Trichotillomania is a recurrent, chronic compulsion to pull hair. It usually starts in early adolescence and can last a lifetime. The behavior causes significant distress physically and emotionally often causing people to withdraw socially for fear of judgment. There is no cure for this disorder, but it can be successfully managed. Therapy by a qualified body-focused repetitive behavior practitioner would be the ideal method to deal with trichotillomania. This article highlights ten things you can do to deal with it.
1. Identify pulling behavior trends.
Increasing awareness is the first step in effective treatment. Identification of pulling behaviors includes tracking patterns. One way to do this is to keep a hair pulling journal that records the following for each hair pulling episode:
- Time of day pulling episode occurs.
- Location pulling occurs.
- How long does it last?
- How do you feel when you start?
- What causes you to stop?
- How do you feel when you’re done?
Keep track for a week or more and then review to look for patterns.
2. Identify triggers.
A trigger is an internal or external cue that occurs right before pulling. Internal cues include emotional states, thoughts, physiological sensations. External cues are people, places, or situations. Often there will be a pattern not only in pulling behavior trends but also in the triggers. Some triggers will be readily identified; others will be more elusive. Anxiety and stress, for example, are known triggers for people who struggle with hair pulling. Experienced differently by everyone, some people pull hair to calm anxiety and stress then feel relief after. Others pull hair to distract from anxiety and stress. Still, others are triggered by imperfections and feel compelled to deal with imperfections but are never satisfied with the results.
You don’t need to know the cause of pulling behavior to change it. Approach trigger identification without judgment. Think of these exercises as scientific inquiry into yourself. The goal is to identify the triggers so you can retrain yourself to respond to them more healthily.
3. Practice mindfulness.
Being mindful is a mental state of focused awareness to the present and acknowledgment of thoughts, feelings, and sensations without judgment. The result is improved self-awareness and reduced self-recrimination.The internet is full of information on how to learn and practice mindfulness.
4. Identify and dispute negative thoughts and feelings.
Practicing nonjudgmental awareness with mindfulness trains you to recognize thoughts and feelings, especially the negative automatic ones that either precede or follow hair pulling behaviors. After negative thoughts are identified, they can be addressed. While it is best to work through issues with a therapist, you can learn to dispute negative thoughts and feelings by writing them down and consciously refuting or reframing them. For example, if you feel helpless over hair pulling behaviors, write down how you feel and then reframe to: “I can learn to manage hair pulling behaviors.”
5. Separate from the behavior.
Trichotillomania does not define you. It is a compulsive behavior, but you are defined by other things. Behaviors occur, but they are separate from you. Take time to write a description of yourself that does not include trichotillomania. What character traits do you possess? What hobbies do you enjoy? How do the people who love you describe you? Keep this list handy for when you need a reminder.
6. Create competing responses.
In Habit Reversal Training (HRT), people learn to proactively engage in behavior that makes pulling hair difficult or impossible to do. Those who use their hands, for example, can create ways to keep their hands doing something else. Some examples include clenching fists and holding them tight when urges arise, sitting on the hands, engaging the hands with fidget or stress devices, or wearing gloves.
7. Create stimulus controls.
Another HRT technique is manipulating the environment to make it impossible to pull hair. For example, someone who pulls hair may do so in a location at home that triggers it. Or maybe hair pulling only occurs when the person is alone. In these cases, the person should avoid being alone at home or could change the trigger location at home in a way that makes pulling difficult or impossible.
8. Use tools to interrupt habits.
Pulling hair involves the hands, so what if you could alert yourself when your hands are in position? Technology developed by HabitAware is an example of a wearable device that you can train to alert you when your hands are moving towards your hair.
9. Connect with others.
Join support groups either online or in person to learn from others, receive encouragement from others, and boost your confidence by helping others.
10. Celebrate victories.
Whether they are small or large, reward yourself for accomplishments. Your first celebration could be finishing this article and committing to recovery!
If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.
Author Bio: Trudi Griffin is a Licensed Professional Counselor (LPC) and is part of the trichstop.com team
The opinions and views expressed in this guest blog do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc.
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I have successfully recovered from trichotillomania. Had it at the age of 7, stresses, bullying , life transitions etc, being the cause, i pulled out MY ENTIRE head of hair. 100% BALD. counselling for a brief amount of time and something to distract me when a trigger did arise (mine was snapping an elastic band on my wrist)I have had very few urges in the last 21 years and have never had so much as a patch missing since that day , except for once to remove a bump off my skull.
How did you get out of this… someone please help me I’m suffering from a lot of pain because of this trichotillomania…. please help mee to get out of it… I have lost a lot of friends and loved once..I feel so alone and different other girls of my age have long hair and I.. please help me if you can.. if really you got recovered so please share me how who helped you which doctor please….I beg you
I have also pulled my hair off and on for 45 years. It is definitely an impulse control, OCD, horrible habit that I have dealt with since I was 10 years old. Thankfully my hair grows back quickly, but my scalp is tender and underneath has thin spots. I wish I could finally become pull-free!
I know I pushed this habit away once and I can do it again, I will try the elastic band technique as I have tried many things putting my hair up is always a trigger for me so I’m trying to keep it down as much as I can and I know being alone and feeling isolated always comes before a pulling session, I try to focus on my art and other things even cleaning or cooking, anything other than sitting alone and indulging in this awful habit, I feel gross after and hate myself for it. We are not alone. It takes a lot of courage even to post about it I have never met another person with the same condition as me but I saw it on a tv show when I was young and some bad stuff was going on for me. I manifested it as a coping mechanism but ultimately it has hurt me and ones I love more than it has ever even briefly given me relief. I hope this helps someone some how know they are not alone, we are not alone and we can use better habits to break this one; like brushing your hair instead, gloves and sitting on my hands has helped as has a lightweight hat I can wear indoors. I try to massage my scalp and turn negative behaviours into loving ones to break the self hate that always follows.
I started pulling my hair on and off when I was about 15 or 16 now I’m 30 I didn’t think anything of it until when I turned 27 I Had to shave my head bald because I pulled out half of it out then my hair grow back within 2 years half of it was bald again I had to shave the other half I wish I could stop completely I had beautiful thick hair growing up I hope one day i can stop completely. I usually pulled out the sides and the middle part of my hair , I noticed it happened more when I’m alone and when I’m stress . Whoever going through this you are not alone.
This is fantastic life changing advice and quite motivating. I actually feel like I might be able to tackle this one day.
I’ve made the first step in reading the article.
Anybody know of any support groups as I think it would be great to talk to others going through the same thing.
I’ve suffered it on and off but the last time it started was five years ago so it’s a rather permanent habit now. Sick of spending so much time and suffering with this. I need to try something to get control of the anxiety. Although I may still be anxious I don’t have to be doing this to myself.
Agree with the others, you are not alone.
Hello, I suffered with this at the age of 6, it’s stopped about 5th grade until I was 21 then it started again now I’m 33 and still pulling been through so many different medications and still can’t stop, it’s a tingling sensation I get in my scalp which leads me to pull my hair out. I’m tired of doing this to myself I wear wigs and I hate it. I don’t know what else to do.
I started this habit when I was 17 and am now 29. The anxiety to pull my hair out comes with a lot of strength and it feels so sweet but the results are heartbreaking. I feel ashamed, low self-esteem, humiliation headache and a times stomach ache that results from chewing the hair. Am really tired of wigs and capes coz I can’t move out without any of them. The worst thing is my two other siblings are also involved. We don’t know what to do but I agree with others that very many are going through the same pain but let’s not give up
I need help
I’ve had this compulsion for quite a few years now. I’m investigating the triggers and writing down questions that ask me what is coming over me when I start reaching for gray hairs to pull out.
Is it a symbolic gesture of becoming an elder and my way of showing my disappointments in parts of my life? With ageism and sexism, be they be subtle or obvious, I remain visible and fight for that visibility. Maybe it’s for me not for society. That’s a good thing. I have to find my acceptance inside myself, not outwardly. Been working on that eternally.
Lately, I’ve been able to stop it before severe damage is done. I watch myself in a mirror and experience numbness. When I have tasks that need to be done in a timely fashion, I resist doing them because they are infringing on my private time. However, I get much private time. Maybe I need less of that? It’s puzzling and the act itself is a waste of time, standing and pulling out hair for 30-45 minutes or longer. I am aware of my hands and what they need to be useful. I deny myself that purposeful habit change.
I am not the disability.
I’m addressing this issue with support.
I found this because I have a hair cutting compulsion and I think it’s different but similar. Had it since 13 years old and it waxes and wanes throughout time. I think I need medication but the side effects are brutal for me almost worse that the obsession. I wish I could stop without medication. I’ve gotten rid of my scissors today but I want the obsession to stop.
I started when I was 13 years old that is when my sister passed away I’m now 56 and I’m still pulling I need help please I have grown children that have never seen me with hair only wearing my wigs….Help
I need help 61 year
I need help! I started pulling my hair when I was 9. Than I stop but don’t remember exactly when but I know I started back again when I was married with my first husband. I taken different medications and still taking them. I’ve gone to a psychiatrist and also done counseling. It seem like nothing helps. I’m not 40 yrs old and I’m not sure that my hair will ever be normal and I’ll be able to go to the swimming pool with my son.
George and Diana,
I will ask one of our Resource Specialists to contact you in private to offer assistance.
Jay
I am 36, been pulling my hair out since I was 11. I have a 3 year old daughter and I need to stop, not just for myself but for her too. I don’t ever want her to be teased for having a Mum that does it! Please help!
Hi Tessa,
We appreciate you sharing as this takes a lot of courage and a great first step towards positive change for yourself. You will be contacted directly with some resources that will help you towards your journey of hope.
Danielle
I am 13 years old and have been doing this for about 2 years now. I noticed I don’t do this whenever I am surrounded by friends or in public. This has been a huge part of my insecurity, and it makes me disappointed. I get mad at myself, and seeing other girls with long lashes and full eyebrows makes me jealous. I have went to a doctor and just have been suggested an eye check up, which had led to nothing. My mom gets upset whenever she sees that I am pulling out my eyelashes and eyebrows. She shames me for doing so, but I cant help it. I have been trying to get myself busy by giving myself toys I could hold whenever I felt like pulling, but nothing worked. I feel so helpless and alone. I feel scared of continuing this habit on in life, I feel scared to be judged by friends and family. I need help.
Hi Sophi,
Thank you so much for reading our blog post and commenting. You seem to be self-aware which is great.
You are doing a great job advocating for yourself by looking for support and resources.
You will be contacted directly, please check your email.
Danielle
Thank you so much.
I know it’s not the same but falls into the same category. I have had compulsive skin picking since I was about 9 – 11 years old. It went away for 10 years but is very bad right now. I haven’t seemed to be able to get control of it again and it’s honestly destroying my life. If someone could please reach out with any help that you may have, I would really appreciate it. Thanks so much.
I pulled out my eyelashes when I was 10 or 11. My mom saw that I had spaces between lashes, so she asked me why. I didn’t know the answer. I tried to control it sense it was noticeable. A few months later I was reading a magazine called “Women’s Day” magazine and happen to see an article about Trich. I read the article and was ashamed and surprised it was a condition. After reading about it being a “thing” I stopped. This was in the 70s. I’m now 62 years of age.
Luckily for me I didn’t continue this behavior for years.
Looking back though, I feel I liked the sensation of pulling my eyelashes out. Due to eye brow thinning,(unrelated to trich, but age related) I decided to have micro blading done on my brows and noticed the sensation of the blade relaxes me.
Hi Elizabeth,
Thank you for reading and commenting on the blog post.
You are doing great with actively looking for resources and advocating for yourself. This is a good step to gaining back control over your compulsions. I will email you directly with some resources that would be helpful to you.
-Danielle
Hi Red,
Thank you for reading and commenting on the blog post. You seem to be self-aware which is great.
If you feel like this is a concern and would like more information to get help locating a therapist where you live, send us an email at help@rtor.org or click this link to Contact a Resource Specialist
-Danielle
I’m 14 years old. I’ve been struggling with this for a few years now, and it’s only gotten worse. I’m on medication for trich, and I’ve tried fidgeting, but neither seem to help. I’ve nearly pulled all my eyelashes out, and I’ve finally come to the conclusion that I probably won’t be rid of this anytime soon. I just feel hopeless sometimes, even though I know I don’t have anything as bad as most of the people here. My parents are disappointed in me, and so am I. I wish things were different.
Hi J,
You have done an excellent job doing research and expressing your need for change, you should be proud of that.
I recommend that you connect with a responsible, trusted adult about treatment options that would be helpful to you. It is always best that you are not doing this alone and that an adult is helping you every step of the way.
Danielle
I also pull my hair and I’m ashamed of my self. I always ask myself why I use to pull my hair and even told my self to stop anytime I pulled it out I can’t stop… I always pray to God to help me stop pull my hair cos I’m tired of wearing caps and wigs
Hi Gold,
Thank you so much for reading and commenting on our blog post as this takes a lot of courage and vulnerability to share. This is not uncommon and many individuals reach out for resources regarding treatment options. I will email you directly with some resources please check your email.
-Danielle
I have been suffering with hair pull at the tender age of 9. I am 57 yrs now with a huge bald patch in the middle of my head. It’s embarrassing. The pulling normally happens when I am sitting comfortably. I will pull until the folic comes out. I can seems to stop once I start please help me.
Hi Kooks,
Thank you for reading our guest blog post, as this takes a lot of courage! I will contact you directly with some resources on treatment options, please check your email.
-Danielle
I am 60 years old. I started pulling out my hair when I was about 11. I would have a big bald spot on top of my head and get teased. I started pulling out my eyelashes around 16 and didn’t have any. I also pulled out all my eyebrows recently and had to cover up that mess for months. Nail biting, scab picking, you name it done it. My therapist recommended that I take N-Acetyl L-Systeine. I still pull my hair out but it is not as bad. I can’t seem to stop. It was gone for years and came back when I started a new job.
Hi Toni,
Thank you for taking the time to read and comment on the blog post. Glad to hear that you have a therapist and that there is some progress with reduced hair pulling. I will contact you directly with resources you may want to consider, please check your email.
-Danielle