Trichotillomania- Hair Pulling

Trichotillomania- Hair Pulling

Amy V. Smith, MS Licensed Mental Health Counselor Registered Play Therapist

Why do people pull their hair out? The short answer is “it just feels good”. Even though it can cause a lot of distress and embarrassment it feels good to the people who do it.

What is Trichotillomania

  1. Recurrent hair pulling with noticeable hair loss
  2. Tension before pulling or when attempting to resist
  3. Pleasure, gratification, or relief when pulling
  4. Not better accounted for by another disorder and not due to a general medical condition
  5. Clinically significant distress or functional impairment

One of the main triggers for Trichotillomania is boredom. However, people often pull due to stress, anger, frustration or other big emotions. Some pull in certain situations or at certain times, while others only pull in certain areas. Hair pulling can be extremely distressing to those who pull, especially those who pull in areas that are visible to others.

Here are some tips on how treat Trichotillomania

First, practice watchful waiting. Watchful waiting means watching the behavior to see if it becomes an issue over time. Should you determine that hair pulling is an issue here are the core elements to treatment:

  • Psychoeducation– good news, you are already doing this by reading this blog
  • Self-monitoring/awareness training– be mindful of the times and trigger points for hair pulling. Record feelings and thoughts before, after, and during hair pulling. Keep count of the number of times you pull each day. This information will allow you to make educated choices on how to stop the behavior.
  • Stimulus control– Examples: wear gloves, put Vaseline on eyelids, cover mirrors, wear a hat, etc. Anything that can make the environment less habitable for hair pulling works here. 
  • Competing response or habit reversal training– The plan is to increase awareness of pulling behaviors as well as do a competing response.
    • Be aware of where your hands are. Oftentimes people do not even realize they are pulling.
  • Doa competing response. A competing response is to do something different then pulling your hair with your hands. Such as, make a fist and hold it for 5 seconds repeating until the desire to pull has passed. Sitting on your hands until the desire to pull goes away. 
  • Relaxation and stress management training- reduce your stress through intentional breathing, meditation, or other relaxation techniques. 

If you are a parent or family member of someone who pulls it’s important to know you are crucial to recovery. Here are some things you can do to help

  • Provide support and encouragement
  • Purchase items needed for stimulus control (if it’s your child)
  • Be willing to cover mirrors etc should that be needed
  • Help keep person entertained at times they are most likely to pull

Living with Trichotillomaina can be difficult for both the person who pulls and their family. If this is something you or a family member is dealing with please know there is help. If you have tried the steps above and are still struggling with hair pulling please feel free to reach out. I can help you on the path to a future free of hair pulling. Give Life Skills Resource Group a call at 407-355-7378.

Amy Smith