Trichotillomania

How common is hair pulling?

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It was believed that this was a rare disorder, however recent studies show that it is actually more prevalent than previously thought.  A study done among college students shows that 1.5 percent of males and 3.4 percent of females had engaged in hair pulling that resulted in visible hair loss.  Unfortunately, many individuals feel shame and embarrassment.  They hide the problem and don’t receive the help they need.  Hair pulling affects individuals’ self-esteem.  It can cause distress and serious social consequences.

This disorder was not well-known before the 1980s, though many hair pullers were struggling with it.  However, studies and developments for OCD treatment caused the media to shed attention on this disorder.  Many individuals began to believe they had a form of OCD because they were so obsessed with pulling their hair.  There have been many studies since then and they provide hope for those suffering with this disorder.  The Trichotillomania Learning Center, Inc. (TLC http://www.trich.org/) is dedicated to raising public awareness and to provide resources and guidance for sufferers and their families.

The success of behavioral treatment depends on the client’s motivation to learn the skills, become aware of the urges, and consistently practice alternative responses.  Usually, individuals who are afflicted with this challenge don’t realize how bad it is until someone else points it out and suggests they seek help.  Individuals who pull hair usually also have problems with picking their skin.  Quite often, it is the physical appearance that’s bothersome.  Others may seek treatment because they don’t like wasting so much time pulling or picking.  Most of the time, clients self-esteem has been affected and they may also be experience anxiety and depression.

Cognitive Behavioral Therapy:

Stress can trigger hair pulling and/or increase the urge to pull or pick.  Relaxation and mindfulness skills are taught to help clients manage their daily living.  Treatment will be geared according to each client’s needs and challenges.

Treatment will consist of awareness, learning competing responses, and modifying the behaviors of concern.  During therapy, it is suggested that clients modify their environments in order to decrease hair pulling.  Reinforcement strategies are used to help clients stay motivated with their work and continue progress.  Cognitive strategies are taught so clients can understand that their thinking is affecting their behavior and feelings.  Clients are invited to do written exercises to identify their negative thoughts and to restructure them.

Treatment is not easy.  However, studies have shown that when individuals seek treatment, they achieve lasting progress when they have family members or friends who support them during treatment.  Open communication between the therapist and clients is of utmost importance to be able to complete treatment successfully.

We will discuss relapse prevention and how clients may expect lapses (symptoms may increase temporarily) during treatment or even after treatment.  However, they need to try not to be discouraged because lapses are bound to occur.  What’s important is to remember the skills learned during treatment and to implement them daily.