Treatment for Trichotillomania- Hair Pulling
Trichotillomania- or Trich is an OCD- related disorder in which a person cannot resist the urge to pull out their hair. Trichotillomania is a Body Focused Repetitive Behavior (BFRB) which also includes Excoriation (Skin Picking) – Hoarding Disorder, and Tic Disorder. While a person plucking some hairs for cosmetic reasons may not be uncommon, compulsive hair pulling may be a sign of something else. When the compulsive hair pulling becomes problematic, causing significant distress in the persons life, it might be indicative of Trich. Body focused repetitive behaviors (BFRBs) can be co-morbid with other related disorders such as OCD. Comorbidity occurs when a person has two or more conditions at the same time.
Signs of Trichotillomania:
Recurrent hair pulling- despite efforts to stop or decrease the pulling behavior.
Excessive time spent hair pulling, over an hour a day.
Excessive time spent thinking about hair pulling or resisting the urge to pull hair.
Hair pulling causes significant distress in the persons life.
Physical impacts on the body from the hair pulling- skin irritation, tissue damage, hair loss, damage to hair follicles, infection.
Negative impact on social/occupational functioning.
Picking behaviors can be preceded for example by feelings of boredom or anxiety. There might be a sense of relief after a person engages in their hair pulling. Certain rituals may be present with hair pulling, which can include the place they do it at or using certain tools to pick. Hair pulling can commonly be done in an automatic sense. Where the person does not even realize they are pulling, leading it be an automatic behavior. This can be particularly distressing as the pulling done automatically may extend for longer periods of time, leading to more damage being done to the areas with hair.
Commonly Pulled Areas:
Hair on the persons head.
Nose Hair.
Eye lashes.
Eyebrows.
Hair on arms or legs.
Pubic hair.
Treatment for Trichotillomania:
Treatment for Trichotillomania is an evidence based practice, Habit Reversal Training (HRT). HRT is a type of Cognitive Behavioral Therapy (CBT). Awareness training during HRT is aimed at helping the person develop better self control and awareness to their BFRB. In HRT, competing responses will be practiced and reinforced once the person is hitting the right goals with their awareness training. Competing responses are going to be behaviors that are the opposite of the BFRB. Competing responses will be behaviors that limit the use of the BFRB. Further goals aim at developing better coping skills, mindfulness exercises and healthy thoughts/behaviors towards your body. As a licensed mental health therapist trained in HRT, I will assist you through the awareness training, competing response development and building motivation for change. If you feel that Trichotillomania has had a negative impact on your life, you might consider counseling and HRT to learn how to handle it more effectively. Please feel free to reach out for a free consultation, where we can discuss the impacts of Trich and benefits of counseling/HRT.
