A Gnawing Problem

Dr. William Grossman was a beaten — and bitten — man.

While not saving lives in the operating room, the former Harvard professor of medicine and chief of cardiology at the University of California, San Francisco, would counsel patients on how to overcome bad habits to improve their heart health.

But Grossman had a bad habit of his own that he couldn’t overcome — nail-biting.

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He tried pepper paint, manicures, and other remedies. Nothing seemed to work. He decided to enlist a power greater than himself.

“Finally, I got down on my knees and asked God for help,” Grossman said. “Then I kind of lost track of it. Maybe two months later or so I noticed something miraculous. I wasn’t biting my nails anymore.”

That was more than 20 years ago.

For many nail-biters, relief from an unsightly and unhealthy habit would indeed seem miraculous.

It is estimated that 30 percent of children, 45 percent of teenagers, 25 percent of young adults, and 5 percent of older adults bite their nails.

Some 30 percent of children, 45 percent of teenagers, 25 percent of young adults, and 5 percent of older adults bite their nails.

(For whatever this is worth, a ton of A-listers are nail-biters: Tom Cruise, ex-British Prime Minister Gordon Brown, Jackie Onassis, Britney Spears, Eva Mendes, Elijah Wood, Phil Collins, Kate Middleton, Andy Roddick. There are probably more we don’t know about.)

Nail-biting isn’t as potentially damaging as some other compulsive habits, but neither is it benign. Among the mental and physical health risks associated with it is infection.

Fingers and fingernails are very efficient collectors of disease-causing bacteria such as salmonella and E. coli. Even for obsessive compulsive hand-washers, bacteria can pass into the body and cause a cornucopia of health problems.

Even for obsessive compulsive hand-washers, bacteria can pass into the body and cause a cornucopia of health problems.

Nail-biting is a two-way street, and bacteria and other microorganisms from the mouth can pass into the skin and cause skin and nail infections — also known as paronychia — that can require surgery. And if you have warts on your hands caused by human papillomavirus, or HPV, those warts can pass from your fingers to your mouth and lips.

“Aside from the obvious (results) that people are more susceptible to getting colds, you can also do harm to your teeth, and if you’re wearing nail polish, you run the risk of ingesting toxins,” said Kristin Thames, a registered nurse at Cure Concierge in Malibu, California. “We have also seen skin infections from nail-biting.”

In 2013, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders upgraded nail-biting from “not otherwise classified” to “Obsessive Compulsive Disorder,” right in there with skin pickers, hand washers and people who have to line up their shoes and clothing in exactly the right way.

In Freudian terms, nail-biting is an oral fixation that goes back to infancy: “In the first stage of personality development, the libido is centered in a baby’s mouth,” Simply Psychology says on its website. “Freud said oral stimulation could lead to an oral fixation in later life. We see oral personalities all around us such as smokers, nail-biters, finger-chewers, and thumb suckers. Oral personalities engage in such oral behaviors, particularly when under stress.”

But Mary Lamia, a San Francisco Bay Area psychologist and psychoanalyst, takes exception with the Freudian theory on nail-biting as a misfire from the first stage of psycho-sexual development.

“When Freud developed the concepts of instincts and drives, he unfortunately did not have the benefit of the science about (emotions) that we now have 100 years later, specifically, that emotions are the primary motivator of behavior,” she told LifeZette.

“This includes the relational triggers of emotion involved in nail-biting. When children experience an obstacle to their attachment to a primary caregiver, certain emotions are activated, including those that lead a child to bite his or her nails.”

She also challenges the APA’s reclassification of nail-biting as an obsessive compulsive disorder.

“Nail-biting can be seen as a compulsive activity, such as hand washing. However, that tells us nothing about why it happens and what to do about it. It simply defines nail-biting as a symptom,” she said. “I have seen people in psychotherapy who gnaw their nails as well as their hands to the point of appearing they are eating themselves alive.”

Lamia said nail-biting is all about connection. A lack of connection can cause the symptom, and connecting with a loved one is the cure.

Lamia said nail-biting is all about connection. A lack of connection can cause the symptom, and connecting with a loved one is the cure, at least in her book.

“The nail-biter is helped by engaging with another person who pays attention to their bitten nails, comforts them, and in that way helps them to become aware of the relationship between what they feel and what they do in response,” she said.

“I recommend to parents of young children, as well as to partners of nail-biters, to take time every evening to hold the hand of the nail-biter and take a look at every nail, noting whether or not the biter has been ‘nice’ or ‘mean’ to each sweet nail that day and giving each nail a kiss. In this way, the biter personifies his or her nails as ‘10 little friends’ who should be treated kindly.”

So, compassion and connection — toward a loved one, or a higher power — will help cure the curse of compulsive nail-biting?

She added quickly, “Although this sounds very California woo-woo, it is not. It’s all about comfort and connection, which is likely what the nail-biter was lacking when he or she began the self-comforting behavior of nail-biting in the first place.”

So, compassion and connection — toward a loved one, or a higher power — will help cure the curse of compulsive nail-biting? For some, yes. But Thames, the nurse, said don’t hold the hot sauce quite yet. In addition to having treated dozens of patients struggling with nail-biting, she’s also the mother of two teenage boys, 17 and 15, who used to gnaw their nails to the quick.

“Coating their nails with hot sauce worked wonders,” she said. When her younger son went to college, he started in again when he had to study for exams.

Chewing gum proved a quick and easy substitute.