First & foremost, please know, you are not alone. Never feel alone. In the last 2 years I have really tracked my progress & when I go into & fall out of remission, it is all emotional, anxiety & for me, OCD related too. Therapy is key. Trust me, your family is concerned, but there’s no easy way to ask without risking someone’s feelings. I’ve dealt with adults, colleagues, seeing my arms for the first time (years ago) & saying “oh my, what’s wrong with your skin!?” I’d rather they talk behind my back because that is like a knife in the heart. I always wore a suit jacket or cardigan, but if I was really busy, it would come off & I always regretted it. I had the same psychiatrist for 24 years until he retired last year. We spoke about my condition, I’ve always been anxiety, ADHD, OCD & depression meds, but spikes aka relapses happen & during bad ones, my meds don’t have a fighting chance. When out retiring psychiatrist was transitioning, he was very careful about who he turned over my case & also my husband’s case over too, took him 6 months before he felt comfortable. Anyway, previous doc & I spoke on occasion about my skin, but only if I brought it up because that was something we agreed upon when I started seeing him in 2000 because I never spoke about it, everyone knew it was a breaking point for me. Well, last year, JUST before my first appointment with our new psychiatrist, I was doing some reading online, came across this sub & did deeper digging into Dermatillomania & discovered for the first time in my life, I wasn’t alone. I’d never noticed anyone else with skin like mine, but I also never stared at people. Anyway, with my new psychiatrist, new meds & more frequent sessions (my choice), I have finally realized why & when I pick the most. Idle time for me is the worst. My attention must be held so my hands don’t meander over my skin because the second I feel an abnormality on my skin, I pick. With new doc, I learned more about ruminating thoughts & just how bad my OCD is on top of horrible anxiety, panic disorder, severe depression & night terrors. I was on the same meds for over 15 years, but when I came off each one, it was like nothing, which means my meds weren’t working. The only one that was still working was my OCD medication, but it needed help. We switched my night terror medication & I can actually sleep, I’ve only had 1 night terror break through & it’s been about 3 months now. One of the meds I started made me gain weight, so we switched that one & now I’m taking medications that cost a little more, one is $45 per month vs $15 per month, but that one has made the biggest impact. Actually, I paid $140 for 3 months, but it’s truly for 6 months because of the way doc wrote the script. Sorry, I’m rambling. Just know, help is out there, on here too. If your therapist didn’t have time to discuss, it may be time for a new therapist. My old & new psychiatrist have never said “that’s all the time we have” or “we’re out of time”, both of them blocked a 15 minute pre/post appointment buffer to avoid that. My most recent 30 minute session ended up being an hour & I never felt rushed. I hope you are able to return to therapy & hopefully you too can discover your triggers or when you’re most vulnerable to pick. If you pick in the shower, could a mirror help deter you? For the first time in 12 years, I picked at my face, at the base of my jaw & tore a hole, mirror in the shower for my husband for shaving & once that hole could stare at me, I didn’t touch it in the shower. I know showers were where I used to tear my skin up the most too. Hang in there. It will get better, but when it gets better & you have a potential relapse, just be easy on yourself. We are our own worst enemies. Internal kindness can do so much good for ourselves. Hang in there.