Trichotillomania
Trichotillomania is also known as Hair-Pulling Disorder and can be identified by the repeated pulling out of one’s own hair resulting in hair loss. Hair pulling can occur at various sites on the body and an episode of pulling is typically preceded by feelings of tension and followed by a sense of relief after the person engages in pulling. The hair pulling causes the individual a great deal of distress and may affect functioning in major life areas such as work, school, and interpersonal relationships. Attempts to reduce pulling or stop altogether may be tried by a person for years before finally seeking treatment.
Signs and Symptoms of Trichotillomania
Hair Pulling
A strong urge and the repeated pulling of one’s own hair.
Hair Loss
Hair loss patterns vary, ranging from thinned areas to full alopecia.
Concealing Hair Loss
Trying to hide hair loss by wearing hats, wigs, or other hair and makeup items.
Avoidance Behaviors
Social situations may be avoided due to feelings of embarrassment.
Significant Distress
Feelings of loss of control, humiliation, and discomfort related to pulling.
Impairment
Areas of functioning such as work, school, and social life are affected.
Feelings of Shame
Feeling ashamed about hair pulling, secrecy and self judgement are common.
Attempts to Stop
Repeated, unsuccessful attempts to reduce or eliminate hair pulling.
Treatment for Trichotillomania
CBT
Cognitive Behavioral Therapy helps clients struggling with Trichotillomania to identify and work to change unhelpful thinking patterns that tend to keep them “stuck” as well as explore the way thoughts, feelings, and behaviors are connected and how they have the power to change unhealthy thinking patterns into healthy ones. Coping skills and confidence are developed to assist in achieving treatment goals. With consistent practice, as the ways in which situations are viewed and interpreted changes, often the situations themselves begin to change, too.
HRT
Habit Reversal Training is a form of behavioral therapy that helps clients develop a greater awareness of how and when their urges to pull their own hair are affecting them as well as identify various situations when they notice the impulse to pull emerge. The client then comes up with a competing response (CR), which is a new behavior that can be done in place of hair-pulling. They then begin to practice using the competing response when they anticipate the urge to engage in a pull session. For example, a competing response for Trichotillomania symptoms may be for the client to write, type, knit, or draw while they wait for the urge to pull to pass.
ACT
Acceptance and Commitment Therapy guides clients to discover what is truly important to them in their life and then take action towards living life in ways that they find deeply meaningful. The acceptance component of ACT emphasizes a non-judgmental approach to the way people experience their thoughts and feelings and encourages purposeful living, even in the face of challenges. If you are struggling with Trichotillomania, ACT can be an effective supplemental approach to treatment to help provide hope, clarity, and a compassionate path towards healing.
“The curious paradox is that when I accept myself just as I am, then I can change.”
— Carl Rogers