What is Trichotillomania? (trick-o-till-o-may-nee-uh)
Shortened to “trich” or TTM, it’s a funny long name for persistent hair-pulling, twirling, or snapping of the hair. Chances are if you pull your hair, or have a friend or relative who does, you’ll know right away, that that’s it.
Not much has been written about TTM in the media, and there is little research on it to date. It is estimated that around 1 in 50 people pull their hair, especially women. I am guessing that many people live quietly with TTM, maybe not realising that it has a name, and that they are not alone.
Other habits that may occur together with TTM
Hair pulling is a body-focused, repetitive behaviour, closely tied to anxiety… making it first cousins with habits such as cheek-biting, nail-biting, skin-picking – and these may occur together.
TTM usually starts in childhood or adolescence, and can continue throughout life. The resulting hair loss can become increasingly visible over time, and the struggle can become more and more distressing.
“Why can’t you just stop?”
Friends and family often make things worse, without meaning to, by pleading with you to stop, asking why you do it, and so on. And to the person doing the pulling, it’s not that easy. Their good intentions can make you feel even more shame, embarrassment, despair.
And sometimes it can be easier just to let yourself continue pulling, aware that you’re doing it, as painful and inconvenient as this may be. You might be used to it, or get by, for example, by styling, cutting or hiding your hair in various ways, and many people may have no idea that you pull.
Plus there may be “good patches” in your life, where the habit kind of subsides, and you stop doing it for a while. Or you may have bigger things going on in your life, and hair-pulling just isn’t on your list of things to worry about.
What would make stopping worthwhile?
If you do decide to address TTM, I am guessing it’d totally worth your while…
As a professional hair twirler myself, I was mortified once to be told by someone that I come across as child-like when I twirl my hair 😕… this realisation was enough to stop me (more or less) in my tracks. I am now much more deliberate and awake to this habit.
Might it be that you want to be back in the driver’s seat of your life, rather than being pushed around by habit? Or maybe you just want the confidence and freedom of not having to hide, cover or dread.
Possibly the biggest plus of breaking free from hair-pulling is that it you may just break free from, or learn to better manage, the buzz of anxiety too!
TTM can be treated
CBT (particularly ACT, DBT and habit reversal training) offers a compassionate, supportive and evidence-based way to treat TTM.
I have noticed that treatment loses momentum if appointments are stretched out or random, and encourage my clients to commit to an hour of therapy a week, typically for about 6-10 weeks.
A few resources,
- There seems to be quite a lot of awareness and support in the US and UK, for example here and here.
- Here is a behaviour modification/awareness bracelet you might try out. It was developed by a clever team of husband and wife, when she realised that it was TTM that she was struggling with.
- Here is an article from the Guardian which may be of interest. It has further avenues to explore for connecting with others, as well as resources.
- You can find a forum moderated by qualified therapists here. It includes an online treatment programme.
- Here in Adelaide there is a support group, and I am happy to see anyone with this type of problem at The ACT Centre. We work with an excellent programme developed by Michael Twohig, including his workbook for clients, “Trichotillomania: an ACT-enhanced behaviour therapy approach.”
Do let me know if you find any other resources that are helpful, and I will include them here.