Trichotillomania Blog

The Role of Thoughts and Beliefs in Trich

No matter which way you look at it trich is a complex disorder. While scientists produce evidence that it is a disorder of compulsion and impulse control, others suggest it is closer to a tic disorder. Since information about the mechanisms that cause trich are important for developing successful treatment strategies, researchers continue to look into genetic, neurological, behavioral, and environmental factors that influence hair pulling behaviors. Thus far, the most effective treatments tend to be psychotherapy with an emphasis on habit reversal and cognitive behavioral therapies. Research lends insight about the role of thoughts and beliefs on hair pulling behaviors which may help therapists and client navigate recovery, and this article will summarize a study conducted in 2015 that identified belief categories.  

Wanting Treatment? How to pay for it.

Many sources of mental health treatment are not free and depending upon one’s financial situation; cost can be the one thing that prevents people from getting the help they need. In the U.S., some programs offer free mental health services, but they often focus on substance abuse or certain populations. Rarely do those services offer expertise in treating body-focused repetitive behaviors. This article will talk about paying for mental health treatment and offer some recommendations.

How do you know if it works?

Treatments for trichotillomania yield mixed results, but does that mean they work or they don’t? A recent study sought to answer that very question.

Research About Research

Multiple studies continue to measure the effectiveness of treatments ranging from pharmaceuticals to therapy. Sometimes the press releases will announce something works, while others report “mixed results.” Let’s take a few moments to demystify the ambiguity of “treatment response.”

In simple terms, treatment response is a measurement used by clinicians and researchers to determine if an intervention works. There are statistics involved, and some of them get pretty complicated. The challenge with results and treatment responses is that an intervention can work yet not yield enough of a treatment response to be called effective. Also, there are many definitions of effective, not to mention the difference in the types of people for which an intervention is effective.

Your Therapist Could be Wrong

A recent PsychCentral article zipped through my inbox almost into the trash until I reminded myself about the many clients I worked with as a therapist who accepted the word of previous therapists as if it were the truth. In my practice, I often worked with “hard” clients or the ones who had been through multiple therapists in the office and then passed on because the other therapists labeled them as “severe.”

My clinical training focused on people who struggle with more than one thing at a time, in counseling terms known as co-occurring disorders. Unfortunately, there are many therapists not trained to work with people as a whole person. As a result, I was fortunate enough to meet with clients with a long pedigree of therapists and medications with symptoms that did not fit neatly into one diagnosis that could be treated with that diagnosis’s treatment manual. Folks with long histories of trauma, substance abuse, dysfunctional families, discordant relationships and overall feeling hopeless because therapists kept referring them elsewhere because their cases were too hard.

A trich-y Case

A report published in the Anatolian Journal of Psychiatry in October 2018, presented a case of trichotillomania that manifested during posttraumatic stress disorder suggesting a possible genetic link between the two.

The patient came to the attention of researchers when he presented to an emergency psychiatric clinic for anxiety, depression, irritability, aggression, and pulling out his hair from various parts of his body. At 20 years old, this young man never showed signs of previous trichotillomania or mental illness. However, his best friend died in a car accident the previous year and viewing his friend's damaged body contributed to the development of PTSD. His anxiety, nightmares, emotional stress and hair pulling all started after viewing his deceased friend.

Are BFRBs more like tic disorders or OCD?

The quest for solid, evidence-based treatment for body-focused repetitive behaviors (BFRBs) continues. Within that quest is the search for the neurological mechanisms of BFRBs like trichotillomania because if a neurological process can be identified, then a chemical or behavioral intervention can also be identified to fix it.

Why participate in research

To put it simply, research makes the treatment world go round. Effective treatments based on credible information need to come from the results of research and research needs participants. This article will explain why research is so important for the BFRB community.

To improve understanding about BFRBs

Before treatments can be developed, first we must understand that which needs treatment. When considering the history of BFRBs or any other mental illness, there is a long trajectory of misunderstanding. For example, BFRBs were once considered a “bad habit” and treatment sought to teach people strategies to counter the habit. Then, the research groups that developed the DSM-5 that was released in 2013 found enough evidence to group BFRBs within the obsessive-compulsive spectrum of disorders. In the past five years, however, new research indicates that BFRBs have traits like tic disorders which makes a difference for treatment. Ultimately, every bit of research leads to more information that helps us understand disorders so that people who suffer from them can get help.

Research Participants Needed


Social Concerns in Adults with

Body-Focused Repetitive Behaviors

Researchers are currently examining the role of social concerns associated with body-focused repetitive behaviors via Qualtrics. Participants must be ages 18-60 and have any of the following BFRBs:

  • Compulsive hair pulling (Trichotillomania)
  • Compulsive skin picking (Excoriation)
  • Compulsive nail biting
  • Compulsive nail picking
  • Compulsive teeth grinding
  • Compulsive cheek biting
  • Other BFRB

All study procedures will be completed in an online survey via Qualtrics. All participants will be placed in a raffle drawing for a chance to win one of five $20 Amazon gift cards.

The power of pictures

Have you ever taken pictures of your hair to keep track of how much hair you lose over time due to pulling? It is a technique that research says is effective for assessment and evaluation, but did you know it can be used to show progress in treatment?   

A study conducted in 2016 set out to find out if taking photos of someone during treatment for trichotillomania had any effect on behaviors or quality of life. There were some difficulties setting up this study so it conformed with parameters of a well-designed study. However, those who took before and after pictures during treatment demonstrated a positive response to using photos. Whether the photos themselves had any impact on a person’s pulling behaviors is unknown, but those who saw visible progress reported feeling better about treatment.


Online Test for Trichotillomania

Find Out The Severity of Your Hair Pulling With This Free Online Test