nail biters, too.

Another related school of thought is that if come from a family of nail biters, you are more likely to be one too ie. you mimic their behavior. And if a parent(s) has mental health issues, you may also be more likely to be a nail biter.

Obsessive Compulsive Disorder (OCD): The idea of nail biting being an OCD activity is one that came into prominence when the American Psychiatric Association’s 2013 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) broadly classified nail biting as something that is both obsessive and compulsive. It was a controversial move because not every repetitive activity is compulsive.

For me personally I guess I could say that nail biting and picking was obsessive at times but it wasn’t compulsive. Something is said to be compulsive when it is due to an irresistible, uncontrollable urge. When I think of my behavior in totality as a nail biter and picker, I put very little thought into it. Many times it was subconscious and automatic. It certainly wasn’t compulsive. I just did it without much consideration or thought.

Body-Focused Repetitive Disorder (BFRD): BFRDs are classified by the above-mentioned DSM-5 as “obsessive-compulsive and related disorders.” Some believe that around 5% of the population have a BFRD of some kind. A BFRD is an activity like nail biting, hair pulling, cheek biting or lip biting that potentially causes us serious harm but that we do anyways repeatedly. They are impulse control behaviors but for nail biters, only a very small percentage of us would fall into the BFRD category.

While some of these other habits can certainly lead to very bad side effects as can nail biting, most nail biters and pickers don’t get to the point of severe bleeding and pain. Most of us don’t bite or pick our nails to feel pain either.

Perfectionism: One study published in 2015 by the Journal of Behavior Therapy and Experimental Psychiatry of nail biters and other sufferers of BFRD concluded that the habit was due to perfectionism. When subjected to situations that invoked stress, anxiety, relaxation and frustration, test subjects were noted to take part in their specific BFRF (ie. nail biting) when they were subject to each of the four situations except for relaxation. When relaxed, they didn’t bite their nails, pull their hair, etc.

The conclusion was that nail biters do the activity when unable to perform or complete a task as required out of frustration and that perfectionism was the culprit. Ripping and tearing apart fingernails doesn’t sound like perfectionism to me.

Summary: I’m not a big fan of labels just for the sake of labeling. My long term nail picking and biting habit may in my younger years have been a result of dealing with stress and anxiety but I bit and picked nails every day for decades. I wasn’t that stressed or anxious! I just did it for something to do and because I was too lazy to quit.

I’m not a perfectionist to the best of my knowledge either. I tend to overthink things but in this case perhaps I’m doing the opposite: My long term nail picking and biting habit if I’m being honest was really just something to do for the most part. I just did it because I felt like it, much like when I bounce my leg while sitting. I could stop. I just choose not to, until I do.

Nail Biting Contributors

Over the years researchers have tied a number of conditions and contributors to nail biting that may make you more likely to do it. These include the following:

• You’re more likely to start nail biting as a child and while most people grow out of it and quit, many of us continue well into adulthood.
• You have a history in your family of nail biters ie. you see your parents doing it so you mimic them.
• Research has also suggested that children are more likely to be nail biters if at least one parent suffers from a psychiatric disorder.
• You have mental health issues (ie. depression) that perhaps could then lead to nail biting as a coping mechanism.
• You are diagnosed with OCD or BFRD more specifically.
• Various triggers that you deal with as mentioned above like stress, anxiety, boredom, etc.

Nail Biting Options To Help You Quit

You probably already know about bitter nail polish and nail biting gloves. You can check out some of the articles I’ve written about quitting nail biting that discuss various other quitting strategies:

How To Quit Biting Your Nails

How Do Psychologists Stop Biting Nails?

Stop Nail Biting Tips: Which Work?

How To Stop Picking At Your Nails

When I look back at my experience, I tried bitter nail polish once as a child on the suggestion of my mum but we gave up after one try. I was always more of a nail picker anyways so an anti-nail biting product would never have really helped me. In that regard, what is mentioned below are newer methods that didn’t exist for me but may help you.

Hypnosis

Hypnosis is used for a number of reasons and one common element that I’ve noticed is that it’s often used to bring old, suppressed memories to the forefront. You can then establish whether or not these memories caused or influenced your current behavior. Perhaps your nail biting began as a reaction to something you experienced as a child. Maybe you witnessed something traumatic and started biting nails as as result.

Interestingly, while nail biting research often comes from medical sources, the hypnosis research I found for nail biting comes mostly from actual hypnosis providers touting their own services. Here is one such practitioner that discusses the use of hypnosis for BFRDs like nail biting in their clinic.

Anti Nail Biting Appliance

Your dentist may be able to design and create a personal anti nail biting appliance that is affixed permanently in your mouth that physically prohibits you from biting your nails. The device can also be removable but undoubtedly a permanently affixed option would be better since once it’s installed, you have no choice but to live with it. It’s known more generally as a habit breaking appliance and can also be designed for other uses like tongue thrusting or lip biting.

A small metal and plastic bracket is affixed to the back of your front teeth so that when you try to bite your nails, it prevents the biting action from happening. You can’t physically bite your nails anymore. Small sample sized research appears to suggest that this sort of product may help to not only prevent nail biting but also act as a behavior modifier of sorts.

Check out my article on the Nail Biting Habit Breaking Appliance by clicking here to learn more.

Behavior Modification Therapy

Behavior modification therapy is a newer strategy that also makes sense to me. While bitter nail polish masks the problem in my thinking, this gets to the root of the problem. One method is a self-administered behavior-modification package where the subject does the work themselves. Another method is habit reversal training that usually involves support from others in your life such as your parents or significant other.

Habit reversal training is considered by some to be the best current method to quit nail biting as the original design of the method encompassed five major areas:

• Awareness training: Increase awareness of your behavior. For me, nail biting and picking was largely subconscious so this makes perfect sense.
• Relaxation training: The above-mentioned research showed that relaxed nail biters tended not to bite their nails or take part in other BFRDs when relaxed.
• Competing response training: When you feel the urge to bite your nails, you do a complete opposite activity until the feeling subsides.
• Motivation procedures: I wasn’t even motivated to quit nail biting so this also ticks a box for me. You need to be motivated to quit.
• Generalization training: In a nail biting context this may refer to training yourself in general to deal with all nail biting triggers using each of the methods you have learned. So regardless of whether you want to bite nails suddenly because of stress, boredom or some other trigger, you can use your training each time to deal with the urge.

Habit reversal training was originally developed with BFRDs in mind where you effectively become aware of the habit and create a competing response every time you feel the urge to bite your nails. So you wean yourself away from nail biting by doing something else that is completely opposite to your habit ie. balling your fist and holding it in place until the feeling to bite your nails subsides.

It’s quite a detailed subject and very specific to each individual. Research on the subject of behavior modification and habit reversal training can be viewed here.

Keys To Quit

In my experience as a long time nail biter and with hindsight, here is what I learned after I quit that I wished I’d known sooner regarding how to quit nail biting and nail picking:

• Write down your nail biting behavior specifically. Document in writing what you are feeling when you bite your nails, why you do it, why you feel powerless to stop doing it, where you were physically at the time you do it and the circumstances. The more specific the better.
• Monitor when you bite or pick your nails if you do both. Why do you do one activity instead of the other? If you only do one, why did you choose to do that instead of the other?
• Persistence is key to quitting. You need to be persistent otherwise you will undoubtedly start the habit again when you get triggered even if you are able to quit for a period of time.
• You need a strong, ongoing desire to quit. This is also key to quitting permanently and long term.
• You need to want to quit nail biting and picking. This probably sounds obvious but it certainly wasn’t for me otherwise I’d have quit decades earlier.
• Wearing a mask to protect against COVID? Use your mask wearing to help you develop the habit of not biting your nails every time the mask is covering your mouth!