Mind and body · Skin picking and hair pulling
What guests often describe after the retreat is a quieter mind, and a clearer view of what the picking or pulling was soothing. Since 2012 we have held a medically supervised iboga retreat on the Mayan Riviera near Cancun, Mexico, where a traditional Missoko Bwiti ceremony is paired with therapy and three months of follow-up at home. It works alongside habit reversal training, never in place of it. If your hands go there before you notice, you are not alone.
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Quiet Hands
Skin picking and hair pulling: the ceremony, the numbers, the research and how to prepare.
How it works
No study has tested iboga or ibogaine for skin picking or hair pulling, so we never promise that the urge will go. A retreat takes you away from your usual triggers for a while, which is not the same as lasting change. What we offer, from our experience since 2012 with 7,677 guests, is a supervised opening alongside therapy.
Before you travel, our physician reviews your health, your skin and your medicines. On the night she and the medical team are in the room, and the practitioner gives the medicine in steps, watching each guest.
In the Missoko Bwiti tradition the ceremony begins with the person, not the habit. Guests often describe a long, lucid review of their life: the tension, boredom or worry the picking or pulling had been carrying. Belief is not required.
Screening with our psychologist, the ceremonies, a life review the next day, then three months of integration calls. With your consent we write to your own therapist, so habit reversal work goes on at home.
Who holds it
Michael and Cory open and hold the ceremony; Tania, our psychologist with close to a decade at Mexico's National Institute of Psychiatry, screens for what iboga cannot hold and carries the integration; Dr Villarreal keeps the body safe.
Safety
Most of what matters is simple, and all of it is asked in screening.
Tell us about every medicine, including SSRIs or clomipramine, and every supplement, NAC included. Some antidepressants change how the body clears ibogaine. Never stop on your own: any taper is planned with your prescriber and our physician.
Our physician checks for open or infected wounds before the ceremony. If you ever eat pulled hair, please tell us: it can block the gut, and we would rather know.
Many people who pick or pull also live with anxiety or depression. Tell us about your mood, now and in the past. Picking and pulling are not suicidal self-harm, but if you have thoughts of ending your life, call or text 988 in the US or Canada.
Iboga affects heart rhythm, so every guest has an ECG and a medical screening before travel; read how we protect your heart. Guests must be 18 or older.
Who it is for
Adults with skin picking or hair pulling, diagnosed or not, who are doing habit reversal work or ready to start it. People who want to look at what the urge has been soothing, and who are willing to keep practising after.
Active psychosis or recent mania, an unstable eating disorder, acute suicidality, a medication that cannot be tapered in time, pregnancy, or a heart condition. The psychologist and the physician decide together, and sometimes the answer is a later date.
Why it is hard
Skin picking (excoriation disorder) and hair pulling (trichotillomania) are body-focused repetitive behaviors, in the same family as OCD. They are not bad habits or weak willpower. In 2020 online surveys of 10,169 US adults, about 1.7% had hair pulling disorder and 2.1% skin picking disorder.
Picking or pulling can ease tension, boredom or anxiety, or simply feel satisfying, and that relief teaches the hands to go back. Some episodes are focused and urge-driven; others are automatic, under way before you notice. Triggers can be sensory, emotional, mental or tied to a place, like the bathroom mirror or the car.
Habit reversal training has the best evidence. With a therapist you learn to notice the urge and the moments that bring it on, then to use a competing response, a movement that keeps your hands busy until the urge passes, with support from someone you trust. In a 2020 review of 24 trials, behavioral therapy with habit reversal had a large effect compared with control. Barriers like gloves or bandages help some people too.
If a therapist is hard to find, self-help habit reversal programs had a medium effect in a 2022 trial of 334 people. The TLC Foundation for BFRBs lists therapists and support groups.
About NAC. N-acetylcysteine, sold over the counter, beat placebo in one 50-person trial in hair pulling and one 66-person trial in skin picking. The evidence is limited, and it does not replace therapy; ask your doctor first. SSRIs give mixed results, and no medicine is FDA-approved for either condition.
Dates
Open retreats and the dedicated veterans' dates. Eight guests each; full list on the schedule.
Your hands have been trying to calm you. Here we look, gently, at what they were calming.
Pricing, US dollars
All inclusive from Cancún airport: screening, ceremonies, room, meals, three months of follow-up. All payments are final, see the terms. Full pricing.
Questions about skin picking and hair pulling
When it is repeated, hard to stop, causes skin lesions and real distress, it is a recognized condition: excoriation disorder, in the obsessive-compulsive and related disorders. That is not a judgment; it means there are treatments built for it.
Recurrent hair pulling that causes hair loss, with repeated attempts to stop and real distress. It can involve the scalp, eyebrows, eyelashes or anywhere else. Clinicians separate focused pulling, driven by an urge, from automatic pulling, which happens without awareness.
About 1.7% of US adults, men and women at similar rates, in a 2020 online survey of 10,169 people. Pulling began at 17.7 years on average, and 79% had another mental health condition as well.
Habit reversal training with a trained therapist is the best-studied approach: noticing the urge, using a competing response, getting support. Barriers like gloves or bandages, and changes to the places where you pick, help some people too.
One 12-week trial of 50 people found 56% much or very much improved on NAC, against 16% on placebo. That is encouraging, but it is one small trial. Talk to your doctor before trying it, and tell us if you take it.
It sits in the same diagnostic family as OCD but is a separate condition. The treatments differ too: habit reversal training is the main therapy for hair pulling and skin picking.
Often. Many people pick to ease tension or worry, and the relief keeps the cycle going. Boredom can trigger it too, which is why therapy maps your own triggers first.
Some people improve, but without treatment it is often long-lasting. With habit reversal training many people pull or pick much less. Slips are part of it and say nothing about your worth.
No. Picking and pulling are not suicidal self-harm, even when they leave marks. They can still travel with low mood. If you ever have thoughts of ending your life, call or text 988 in the US or Canada.
No study has tested iboga or ibogaine for either, so we do not claim it does. Guests describe a quieter mind and a clearer look at what the urge was soothing. We offer that as a supervised opening alongside habit reversal work, never instead of it.
Usually, once our physician has reviewed it. List every medicine and supplement on your health form. Never stop an antidepressant on your own; any taper is planned ahead with your prescriber.
Yes. Guests must be 18 or older. Pulling often starts in the teenage years; for a young person, a therapist trained in habit reversal is the right first step.
You've carried this long enough. Start with a conversation with our medical team.
