Monthly Archives: April 2007

Purple nostrils? Talk to your doctor about imipramine

Case report

The man with the purple nostrils: a case of rhinotrichotillomania secondary to body dysmorphic disorder

L. F. Fontenelle11The Anxiety and Depression Research Program and ,
M. V. Mendlowicz22The Ethics Research Program, Institute of Psychiatry of the Federal University of Rio de Janeiro (IPUB/UFRJ), Rio de Janeiro, Brazil,
Dr Leonardo F. Fontenelle, Rua Lopes Trovão 88, apt. 1501, Bloco A, Icaraí, Niterói, RJ, CEP 24220 071, Brazil
Fontenelle LF, Mendlowicz MV, Mussi TC, Marques C, Versiani M. The man with the purple nostrils: a case of rhinotrichotillomania secondary to body dysmorphic disorder.
Acta Psychiatr Scand 2002: 106: 464–466. © Blackwell Munksgaard 2002.


Objective: To describe a different type of self-injurious behavior that may be secondary to body dysmorphic disorder (BDD).

Method: Single case report.

Results: We reported a case of an individual who have developed the self-destructive habit of pulling and severely scraping hairs and debris out of the mucous membrane of his nasal cavities. We have proposed the term rhinotrichotillomania to emphasize the phenomenological overlapping between trichotillomania (TTM) and rhinotillexomania (RTM) exhibited by this case. The main motivation behind the patient’s actions was a distressing preoccupation with an imaginary defect in his appearance, which constitutes the core characteristic of BDD. The patient was successfully treated with imipramine.

Conclusion: The case suggests that certain features of TTM, RTM, and BDD may overlap and produce serious clinical consequences. Patients with this condition may benefit from a trial of tricyclics when other effective medications, such as serotonin reuptake inhibitors, are not available for use.


Is it a sin?

Nose-picking is the act of removing mucous from one’s nose with a finger or other body extremity. In the past, it was regarded as disgusting and led to social isolation, but in recent years civil rights groups, including INPA, have sought to make nose-picking socially acceptable. Nose-pickers are often called “pointers” in modern slang.
Pointer Politics
Pointers were once ostracized and shunned by society. Lately, however, they have been embraced as living an “alternative lifestyle” by more liberal groups. Meanwhile, conservative groups have stepped up their opposition to nose-picking, encouraging the public to boycott Pointer-themed movies and television shows and even calling for a ban on Pointer Marriages.

The problem is made more complex by that fact that while most Americans are totally disgusted by the idea of nose-picking, they don’t see the harm in a person picking their own or others’ noses in private. This led to loud arguments as to whether marraiges were public or private (including those where the members picked one another’s noses to exchange bodily fluids instead of kissing). Civil rights groups insist that those that object to nose-picking are being too Puritanical and old-fashioned, and that if they really long for the “good old days,” they should move to Pennsylvania and become Amish, or to Alabama and become a redneck. Several have taken this advice, but more to be away from the civil rights groups than from the Pointers.

Pointer Pride Parades
Pointers have organized several Pointer Pride Parades (often on St. Patrick’s Day, in honor of green, their favorite color). The most famous of these are held in Boston and San Francisco, where Pointers wear lots of nose jewelry, Groucho Marx glasses, and other nose-enhancing paraphernalia to enhance the prominence of their noses. Despite the success of these rallies, it is quite common to do, and see people picking their noses.

Fundamentalist Response to Pointers
Fundamentalist Churches have issued strong words against pointers, claiming that nose-picking is a sin and that unrepentant pointers are going to get a free ticket to Hell. Many former pointers have come forward and publicly denounced nose-picking, claiming that nose-picking is a choice, and a sinful one at that. Pointer-rights groups counter that some children are born with a natural tendency to pick their nose. Christian scientists dismiss this, noting that no animals in nature pick their nose. Other Christian groups have been more open to pointers, noting that God made everyone different, and that they are all beautiful. Even Michael Jackson.

Some more X-treme Churches, like the Westboro Baptist Church, claim that all of America is going straight to Hell without even a God-presided show-trial because of pointers. They point to the fact that there hasn’t been a law that we shoot anyone that picks their nose on sight in over 50 years as a sign that we are “losing touch with God.” The church adopted this policy because they believe that anyone who has ever picked their nose is an eternally damned sinner with no hope of salvation, because God just isn’t that powerful. It has been said that this Church has created more Atheists than Pat Robertson, but it is doubted that that is even possible. While they are devout in their beliefs, they are often ignored and despised by the rest of America.

If I had to pick, I’d pick

672 people were asked to finish the sentence “If I had to pick, I’d pick…”

Here are the results.


Way to go, J-Lo!


How to Pick Your Nose: In Defense of Nosepicking, the Unjustly Maligned Hobby

By Tom Russell

Parents, educators, and the medical establishment have disparaged nose-picking for years. It’s time to stop the hate.

Nose-picking is somewhat similiar to masturbation, in that both have been villified for centuries. Only recently has masturbation come to be seen as a healthy and normal human activity. Is it something we should talk about in polite company? No. Is it something that we should be doing in front of others? Of course not. But it’s not going to make you go blind or insane or any of the other silly “dangers” that parents, educators, and the medical establishment (the PEME) had been warning us about until cooler heads prevailed.

It’s the same with nose-picking. The PEME will tell you that it is unhygenic, that it is not safe, that a retrograde infection can spread from your nose to your brain. All that’s just a load of snot.

When done properly, picking your nose is not only hygenic and safe but fun. It also has a number of benefits. There is no better way to cleanse your nostrils of excess snot, thus improving the unhindered flow of air to your lungs. Blowing your nose is hit and miss. The PEME says that if you absolutely must pick your nose, you should use a facial tissue. This is not actually a viable alternative, but rather a tricky bit of discouragement from the PEME, as it is extremely difficult to pick your nose with any sort of precision while using a tissue. Your digit of choice requires as free a range as possible within the cramped space of your nostrils; fingernails are required to carefully pull the mucous out of your nose.

Nose-picking is also a very relaxing activity. It does not require a tremendous amount of thought or effort, but it is not boring, either. In some ways, its remarkably zen-like.

To properly pick your nose, you should be in a quiet, secluded area, sitting comfortably with your back fully supported. Make sure that your hands and fingers are clean; I don’t want anyone picking their nose after changing the oil in their car, which probably will cause an infection and give the PEME more ammunition. This is a cultural war, my friends, and so it’s up to all of us to pick our noses responsibly if we are to win it.

Generally, the two digits you’ll be using are your thumb and your prime (or index) finger. The prime finger is handy for scrapping snot from the septum, or the “inner wall” that divides the two nostrils. In most noses, this area holds very little excess mucous, both because of its small surface area and its shape. In the rest of the nostril, with its spherical dome, you’ll find vast deposits. And for this, you use your handy, dandy and opposable thumb.

Probe softly and pick lightly. As a general rule, your thumb should not enter the nostril any deeper than the length of your thumbnail. Do not shove your digits into your nose, and do not enter the actual nasal cavity.

And, while we’re at it, don’t pick your nose while you’re driving. First of all, the zen-like state of happiness that nose-picking induces will distract you from the dangers of the road. Secondly, a sudden stop and you could shove your finger or your thumb right up into that nasal cavity, causing your nose to bleed. And you certainly don’t want to jab into your brain.

Now, all of this sounds dangerous, but it’s really not; the danger has been exaggerated by the PEME and their hideous anti-nosepicking agenda. By keeping your fingers clean and exercising proper caution, you can pick your nose without incident for your entire life.

It’s important to restrict yourself to the picking of excess snot. If you pick too much, there won’t be enough mucous to do its job as part of your immune system. Generally, the mucous picked during one session should be no longer than half the width of the tip of your fingernail. It should also be of such a width to fit comfortably underneath your fingernail, which brings us to the real reason why people pick their noses: so they can play with it.

Roll it between your fingers, press it into the sides of each fingernail in turn. Rolling it on your pants, particularly corduroy, can be extremely relaxing.

It is important, however, to pick the proper kind of mucous for this sort of recreational use. Gooey, light yellowish-green snot simply does not do. It’s too sticky to roll properly and is not sufficiently pliable. The dried-up and crusty variety tends to flake apart like old parchment. On the bright side, both of these are signs of excess and in removing them, you’re helping the general health of your nose.

For recreational use, you really want something akin to dark green play-doh. It rolls nicely between the fingers, it is pliable and bends to your command, and yet it holds itself together rather nicely. You should be able to play with for an hour or so before it starts to harden. I find that the more I keep it moving, bending, and reshaping, the longer it remains pliable. Keep it stationary for too long and it hardens faster.

When it comes time to dispose of your mucous, pull out a tissue and deposit your hardening snot into its center. Fold it up and toss it into the garbage. Do not leave it on a table or, God help you, under one. Once you are done, wash your hands thoroughly.

By exercising these simple cautions and by refraining from public performance, one can find entertainment, excitement, relaxation, and, perhaps, philosophy, every time they go digging for gold. This threatens the PEME, who have been taught to find these things, and happiness in general, through the acquisition of material goods and martial conquest. This saddens me, and I hope that this article, in some small way, will help the new generation reject the rampant capitalism and imperalism of the PEME.

This is why I am in favour of a Nose-Picking for Peace Day.

2007 © Associated Content

Perchance to pick one’s nose

Musings on life, death and the nature of reality

by Jan Morris

This is what I dreamed. It was a short dream. I dreamed that Elizabeth said to me, casually over our coffee, “By the way, when you had the paper held up before your face before supper, was it because you were picking your nose, and didn’t want me to see?”
I had to admit that it was. “I have to admit that it was. It’s such an ugly thing to do, isn’t it, but sometimes I find it necessary. My nose gets so stuffed up. Do you suppose everyone does it? Does the Queen pick her nose when nobody’s looking?”
“I’m quite sure she does,” Elizabeth said, and there the matter dropped.
But it was a dream that was not entirely a dream. Was it a dream at all? Elizabeth tells me that we have never had such a conversation, but I have to admit that I had in fact picked my nose before supper, and had indeed hidden myself shamefaced behind the paper. It is such an ugly thing to do, isn’t it, though sometimes necessary even for the most fastidious. What has disturbed me about this little experience is its blending of sleep and wake, its accuracy so exact in some ways, so blurred in others, which has made me wonder where hallucination ended and memory began. Perhaps this overlap is true of most dreams but as I approach my eightieth year, I begin to wonder how much of it is true of life itself, and if the peculiarly easy, frank, inessential, glancing, but conclusive nature of our exchange over the coffee is what dying is going to be like.
Why, I wonder, should this particular inconsequential dream lead me to such portentous speculation? Something to do with childhood, you will doubtless say. It is true that I have one or two deeply ingrained phobias—for example anything to do with candles, like candlelit dinners, or candle wax—which I can only explain to myself by supposing they were planted by some experience in infancy. And it is also true that one of my most vivid memories, not a dream at all, concerns picking one’s nose.
Whenever I like, if I close my eyes and think hard, I can feel myself to be back within the few square feet of space, part light, part shade, that lies beneath the archway of Torn Gate at Christ Church College, Oxford. I have known it all my life, and whenever I please I can transport myself there. I’ll do it now. Sure enough, here I am in that shadowy archway, beneath the majestic tower, and even now its bell, Great Torn, reverberates around me, striking the hour. On my left is a fluttering bulletin board, and the usual jumble of bikes. On the right a stately porter in a bowler hat sits in his glass-windowed cubicle—the very same man, I swear it, who sat there in the 1930s, except that now he may be black. Students, dons and tourists sporadically pass through, and their progress in and out of the shadow of old Torn is like crossing a frontier.
For on one side the gate opens on to the tumultuous St Aldate’s Street, where the tide of the world thunders by, but on the other it admits its visitors to Torn Quad, one of the most magnificent quadrangles in Europe, regally serene and private. As I stand there halfway between the two it is like sniffing two drinks, a Heineken, say, and a Burgundy, whose bouquets seep in from opposite directions but never quite blend. They used to call this dichotomy “Town and Gown,” but nowadays it is a confrontation more subtle.
“Can I help you?” says the porter in a meaningful way, seeing me loitering there, half in and half out of the shadows of the gate. Christ Church College is a decidedly authoritarian establishment, founded in the first place by a cardinal and a king. But it is authority from the other side, the St Aldate’s side, the interference of the great world, of politicians and bureaucrats, of tabloids and ideologues, that I associate most pungently with Torn Gate. When I was eight or nine years old I was passing through the arch one day when I felt a tickle on my cheek, and scratched it with my finger as I walked.
At that moment there paraded down the pavement, walking in line ahead towards the police station along the street, half a dozen policemen, burly and helmeted in the manner of those days. They marched along, as they did then, in a semi-military way, and, with their antique helmets and their big boots, struck me as homely and rather comical. As they passed me one of them spoke out of the corner of his mouth. “Don’t pick your nose,” he said.
I wasn’t picking my nose! I was scratching my cheek! But I had no chance to remonstrate. The constables went dumping on, and seven decades later, as I meditate now, the resentment of that moment lives with me still. The unfairness of it! The arrogance! Perhaps it really is the emotion of that distant injustice, the latent dislike of authority that I feel to this day, which has obscurely linked the matter of nose-picking with the matter of mortality, via a short dream. Even if I had been picking my nose, what business was it of Mr Plod’s? And why shouldn’t I pick my nose now if I want to, whoever is watching, in my own house, seventy-eight years old?
But I protest too much. Shame enters my introspections. The habit of picking my nose only seized me, in fact, long years after that episode at Tom Gate, when a minor operation on my nose left it slightly dysfunctional—unable to clear itself by the normal processes of blowing or, I imagine, natural dissolution. Ever since, I have had to help it along by the unlovely process of picking it.
It’s such an unlovely thing to do, isn’t it, but d’you suppose everyone does it? I expect so, but since I am obliged to do so more often than most people, I am profoundly ashamed of it. As a matter of fact it is my only guilty secret, this unlovely habit. There have been times when I have been detected in the act. Passing motorists have caught sight of me picking my nose at the wheel, or at least I have thought they have, and although I have hastily scratched my cheek instead, and tried to persuade myself that they could not really have seen me, and anyway will never see me again, and probably don’t in the least care anyway, and are perhaps even gratified to find that somebody else does it too—even so, when they have flashed by, I am left ashamed of myself. It is such an ugly habit, isn’t it?
I am not actually ashamed of shame, if you follow me. Shame can be a saving grace, and certainly a consolation. We feel better ourselves if we are ashamed of something we’ve done, and, with luck, a show of shame can reduce the sentence in the courtroom, where slower-witted justices can be persuaded that shame is synonymous with regret. “My client is truly ashamed, m’lud,” counsel often successfully pleads, and he would have to be a moron to add, “but, m’lud, he doesn’t in the least regret it, and it would give him the greatest pleasure to do it again.” Shame and regret are certainly not the same things: je ne regrette rien, like charity, can cover a multitude of sins.
Shame can operate as a prophylactic, too. I first heard the word prophylactic when, with my batch of innocent recruits to the wartime British Army, I was given a welcoming lecture about the pitfalls of sex. I confused the word in my mind—why?—with little prayer-scrolls that used to be carried in leather pouches around the necks of rabbis, until my cruder comrades made songs and jokes out of it, and it was years before I realized that it had nothing either specifically sexual nor remotely Jewish about it, but merely meant a technique of preventive medicine.
The prophylaxis of shame can prevent bad behaviour before it happens. Often enough, like many another coward, I have been brave because I am ashamed to be frightened—or ashamed to look frightened perhaps, an even less admirable motive. Perhaps it’s true of everyone. I notice that shame, though it prevents me picking my nose in public, does not invariably bring out my better self when I am all alone.
But here’s a thought. Perhaps I was picking my nose that day, when the policemen marched past Torn Gate! I remember with absolute clarity that I was only scratching my cheek, but what if I wasn’t? It has been a dogma of my life that truth and imagination are not simply interchangeable but are often one and the same. Something imagined is as real, to my mind, as something one can touch or eat. A fanciful fear is as alarming as a genuine one, a love conceived as glorious as a love achieved. A virtual reality may only be in one’s own mind, imperceptible to anyone else, but why is it any the less true for that?
It is easy for writers, even writers of non-fiction, to think like this. Every sentence we create we have created from nothing, and made real, and every situation has been touched up in our memory. For years I remembered clearly how the roofs of Sydney Opera House hung like sails over the harbour when I first visited the city, until it was drawn to my attention that the Opera House hadn’t been built then. Every place I ever wrote about became more and more my own interpretation of it, more and more an aspect of myself, until in the end I determined that I was the city of Trieste, and Trieste was me, and decided it was time for me to give up travel writing.
I realized then that my dreams and my realities were merging. Could it be that much of what I had experienced in life I had not really experienced at all, except in my imagination? This was not at all an unpleasant conjecture—oddly soothing in fact, and it is what made me think that my dream about picking my nose, my shame about it, my secrecy, my denial, my realization that half was a dream and half wasn’t, the easy resolution of the conundrum, the sensation that it didn’t much matter anyway—all made me think that such a cloudy transition from one condition to another, or vice versa, might be what death will be like. If this essay is a muddle too, with its inconsequential repetitions—not at all my waking style—that is because I have allowed it to float along with the stream of instinct, among the weeds and little whirlpools, like Ophelia.
I always used to think that the most frightening words in literature were Hamlet’s “perchance to dream:” To die—to sleep/ To sleep, perchance to dream/ Ay, there’s the rub/ For in that sleep of death what dreams may come…
For years I laughed at Ivor Novello, who used the phrase as the title of a frothy operetta. But now I think the dreams of death may turn out to be much like my dream of life, mysteries gradually dispersing, shames forgotten, truth and fancy reconciled, drifting downstream through the weeds and the reeds—lazily, as Lord Salisbury once said of British foreign policy, “and only occasionally putting out a boathook to avoid a collision.”
“Picking one’s nose is a horribly distasteful habit, isn’t it,” I said, “though I don’t quite know why. D’you think Marilyn Monroe did it?”
“I’m sure she did. Edith Sitwell, too. I imagine Caligula did. Rabbis do it, spacemen do it, policemen marching down the street do it …” She was singing the words by now, to a familiar melody by Scriabin, but soon I woke up, and high time too.

Excerpted from the British literary journal Granta (issue 87, autumn 2004). Subscription information: Granta, 2-3 Hanover Yard, Noel Road, London N1 8BE, United Kingdom,,

Justin Timberlake’s nose pick

by Life Style Extra (UK)

Justin Timberlake has confessed he picks his nose.

The ‘SexyBack’ singer admits his worst habit is his penchant for a nasal rummage but insists he isn’t embarrassed to admit it.

He said: “I pick my nose and I’m not ashamed to admit it. If there’s a bogey there then just pick it man!”

Although he will proudly admit to picking his nose, Justin – who has previously dated Scarlett Johansson and Britney Spears – insists he “doesn’t” eat the contents of his nostrils.

Meanwhile, Justin has been seen kissing Jessica Biel at a Malibu party.

The pair arrived at a friend’s birthday party holding hands on April 6.

A source said: “If Jessica was talking to a group of girls, Justin would come over, kiss her neck and start making out with her.”

Shortly after Justin split from Cameron, he and Jessica were seen flirting at Prince’s post-Oscars party and also enjoyed a skiing holiday – but denied they were dating.

(C) Bang Media Intl.