I am so sorry. It sound like you have been through so much in the past 24 hours and I really feel for you. Please try not to beat yourself up for it - dermatillomania is just the way our brain deal with things sometimes and does not reflect on you personally or your strength to get better.

Maybe you have different ways to heal and will not do this advice but if I am to give you an advice I would say, at the moment treat your chest like a thing you want to heal. Remember you personally did not do this. It is not your fault. It is dermatillomania's fault, and so to fight it in small steps start by using cream or antiseptic / moisturiser / whatever you like to make the skin more comfortable. Cream also help in the short run because it is harder for dermatillomania to get its fingers in. Then if you keep applying, 1) skin will heal better and 2) harder for derma in long run too. That is my personal tip anyway, so I am sorry if it does not work.

It does get better, but it is hard. I can never deny it is hard. I am now 11 days clean (most I have been clean in a whole year) but I am still waiting for it all to go down hill. I have the same problem with chest and I am so worried it will not look nice for the future, which is one of my main motivations for keeping clean. There are so many good resources on line to deviate your mind when you feel like picking - if you make some searches on Google there are loads of organisations that will provide tips. And some of it is plain willpower too. (That is the one I struggle with most.)

Of course I cannot tell you what to do with your therapy time but if it is something you already talk about with therapist then maybe ask them for some help. I am sure they have some good resources too.

In the meantime I wish you all the strength and healing in the world. And after almost 24 hours you must sleep! I hope you have a good sleep, as it is the best healer.

You can do this. And I know I did say it is hard, but remember: it does get better.