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.

Abstract

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