How to Cope with Trichotillomania
Trichotillomania is a psychological disorder in which a person feels an intense urge to pluck their hair when they are triggered by certain uncomfortable situations. This behavioral disorder oftentimes brings excitement and soothing during the hair pulling action, but afterwards usually leads to shame, guilt, depression, and even social isolation. Currently, there is no medication for this disorder, but there are plenty of ways to manage it. The majority of people find that the most effective way to minimize and control this behavior is with the help from a trained therapist. However, there are some tips on how you can manage it yourself.
1) Figure out what triggers you
When you start to pull hair, try to understand your current situation. You can focus on 3 main parts- your current emotions, thoughts and actions. How do you feel in that moment? Are you stressed, overwhelmed, scared, guilty, depressed, angry, frustrated, etc.? What are you thinking about? Are you thinking about your job situation, family issues, or maybe even needing to see or meet new people? What are you doing in that moment? Are you studying, working, babysitting, completing tasks, etc.?
Once you bring awareness to the emotions and activities that trigger you to pull, you will have a much easier time to control your situation and understand yourself better Your next step would be to dig deeper and see why those emotions, thoughts and actions are your triggers and how you can overcome them through therapy.
2) Try to eliminate the triggers
Depending on the nature of the trigger, not all of them can be fully eliminated, but plenty of times they can be minimized, controlled and managed. Once you identify your triggers, you are one step closer to controlling your hair pulling impulse and ultimately your life. If a certain location or a specific person is a trigger, sometimes it’s possible to limit exposure to that location or minimize contact with that person. For example, if your office or your boss/coworker is a trigger, you can ask to work from home or look for a new job. This way you are distancing yourself from that location or person. Obviously, this is not always realistic or possible. This is why it’s not only important to learn better coping methods to deal with these situations, but it’s also important to talk to your therapist about this issue in order to understand its origins and gradually move towards a fundamental change.
3) Recognize the initial feelings
By understanding the feelings that we have prior to the hair pulling, we can get an idea what hair pulling does for us, what is its job or purpose. Does it relieve us from anxiety or maybe stress? If we are anxious or stressed and resort to hair pulling which immediately calms us down, we will have a higher motivation to resort to hair pulling again, the next time we feel anxious or stressed. Our mind learned that this is a valid soothing tactic even though it’s unhealthy and not what we want. However, if we understand what the purpose of our hair pulling is (like anxiety reliever), we can engage in healthier activities that have the same purpose that we would benefit from. In this example, we would now know that we need to engage in a calming activity that will replace the “job” of hair pulling. Once we realize this and find our new activity with the same purpose, we would practice it ever time we felt that trigger emotion and eventually it would become a habit and our go-to soothing activity instead of hair pulling.
4) Replace hair-pulling with a different activity
Once you feel the need to pull, try to keep your hands busy with a different action. That way not only will you distract yourself with that new activity, but also you won’t have available tools (hands) to hair pull anymore! Your mind is now focused on that new action and your hands are being used to complete it. For example, this can be a squeeze ball, fidgeting with your bracelet, rings or even keychains, scribbling, cleaning, etc. If this doesn’t work, try an activity that is not as automatic and uses more brainpower. Ex, drawing, writing, painting, or playing video games. Another activity that I have seen work in people is tactile stimulation. This includes using your fingernail on your thumb to poke your index fingertip on the same hand multiple times in a short period, like a heartbeat. You can do this with both hands at once. This activity creates a distinctive feeling in your index fingers that is calming, but also distracting enough for you to keep doing it while conducting other tasks. It’s a repetitive action which is calming and keeping your hands busy.
5) Be patient with yourself
With the right support and therapy, you can successfully learn to control your pulling impulses and have more control over your actions. This will bring you more confidence and a sense of achievement and control over your life. Understand that this cannot be done overnight and that it is a long and painstaking process. However, with the right therapist, self-determination, and time, it is very possible to achieve this goal.
6) Notice, interrupt & choose different actions
After you’ve brought to your awareness (or verbalized) the emotions, thoughts, and actions connected to hair pulling, now you will have the power to make conscious decisions! This self-awareness will help you recognize your urge to pull when it occurs and by doing so you will be able to choose and interrupt that negative cycle of thoughts and feelings and engage in a different activity that will distract you from hair pulling and help you become calmer. Instead of being a slave to hair pulling, you will now have the necessary tools and knowledge on how to stop that negative process and consciously choose better and healthier coping strategies which will bring you calmness without the negative feelings of shame and guilt afterwards.
