You’ve had a rough day at work. You have deadlines, a demanding boss, and traffic was terrible on the way home. You walk in, head for your room, turn on the TV, and start playing with your hair. You don’t set out to pull, but as you’re running your fingers through, you find that one hair that stands out from the rest. This is your routine. Maybe it’s from your eyebrows or your eyelashes. Maybe it’s from your head. It feels so soothing in the moment that the urge to pull is more powerful than the thought of the consequences. You’ve done this since you were 10 years old, and don’t exactly know why you do it, but it’s always provided a sense of relief.
Yet when that wears off, you’re racked with guilt and shame. You have a bald spot on your head, or patchy eyebrows, or noticeably missing eyelashes. You have to brush your hair a certain way to cover it up, or perhaps even buy an expensive wig. You’ve become an expert makeup artist, trying to fill in the gaps of your eyebrows and eyelashes. You may have even done some permanent damage to them. It’s embarrassing and you’re afraid that no one will understand, so it’s become your little secret. Friends and family tell you to just stop, not realizing that not doing it makes you feel even worse.
The average age of onset for trich for most people is between 9 and 13 years old, so there’s a good chance that you don’t remember a time when you didn’t have an urge to pull. It’s second nature at this point, and is a part of your routine. Because of this, the idea of not pulling is hard to fathom.
There is hope. Our understanding of trich has improved significantly over the last decade, and effective trichotillomania treatment has developed over that time. The ideas of therapy, treatment, or even psychology in general can seem so vague, but on a fundamental level, you are looking for a solution to a problem. I understand that, and my goal is to help you find it.
Trichotillomania is the intense urge to pull out hair from your scalp, eyebrows, or other parts of your body. This is usually preceded by an ever-increasing anxiousness prior to pulling your hair out, and then there’s a great sense of relief after you’ve done it.
Trich often involves rituals. The hair is usually pulled from the same spot, and then the puller will often do something with the hair after the fact. Some people will chew or eat their pulled hair. Others will play with it, or arrange it in a certain fashion. These rituals are part of the entire process that’s associated with trichotillomania.
How Common Is Trichotillomania?
Many trich sufferers are ashamed of it, and try their best to hide it from the rest of the world. They are afraid that no one will understand their condition, and will judge them as a result. Unlike other mental health disorders, trichotillomania often comes with symptoms that everyone else can see. Bald patches on your scalp, missing portions of your eyebrow…the types of things that are going to elicit questions from strangers and loved ones alike. And you have no interest in answering those questions, so you do your best to cover up.
Trichotillomania is far more common than you might think. A 2013 study by he Chicago College of Osteopathic Medicine found that around 3.4% of the US population has suffered from trich in their lifetime. That’s 1 in 30 people. So that “strange little thing that you do with your hair, eyebrows, etc” isn’t so unusual after all. If you’re working out at the gym, at a restaurant, or even at work, there’s a pretty good chance that someone else in that room has trichotillomania as well. However, just like you, they’ve probably gotten pretty good at hiding it, and you would never know.
Why does pulling my hair feel good?
Studies have shown that pullers experience a rush of dopamine, the body’s “pleasure” chemical. The pulling is often done as a response to anxiety, stress, boredom, sadness, or even hunger. The pulling releases the dopamine, which eases the stress that the body is under, but then the pulling leads to self-loathing, guilt, and disappointment.
In this way, the cycle of pulling feeds itself. Stress, guilt, anxiety, etc. lead to pulling, pulling leads to relief, then relief fades and turns into stress, guilt, anxiety, etc. about the pulling. Trichotillomania treatment helps you break that cycle.
I’ve tried to stop before. Why would this time be different?
I cannot guarantee you that it will be. Trichotillomania treatment is not a magic trick, and it requires a commitment from you. It’s a two way street, where we’re partners in your healing.
That being said, this time can most certainly be different. Cognitive Behavioral Therapy (CBT) is a highly effective trichotillomania treatment, and backed by a significant amount of research. CBT is a solution focused and relatively short term therapy. In CBT, we focus on identifying and changing the thoughts, behaviors, and situation that lead to pulling .
I’ve tried other therapists…
While I cannot speak to your specific situation, I am a verified treatment provider by the Trichotillomania Learning Center (www.trich.org), and have certainly seen my fair share of trich cases. Trich is, well…tricky…and many therapists do not have the training necessary to provide adequate trichotillomania treatment. I have plenty of experience helping those who pull. My office is a safe place where you will be understood.
I’m not ready to commit to trichotillomania treatment just yet. What now?
You’re absolutely right that you can do this, but embarking on this journey can feel daunting. I understand that, and have helped many people just like you to get the trichotillomania treatment that they need. Please subscribe to my Trich Newsletter, or call me at (424) 262-2014 for a free, 15 minute phone consultation, where we can discuss how to start your journey toward ending the pulling.