Happiful – September 2019

September 2019 • happiful.com • 31

However trichotillomania
first occurs, the brain begins
to associate the completion of
the urge with a sense of relief.
Louise provides some insight:
“Many people report of a building
physical urge to pull, which is
replaced by a feeling of release,
or discharge of physical tension,
when the hair is pulled out.” So,
whenever the body feels stressed,
anxious or tense, the brain’s
automatic response is to compel
the person to pull out their hair.
“My hair-pulling is less regular
than it used to be, but it always
gets worse if I am stressed or
anxious,” says Natalie. “I
would also definitely
refer to myself as a
perfectionist and, to
be honest, even a bit

of a control freak. I do think that
those traits contribute to being a
sufferer.”
The perfectionist thing is
something that I whole-heartedly
relate to. And, interestingly, when
I asked psychologist Louise about
this, she concurred.
“Trichotillomania sufferers often
appear to have perfectionistic

traits, which explains why pulling

is frequently preceded by the

search for ‘the right hair’. This

may be a hair that feels different

from the rest, such as being

rougher or thicker, and can often

make it difficult for sufferers to

resist pulling out new hairs as

they grow back after an episode,”

Louise explains.

How is trich treated?

A commonly used treatment is

a type of cognitive behavioural

therapy (CBT) called habit reversal

training, but it’s also thought

that hypnosis could be effective

in helping sufferers break the

habitual thought-patterns. To be

successful, you have to replace

the urge with something that’s not

harmful.

“In my experience, the most

significant factor in breaking the

habit cycle is having an increased

awareness of times when you are

likely to pull, so that you can pre-

empt them,” says Louise. “Equally

important is finding a competing

response (or range of responses)

that can be used to replace the

pulling behaviour at those times.

Carrying out the competing

response instead of pulling should

help reduce the urge, although it

may not eradicate it entirely.”

What that response is will differ

from person to person, and

situation to situation. Ideally,

though, it should be something

that keeps your hands occupied

and away from your hair –

perhaps even simply holding

something, Louise tells me.

“An advantage to having

something in your hands is that

you will need to put it down

before you act upon the urge

to pull. This not only brings

the pulling into conscious

awareness, but it also gives you

those critical few moments

where you can decide whether

going along

with the urge is

something you

really want to do.”

Am I over these

urges? For the most

part, I think so.

But, sitting here

writing this now, I

can feel the same

sense of dread that

used to haunt me

almost on a daily

basis. Perhaps that is a good

thing, though. Even after all

these years, the memory of how

trichotillomania made me feel

still hangs heavy on my heart.

This article has been difficult

for me to write, but I feel I

have finally acknowledged the

torment of my teenage mind

and addressed the stigma (and,

indeed, the lack of knowledge)

around this condition.

If you’re dealing with trich right

now, or if you’re a parent worried

about your child, please know

that it won’t last forever. I’m now

free from these urges and, with a

little time and patience, you could

be too.

Telling someone not to do

something they feel an

overwhelming urge to do is like

telling someone not to scratch

when they have an itch