Tasneem Abrahams

Mastering Hair Pulling

Now I Know I Have Trichotillomania, What Can I Do About It?

We describe some of the key aspects of dealing with compulsive hair pulling

Posted Aug 10, 2016

Do I Have Trichotillomania?

If you are asking this question you most likely have been pulling hair for some time, but only ever regarded it as a bad habit. Then one day something makes you stop and wonder if there is more to it than that. 

American Psychiatric Association
Source: American Psychiatric Association

One of the key clues that behavior may have a clinical component is if it  has a negative impact on your functioning and your ability to engage in meaningful occupations, or if it negatively affects your relationships. Some of the warning signs that hair pulling is affecting your function include:

  • Not being able to go out in public without covering up the pulling site, e.g. wearing hats, scarves, sunglasses
  • Avoidance of social situations when conditions are windy or wet, e.g. swimming
  • Constantly being late due to spending extended periods of time pulling
  • Feeling you are not in control of the ability to stop pulling

When presented before a health professional, diagnosis of hair pulling disorder is guided by diagnostic criteria as outlined in the Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (APA). The most recent version, the DSM-5 clearly differentiates hair pulling as a disorder from other non-clinical hair pulling behaviours. 

I Have Trichotillomania, Now What?!

For years many have suffered alone and in silence, often feeling guilty and ashamed for their actions and for not being able to control it. But through the collective efforts of advocacy groups such as the TLC BFRB Foundation and the Canadian Body-Focussed Repetitive Support Network (CBSN), there has been an upsurge in awareness about trichotillomania and other body-focused repetitive behaviors (BFRBs) such as excoriation or compulsive skin picking disorder. Prior to this many people didn't even know that their behaviors had a name let alone that it was a recognized clinical condition. Many people report that sometimes just knowing that there are others like you, and to have the acknowledgement that this is a very real struggle can be empowering. But the question remains - now that you know you have something called Trichotillomania, what next?

A Solid Support Base

A fundamental aspect to overcoming Trichotillomania is to have a support base when you fall and to cheer you on when you conquer. For some this may be from family, a close friend, a partner, or for some it may even come from the anonymity of an online support forum. Wherever it comes from, having a place you can talk about your fears, your sadness or despair, but also to share your hopes and your victories, can be very empowering and will be the key to getting your through the darker days.

The Power of Knowledge

The more you learn and understand about your condition, the better equipped you will be to make informed choices about treatment and  recovery. With increased awareness of Trichotillomania has also come an increased interest in research into the condition in the medical field. The internet is a great source of information and access to information and the latest research. However it should be noted that one should be careful about trusting all the information you find on the web. Always check that the source is credible and that claims of an effective type of treatment is evidence-based. For example there are numerous studies indicating that cognitive behavioral therapy (CBT) is the most effective type of face-to-face therapy for BFRBs, and there is evidence that an online self-driven therapy format has been effective in those with Obssessive Compulsive Disorder (OCD).

Professional Help

Source: Geralt/Pixabay

Despite the advancements we have made in understanding Trichotillomania and learning what methods of treatment are effective in the management of the condition, there is still a scarcity of health professionals who have the knowledge or experience to know how to deal with this condition. The BFRB Foundation provides a comprehensive list of treatment providers with contact numbers. They are also the only organization that offers accredited training for health professionals in the treatment of BFRBs. For some there is however still limited access to face-to-face therapy either due to distance or because of cost as individual therapy can be expensive. As alternative there has been an upsurge in online therapy such as counseling sessions via Skype or self-directed treatment. Group therapy can also be beneficial where it is available.

Holistic Health

There are many alternative therapies and activities that have been found to help relieve stress and thereby reducing hair pulling urges. These include meditation, yoga, and even hypnosis. It has also been seen that through the correct diet, exercise and a balanced lifestyle, the person may experience less stress and anxiety which could in turn result in a reduction in urges to pull.

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