A Business Management Student


This study is a study involving a 24-year-old female student, R.O, pursuing a degree in business management having the habit of nail biting exhibited through its functional analysis (Iorizzo et al., 2007). She decided to look for help due to a lot of stigmatization and backlash from her peers and infections on her fingers due to the regular nail biting exposing sensitive skin (Vyas 2017). She hopes to reduce the habit or better still, stop it completely and find a better way to cope with her anxiety, to rebuild her confidence and generally improve her concentration. After the implementation of the treatment, there is decrease of the nail biting that was shown by the growth of nail and participant self recorded data of the participant.

R.O is an undergraduate student aged 24 years in southeastern United States studying in a public university who decided to seek for help due to her continuous nail biting habit. According her report, she has been doing nail biting from her early teenage years. She has never sort for any professional treatment for nail biting as she thought it was just a phase, although a number of self-implemented strategies have been tried by her such as application of nail lacquer. However, none of her strategies have been successful. There was no report of her having any history of depression or anxiety as reported by her but she admitted to often biting her nails when worried or in deep thought (Sun et al., 2018). Recently, she started having infections in her fingers and also the frequent backlash from her peers due to her habit have affected her and made her look for help.


Ethics Statement

The governing procedures under the code of ethics were explained in detail to the client, boundaries were established which she got to understand and was happy to continue on the terms. The tutor gave consent regarding submission of the findings from working with this client as a case study.

The analysis of R.O’s nail biting habit has revealed a number of triggering factors both from within and externally. From within, it was noted that her impatience causes her to get anxious leading to the biting of her nails as a distraction from what is going on around her. External factors included lack of friends causing her to try and distract herself, unhealthy study habits making her lose concentration fast. Her frequent anxiety and low confidence was due to her spending a lot of her time alone therefore not being exposed to a lot of people making her anxious whenever she is around people and also her peers making fun of her habit (McCloughan 2016). Adjunct measurement was effective for the treatment where R.O recorded the nail biting with a frequency count throughout the day within 1 hour interval outside the setting of a clinic. The data that has been self recorded have been collected in a 4 week period.

Treatment Proposed: It was decided that this approach would help R.O reduce her nail biting habit, improve her confidence and concentration in everything she does.

The client was to attend a total of three sessions where PMR, Deepener and suggestions would be used in all the sessions (McCloughan 2016). The inductions would be short in the first session. The sessions would be carried out to try and help R.O control her nail biting habit, anxiety and general concentration. Homework will be set after the first and second session they’ll include telling her to try say hi to at least five people on her way home and start a conversation with at least one person, get out of her room at least thrice a day and visit a park and any place that excites her among other few things. Feedback will be collected at the beginning of the next session she attends after her homework. The sessions will be held weekly and regression will not be used.

R.O was told in detail how the sessions would help her tackle her nail biting habit, improve her concentration and confidence with an emphasis being made on how important the therapy would be to her if she cooperated and relaxed. The inductions were then explained to her and she had some idea as she said she had followed some guided inductions on YouTube. R.O was receptive to PMR as she followed the instructions given and her body immediately relaxed (Ortega 2017). It was observed that she let her guard down and was open to a number of suggestions. She was more receptive with time and even said she would try use the induction to make herself relax even away from the session. The deepener then helped her explore and examine herself and she described it as a self-awareness journey which she said was very helpful as she listened to even the parts of her that she had never paid attention to. It was however not so long as the inductions were to be short for the first sessions but she enjoyed them and could not wait to come back for a long induction session. When asked about the subject, she talked of her love for animals which was incorporated in the deepener and she seemed to love it. She bit her nails twice at the beginning of the session. At the end of the session, she noted how she felt. She was assigned a homework of leaving her house at least thrice that week for places other than class.

On attending the second session, R.O appeared eager, relaxed and happier than in the first session. On inquiry, she said her moods had been lifted throughout the week. She even offered information on the homework given to her on her own. She had been to the park, had gone for a run one morning, gone to a bookshop and bought a book on animals living in the Himalayas and had gone for a walk one evening. All this were noted as improvements as initially she had talked of loving staying indoors alone than leaving her house. R.O also mentioned having read her books for two hours and concentrated throughout as opposed to before where she could barely last an hour. The session began and R.O easily relaxed this time faster than before until her breathing became slow and evened out. She allowed her body become relaxed physically as the PMR induction continued and released all her day’s stress and her muscles let go of tension as her creases disappeared and shoulders relaxed. After she relaxed, staircase deepener was incorporated. She was very receptive and sank deeper into relaxation as she was led to descend the staircase which was aimed to lead her into deeper relaxation with each step. She was then led into the animal world which she seemed to enjoy a lot. On being brought out of her hypnosis, R.O was all smiling and talked of how she had seen a number of animals even those in the Himalayas and how beautiful it was. Animals intrigued her and her favorite were Alpacas, she loved how gentle they were and had wanted to own one since she was young. She was so pleased and proud of herself and some increased self-love as observed. She again noted any improvements and observed that she had not bitten her nails even once since we started the inductions. When the session ended, she was given the task of saying his to at least three people and starting a conversation with at least two people.

R.O was available for the session early and could not wait for it to start. She had carried her notebook where she happily showed how her nail biting had gone down that week. She could stay for four hours at times more without biting her nails and she was happy to talk of how she had tried the relaxation induction therapy at her home and had felt relaxed. On inquiry, she had managed to say hi to five people but had failed to strike any deep conversation with any of the people. Her spirits had started deflating but after her big achievement of having tried to make friends had been pointed out she was happy. Within the session, authoritarian permissive muscle relaxation (PMR) was adopted which was slightly different from the previous permissive PMR used in the two sessions. She was guided through the process and she understood that she was the one in control this time. After a slightly longer time, she managed to relax and concentrate on the voice guiding her and the outside voices faded as she concentrated on her breathing. Her body then proceeded to relax further as her muscles released her tension and she was receptive of the change. She was guided through an awareness deepener as deeper with each passing minute. She was guided to be aware of each part her body and she was able to slow her heartbeat and whole body using her mind, to feel each part of her body and it was observed that her muscles relaxed including her face muscles. She was then led into an imaginary world full of animals as she had describing liking previously. R.O was guided to use her much acquired skills in generating energies that would lift her confidence, focus and reduce her anxieties (Panda 2014). She was very still and on ending the session she did not appear to want to come back to the real world. This raised alarm but on using her full names and much counting up and much coaxing, she woke up. She had a smile throughout and wished the session would not end. She talked of the number of changes she had noted through the sessions and how light and relaxed she felt.

It was observed that R.O’s nail biting had gone down a lot as she had reported to have been biting her nails at times twice a day or thrice. She had not stopped completely but had made big improvements. She was more aware of herself and more confident. The goal of helping her stop her nail biting, helping her with her confidence and concentration was not fully achieved as she still occasionally bit her nails but a large part was achieved. She was very happy all the same as she had managed to achieve her purpose as over the sessions she had become better , had managed to carry out the homework given and had recorded a great improvement. It was clear R.O had gained a lot from the sessions and this could be seen by her joyful state and a more healthy perspective of how she perceived herself. It was agreed that more sessions be scheduled at the end of the study to help her stop her nail biting and anxiety fully, permission was granted by the tutor. Two more sessions were scheduled for after the study.

When there was measurement of the total nails length during the next session of the treatment, total length of the nail was 10.4 cm. However, following the introduction of the complete first session, total length of the nail augmented over the next two sessions of treatment (Halteh et al., 2017)

As the effectiveness of treatment’s adjunct measure, R.O had self-recorded the frequency data of nail biting during the interval of one hour for a 4 week period that took place throughout the day every day. The self-recorded nail biting results are provided in the Figure below.

Global Railway versus Air Global Railway versus Air

R.O was generally receptive throughout the sessions and responded well to the suggestions. Regression was not used and further studies will be made on how best to awaken a client who goes into a very deep state as this had caused some alarm and a little panic. The study of just one participant makes the study limited in terms of external validity. The functional analysis literature of nail biting is sought to be extended in this study that includes the development of treatment package from the data of functional analysis. Other inductions should also have been used and a reason for the client resorting to nail biting in the past when it begun looked into.

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The therapy sessions have helped R.O reduce her nail biting, improve her confidence and concentration. The study has proved the effectiveness of the inductions and the whole therapy in helping control certain harmful habits. R.O had come for help for her to stop her nail biting habit and build her confidence. She knew she had achieved part of her goal as the nail biting reduced tremendously, she was feeling relaxed and happy and was more aware of her body which lead to her increased confidence.

When did it begin?
How has your life been affected?
What have you tried before?
What do you hope to achieve?
How will you know when you achieve?
What comes to your mind when you think of a very relaxing place to be?

Medical History

What frequent illnesses have you been diagnosed with in the past? Do you currently suffer from any prolonged illness? If yes, kindly explain. List current medications you are taking: Have you ever been treated for a mental illness or behavioral problem? If yes, kindly explain

Terms and conditions

The above practitioner may not guarantee results and I understand that.
Hypnosis does not diagnose any condition or treat or prescribe any drugs.
I am aware that the practitioner is still learning hypnosis hence the process being done for free.
I have been informed that I am free to stop any or all sessions at any given time. I have agreed to proceed with the sessions.
I understand that confidentiality is guaranteed.
Further treatment may be suggested if it is determined that my condition is beyond this level of therapy. I agree to all the above terms.


  • Falkenstein, M. J. (2016). Clinical Aspects of Hair Pulling, Skin Picking, and Nail Biting. Current Treatment Options in Psychiatry, 3(4), 375-384.
  • Halteh, P., Scher, R. K., & Lipner, S. R. (2017). Onychophagia: a nail-biting conundrum for physicians. Journal of Dermatological Treatment, 28(2), 166-172.
  • Andy Moore, Faith Waude, and Steve Armstrong (2018). PMR and Hypnotic Deepeners. Retrieved from
  • Iorizzo, M., Piraccini, B. M. and Tosti, A. (2007) ‘Nail cosmetics in nail disorders’, Journal of Cosmetic Dermatology, 6, 53-58.
  • McCloughan, L. J., Hanrahan, S. J., Anderson, R., & Halson, S. R. (2016). Psychological recovery: progressive muscle relaxation (PMR), anxiety, and sleep in dancers. Performance Enhancement & Health, 4(1-2), 12-17.
  • Ortega, T., & Ortega, F. F. U. T. (2017). Stress Management Series: Progressive Muscle Relaxation.
  • Panda, S. (2014). Stress and health: Symptoms and techniques of psychotherapeutic management. Indian Journal of Positive Psychology, 5(4), 516.
  • Roozbahani, T., Nourian, M., Saatchi, K., & Moslemi, A. (2017). Effect of Progressive Muscle Relaxation on Anxiety in Pre-University Students: A Randomized Controlled Clinical Trial. Advances in Nursing & Midwifery, 27(1), 32-37.
  • Sun, D., Reziwan, K., Wang, J., Zhang, J., Cao, M., Wang, X., & Zhong, L. (2018). Auricular Acupressure Improves Habit Reversal Treatment for Nail Biting. The Journal of Alternative and Complementary Medicine.
  • Vyas, T. (2017). EFFECT OF CHRONIC NAIL BITING AND NON-NAIL BITING HABIT ON THE ORAL CARRIAGE OF ENTEROBACTERIACEAE. Journal of Advanced Medical and Dental Sciences Research, 5(5), 53.

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