Trichotillomania Blog

Emotional Avoidance and Hair Pulling

Avoidance…it’s something we all do. It’s our go-to when we just don’t want to do something. But there’s avoidance of something just unpleasant and then there’s avoidance of emotions that can create distress. In this webinar, Dr. Vladimir Miletic talks about emotional avoidance and how avoiding difficult emotions and memories may lead to hair pulling.

What Avoidance Is and Why We Do It

Emotional avoidance occurs when a person is unwilling to deal with certain private experiences such as body sensations, emotions, or thoughts and takes steps to alter the form or frequency of these events and the contexts in which they occur. Dr. Miletic frames this behavior as the things a person is willing to do to minimize or change their experience so they don’t have to deal with it.

We use avoidance behaviors all the time. Some are relatively benign. Others, like hair pulling, can have significant, often unintended, consequences. So, the question is, why do we avoid if we know that it causes problems?

Evidence Based Treatment and BFRBs: What It Is and Why It Matters

They say for every problem, there’s a solution. Well, that might be true, but it depends on how you define the solution. When you’re looking for answers to a problem, there’s no shortage of recommendations, stories, and downright fantastical tales of overnight cures. A quick spin around the internet will yield thousands of promises, cures, and magical treatments all promising relief for BFRBs like hairpulling and skin picking. Some of them even sound plausible. It’s tempting to latch on to whatever “sounds” good. The problem is, how do you know if it actually is helpful?

If you struggle with a BFRB, you’ve no doubt done your share of searching for relief. In your search for treatment, you’ve probably come across the term “evidence-based treatment” or EBT. It sounds good, right? But what does “evidence-based” really mean? More importantly, what does EBT mean for people living with BFRBs?

The answers lie in science.

Habit Reversal Training and BFRBs: What Research Has To Say

BFRBs are not a single disorder but a group of disorders characterized by repetitive behaviors that cause injury to the body. BRFBs include trichotillomania (hair pulling), excoriation (skin picking), onychophagia (nail biting), morsicatio buccarum (cheek biting), and others. While each of these disorders is different in its focus on the body, they do share common trajectories. BFRBs result in varying degrees of physical injury to the body and can markedly impair emotional and social functioning. BFRBs are relatively common and not everyone will have significant problems. However, for those that do, finding treatment that can reduce symptoms and improve their quality of life is a priority and sustained effort.

Hair Pulling Trances: What We Know About Them

In a recent webinar, Dr. Vladimir Miletic tackled the topic of hair-pulling “trances”. While this behavior is something we know happens, there is surprisingly little literature on this phenomenon. Much of what we know about trance pulling comes from anecdotal evidence. In other words, people report doing it and talk about it. So, just what do we know about trances? Turns out, quite a bit.

Defining A Hair Pulling Trance

A hair-pulling trance is a prolonged episode of hair-pulling that is all-engaging. The person becomes intently focused and completely absorbed in the experience of pulling. They may be completely unaware of what’s happening around them and they might not even be aware that they’re pulling. As a result, the use of competing responses is rather ineffective because they’re not going to attend to it. The focus of the trance is pulling.

Sleep Quality and Hair Pulling: What’s the Connection?

When it comes to physical health, the benefits of healthy lifestyle habits are well-known. Actions like maintaining a proper diet, exercising, not smoking, and getting enough sleep have been shown to improve many health conditions. What you might not know is that lifestyle habits can also have an effect on mental health. A growing body of evidence has linked healthy lifestyle habits to improvement in conditions like depression, anxiety, and ADHD. Now, research suggests that sleep quality can have a major impact on trichotillomania (TTM).

A new study in the journal Comprehensive Psychiatry looked at the effects of sleep quality on trichotillomania (TTM) and skin-picking disorder (SPD). What they found could be a game-changer for people dealing with body-focused repetitive behaviors.

Psychodermatology And Hair-Pulling In Children

While trichotillomania (TTM) can occur at any age, the onset is most often seen in children ages 10-13, and more common among females. Some studies suggest that it’s not uncommon to seek out a dermatologist for treatment. After all, trichotillomania and skin picking present with distinct dermatological issues. But, these disorders also have distinct psychological underpinnings that perpetuate the behavior that creates skin and hair issues. Other studies suggest that people tend to seek out mental health support. Determining who to see and when isn’t always clear. So, the logical question one might ask is, “Do I need a psychiatrist or a dermatologist?” When it comes to body-focused repetitive behaviors (BFRBs) and some other skin disorders, the answer seems to be both.

Trichotillomania and Defining Subtypes: The Latest Research

When it comes to Trichotillomania (TTM), not all hairpulling is the same. While hair pulling is the dominant feature of TTM, new research published in The Journal of Psychiatric Research suggests that there’s much more to the clinical picture. These results have significant implications for diagnosing, categorizing, and treating TTM.

The Need for Better Data

A relatively common disorder, TTM affects about 3% of the population. Despite its prevalence, TTM remains under-represented in the research literature and often goes untreated.

The Role of Self in Hair-Pulling Disorder

Trichotillomania, also known as hair-pulling disorder (HPD), could be more common than originally thought. In fact, approximately 2% of the general population struggles with HPD at any given time. But, because HPD sufferers tend to be ashamed of their behaviors, many do not seek treatment, leaving many cases unreported.

Living with Trichotillomania – The Real Deal

Trichotillomania, also known as hair-pulling (HPD), is a condition that involves pulling at, “messing with,” yanking out, and/or over-plucking (i.e. eyebrows, genital hair, and hair on your arms and legs, and under your armpits) your hair. This behavior not only affects your appearance, but also your self-esteem, sense of self, mood, and quality of life.

Art Therapy & BFRBS

Body-focused repetitive behaviors (BFRBs) like trichotillomania, also known as hair-pulling disorder (HPD), can trigger a wide range of emotions and social and psychological issues. It can also impact various areas of your life, such as friendships, romantic relationships, family dynamics, and/or work productivity. The most common feelings associated with HPD are shame, embarrassment, anxiety, depression, mood swings, low self-esteem and self-confidence, body image issues, frustration and loneliness, and guilt.

Can Art Therapy Really Help Reduce BFRBs like hair-pulling disorder (HPD)? Possibly


Online Test for Trichotillomania

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