Some Helpful Tips for Dealing with Trichotillomania

I’ve spent a lot of time pulling hair and I’ve also spent a lot of time seeking treatment for it, too.  I’ve seen many different doctors and tried many different methods to stop pulling hair.  I’m not “cured” and may never completely be cured because technically there is no cure for hair-pulling…which really sucks.  There are, however, ways to manage hair-pulling so as to keep it to an absolute minimum.  (Please know I am not a doctor and don’t have any qualifications; if you are suffering from Trichotillomania, please see a real doctor and get their advice!  I’m just offering my collection of experiences and opinions to hopefully help.)

As of right now, there are two main ways of dealing with Trichotillomania.  One is behavior modification, in which different techniques are used to alter undesirable habits.  The other is medication.  There is unfortunately no “magic” pill that makes hair-pulling go away, but there are a handful of anti-anxiety medications that can help with the urge to pull.  I haven’t actually tried any of them because of the negative side-effects (such as weight gain and hair-thinning), and the fact that I’m already taking an anti-depressant.  I have tried many different behavior modification techniques though and I will list them for you below (and rate how helpful I thought they were)!

  1. Wear a hat.  When you’re feeling tempted to pull hair, eliminate that possibility by covering your hair with a hat.  I’ve done this many times at home and it’s helped a lot.  The only problem is that I get annoyed by it and take it off too soon.  If I were able to leave it on, it would be extremely effective.
  2. Cover the bathroom mirror.  I do most of my pulling in front of the mirror.  If I see a gray hair or a wiry hair, or just any hair in general, I want to pull it.  When I realized that, I covered the entire bathroom mirror with newspaper.  It cut the pulling down by probably 90%.  The only difficulty was having to be able to use some mirror somewhere to get ready to go out of the house.
  3. Wear a rubber-band.  Thump yourself with it every time you pull a hair.  It didn’t work very well for me but, hey, maybe it would work for you!
  4. Set a timer in the bathroom.  I pull most of my hair when I’m in the bathroom getting ready, so I found that setting a timer helps me to stay focused and not be in the bathroom any longer than necessary.  It also helps me snap out of a hair-pulling trance if I’m in one.
  5. Set up a reward system.  Set goals for yourself.  If you can make it to the end of the day without pulling, have a piece of chocolate.  Make it to the end of the week, you can get that new Twenty One Pilots album you’ve been wanting.  Pull one hair and you can’t.  This works really well for me…when I can afford to do it!
  6. Peppermint oil.  After I’ve pulled from a certain area, it gets sore and extra-sensitive, which makes me want to keep pulling from the same spot.  It’s like I can feel the hairs squirming around and they’re itching and I can’t think about anything else!  That’s when I rub some peppermint essential oil on the spot and within seconds, the area is cool and tingly and almost completely knocks the urge.  (Peppermint oil is also great for acne and stimulating new hair growth…so there are many benefits!)  I keep this jank in stock and I use it all the time.
  7. Get a Pavlok.  This is similar to the rubber-band idea, but it was much more effective for me.  The Pavlok is a bracelet that shocks you when you touch the surface, so if you’re pulling you just tap it and it shocks you.  It can help break you out of the pulling trance and also help re-wire your brain to associate hair-pulling with pain instead of pleasure.  I have to admit this thing was awesome when I bought it and it was 100% effective because it hurt like a motherfudger!  But after several weeks I started getting used to the shock and it didn’t deter me like it did at first…which is unfortunate because it was $200.  Still…if it cures you, it’s worth it, right?  (You can buy them on Amazon which is what I would recommend because Amazon’s return policy is better than the actual Pavlok company.)
  8. Count every single hair you pull and write it down.  This was actually suggested to me by the first therapist I saw, and he said when he told another patient to try this, it cured her immediately because she didn’t want the embarrassment of having to tell him how many hairs she’d pulled.  For me, though, it didn’t work very well.  I ‘estimated’ how many hairs I pulled and then wrote that down because I was too ashamed and angry with myself to actually sit down and count all of them.  (When the sink is full of hair, counting them all seems kind of daunting…which is the point, I suppose.)  Maybe you’ll have better luck with this one.
  9. Join a support group.  I’ve never actually done this but I know they’re out there!  Having people to talk to who can relate to your issues can be very helpful.  And even if you’re too afraid to join a group, at least tell some friends and/or family members you trust about your hair-pulling problem.  Their support and encouragement will be priceless.  Trust me.
  10. Buy a fidget toy.  If you pull because your hands need something to do or because you’re bored, get a type of toy that will keep your hands occupied!  There are many different types of fidget toys from clickers to little tangly things to stress balls.  Whatever floats your boat, man.  I had a Tangle Jr. plastic noodle fidget toy and it really helped me (and was a lot of fun!) but I just never seemed to have it when I actually needed it.
  11. Self-hypnosis.  I bought a self-hypnosis cd and have found it to be extremely helpful (when I have the time to actually sit down and listen uninterrupted for 35 minutes).  The cd I have is called Growth and is 35ish minutes of a pleasant-sounding British woman speaking to you and telling you you are “effortlessly and easily pull-free” and that it’s not your fault and you shouldn’t feel guilty.  It’s a very positive and soothing experience and I highly recommend buying the cd.  (Also, the website that advertises the cd is also very helpful for all things Trich-related.)
  12. Meditate.  You might be thinking meditation is just a hyped-up hipster trend that has no actual physical and mental benefits, but hear me out.  I actually used to think the same thing…until I tried it.  The neurologist I go to made me read a book on meditation called Mindfulness Is Better Than Chocolate and then actually try to meditate, and I cannot tell you how much it has helped me!  You don’t have to buy a Buddha statue or burn incense or anything like that (even though incense is awesome!), you just have to sit comfortably and quietly and count your breaths.  Set a timer on your phone for just two minutes and during that time, breathe in and out and count each breath.  When you get to 4, start over.  Think about nothing else except your breathing and whichever number you’re on.  I won’t lie, it was very difficult for me starting out and I had to keep redirecting my thoughts, but I eventually got better and was able to start setting my timer to five minutes and then ten minutes.  I’m still not great at meditating but I really enjoy it – it calms me, refocuses me, and allows me to be present in the moment instead of stressing out, thinking about a million different things at once, and absentmindedly pulling hair.  (If you read the book, you will be amazed at how beneficial meditation can be for your health in addition to hair-pulling!  It doesn’t just make you calmer, it strengthens your immune system too.  How nifty is that???)

Those are the techniques I’ve tried so far.  Basically, figure out where/when you pull.  Are you in a certain room of the house?  Is it when you’re by yourself?  What are the circumstances – are you stressed about something or bored or…?  Try to figure out when you’re most vulnerable and then take the appropriate steps to limit your ability to pull hair.  Another thing my neurologist told me is that our brains create pathways – in other words, the more we do something the more habitual that thing becomes.  (Like a path in the forest…walk on it long enough and the plants die and you have an actual dirt path to follow.)  He said when people have seizures, it’s incredibly important to start medication and stop the seizures as soon as possible because our brains remember how to get back to that point and the seizures will quickly get worse and last longer if left untreated.  Trichotillomania is like that – the more you pull, the more habitual it becomes.  So break the habit before it becomes a habit!

Do you have any tips or tricks to add to my list?  Have you tried any of the suggestions I listed?  I’d love to hear from any of you about which methods worked or didn’t work, or just your experience with Trichotillomania in general.  I hope this little compendium of my knowledge helped you at least a little!  Best wishes!!!

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