Date Published:
Publisher: Hypnosis Motivation Institute
Compulsive Hair Pulling
Most people don't know that it has a name! Trichotillomania (TTM) is a disorder of shame and embarrassment. Oftentimes, people go to great lengths to hide this behavior for fear of how others might perceive them. It affects an estimated 8-11 million people, and this number might even be underestimated, due to the secretiveness of this disorder.
Trichotillomania is an impulse disorder, whereby a person pulls their hair from their body, particularly the scalp, eyebrows, and eyelashes. It frequently begins in pre or early adolescence, the average age being around 12 years old. Prior to pulling out the hair, a person notices an increase in tension and then a feeling of pleasure or relief after the hair is pulled.
Trying to understand the etiology of Trichotillomania is very difficult and complex, and health professionals are often in disagreement as to its cause. Some believe it is a type of obsessive compulsive disorder and is a result of feelings of loss or perceived threats. Others contend that it is because of neurobiological factors and is similar in nature to Tourette Syndrome, as they are both repetitive behaviors. Still others feel that it is a coping mechanism, in response to stress and anxiety, or it could be self-injurious behavior.
Hair pulling is an anxiety reduction process, whereby the person associates the behavior with relaxation. When assessing a client with Trichotillomania, I go into great detail in the interview process with regard to the history of their hair pulling. I ask them when it started, how it occurs, what their behaviors are, if there have been times when they have been free of hair pulling, how often they do it, what they feel the cause is, how strong their desire is to stop, and much more. I will consider the severity, and if there is any concern regarding infections or self-mutilation, I will immediately refer the client to their doctor.
Hypnosis and imagery can be effective modalities to reduce and eliminate symptoms, by teaching the client to identify what the triggers are and to teach them stress relief tools. It is followed up by giving the client positive replacement strategies. Oftentimes, people with Trichotillomania suffer from additional problems such as depression which needs to be addressed by a medical professional.