by Were it not for Aneela Idnani’s highly visible sign of mental health, she probably would have kept it a lifelong secret, even from loved ones. But when she fell on her husband in the bathroom early one morning in 2013, she was no longer in hiding: She could see, as clear as day, that her eyebrows were completely gone, after an outburst the night before her hair loss. a condition characterized by the desire to pull one’s hair. Because of the stigma attached to hair loss, Idnani had carefully patched holes in her eyebrows with skillful makeup moves for years, instead of dealing with it. But at the end of the opening to her husband she came up with an idea for an awareness-focused solution to help both herself and others on the same boat.
Shortly after revealing her condition to her husband, Idnani did her typical hair pull one day while sitting on the couch – until she gently grabbed her wrist. “This feeling created an instant a-ha moment,” says Idnani. “I thought, ‘Oh, if I could have something on my wrist that would alert me right away when I was going to pull, could that help me?’ It was then that he first realized the power of real-time awareness to stop semi-conscious behaviors, including those typical of trichotillomania, as well as other repetitive body-focused behaviors (BFRBs), such as skin picking and biting. nails. Thus was formed the original idea for a bracelet with technology that could create this useful awareness with a slight vibration.
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In 2016, Idnani — one of Well + Good’s 2021 Changemakers — formally relinquished its full-time position in digital advertising to start HabitAware with her husband, Sameer Kumar, whose physical and engineering background would help consolidate the design of its first company. product, Keen. It is a wearable that you can train to detect gestures associated with unwanted BFRBs, such as raising your hand to your face. When Keen senses these movements, he vibrates and, in turn, brings the user acute awareness of such behavior. A connected application also monitors behavioral incidents, which can help the user better understand any patterns.
“With repetitive body-focused behaviors, people will say, ‘Oh, why don’t you stop doing it, stop collecting or pulling?’ “But that is like asking someone to stop pumping blood.” —Aneela Idnani, co-founder of HabitAware
In many cases, this awareness alone can change lives. “With repetitive body-focused behaviors, people will say, ‘Oh, why don’t you stop doing it, stop collecting or pulling?’ “But it’s like asking someone to stop pumping blood.” “These behaviors occur mainly in the unconscious part of the brain. While you may be vaguely aware that you are doing it, for the most part you are out of control. But when you have the vibration [from Keen]the behavior becomes fully conscious and you have the power of whether to keep doing it or to stop. “
The role of repetitive behaviors that focus on the body in mental health
Actions such as pulling your eyebrows or hair, biting your nails, or picking up your towels or skin may seem harmless to those who do not have a BFRB. But it was this perception that allowed these conditions – which affect about 20 percent of the population – to exist in the shadows until recently. The category was added to the Mental Disorders Diagnostic and Statistical Manual (DSM-5), the American Psychiatric Association archive for all mental health disorders, in 2013, just as Idnani was seeking help from a therapist – the who just got away with it. “I told her I could not stop pulling my hair and she said, ‘Okay, stop doing this. “Let’s talk about your father’s death,” he says.
“How I describe BFRBs is that they serve a purpose, which is to soothe themselves, but they just do not serve it well.” —Indnani
What the therapist lacked is that the two are inextricably linked: Repetitive body-focused behaviors are often self-healing mechanisms that, in Idnani’s case, had emerged as part of the way she dealt with her father’s death. and reappeared when she was particularly stressed. “How I describe BFRBs is that they serve a purpose, which is to soothe themselves, but they just do not serve them well,” says Idnani. It is like a message from our subconscious to our consciousness, saying “Watch me”.
Certainly not everyone struggles with BFRB with a deeper problem or trauma of the past. In many cases, this feeling of discomfort caused by the behavior may be related to current stress, anxious thoughts, or overexertion — or any of the ways in which one may ignore one’s needs when those feelings arise. “When you realize that a behavior is happening in real time, you can then ask yourself questions to understand the source of this discomfort: Is it one in the morning and you are exhausted from the day and just need to sleep? Is it one in the afternoon and you haven’t gotten up from your desk in six hours? “The point is to be able to answer the call, whatever it is,” says Idnani.
This is exactly why Keen’s current iteration, Keen2, will soon surpass the moment awareness to include strategies for actually replacing junk behavior with a healthier one.
How HabitAware is evolving to help anyone with repetitive body-focused behavior break the cycle
While awareness was the cornerstone of Keen’s original bracelet, “it did not answer the whole question of the behavior change process,” says Idnani, “which is to understand how, once you realize the behavior, you can still fulfill its soothing purpose. but in a healthier way. ” In essence, this means identifying a replacement behavior and engaging in training to completely reverse the original habit – both of which will be available on Keen2.
This newer version, released earlier this year as part of the National Institutes of Health (NIH) Phase 1 research grant, has a few more portable bells and whistles (now includes time and step tracking, for example), also as an improved algorithm for detecting and measuring unwanted gestures as they occur. The related application also includes a more detailed toolbar, where users can access peer-to-peer guidance and will soon be able to practice new reversal techniques.
“We’ve played and digitized this reversal training into three elements,” says Idnani. “The first is awareness training, with a program called Beat Keen, where you can actually delay the vibration by showing that you know an unwanted gesture as soon as it starts. The second is training in competition, where the application asks you to record a wrist gesture, which it may later ask you to do instead of the BFRB gesture. And the third is support training, which is provided through in-app motivation videos. “
The goal is for HabitAware to become a single store for anyone who wants to identify, control, and ultimately treat a BFRB. “As we look at new innovations, it really has to do with understanding what makes our user stand out, in a sense. Why are you susceptible to this behavior? What triggers you? And how can we really help you take care of yourself in a different, more supportive way? ” says Indnani.
As repetitive body-focused behaviors become more and more recognized and normalized – in part because of HabitAware itself and the wider mental health issue in general – Idnani’s focus extends to other situations, with the help of a national phase 2 Grant of the Scientific Foundation. “We work with treatment professionals to develop a methodology that can help people with other conditions of which lack of awareness is paramount,” he says. “Our hope now is to see what other mental health communities we can serve that have been largely ignored or rejected in the past.”
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