It is encouraging to see the increased awareness and academic interest in the medical research fields in body-focussed repetitive behaviors (BFRBs) such as trichotillomania. These widely experienced, yet little known disorders often go undiagnosed because either the patient is too ashamed to seek help, or the patient or mental health professional is not aware it is a clinical condition. Often clients engaged in the online therapy program offered here at Trichstop report that the health professionals they spoke to about their hair pulling concerns, would shrug off their concerns saying that it was just a bad habit the individual needed to learn to control themselves.
One of the frequently asked questions on forums and support groups from compulsive hair pullers is whether or not the inability to stop pulling ones hair is due to lack of willpower and can strengthening the willpower enable them to stop? Partly this question stems from the deep inner feelings of shame and guilt at not being able to control a behavior the person is inherently aware is not healthy and so desperately does not want to engage in despite the damage it may cause to the area of targeted pulling. But it also stems from the common societal ignorance regarding mental illness where behavioral control is compromised such as is the case with addiction, obsessive compulsive disorder, and body-focussed repetitive behaviors (BFRBs).
Meet Emma Garcia, a young vlogger since 2013 who shares intimate feelings and experiences about living with trichotillomania. In this vlog, Emma talks about the two sides she experiences with having trichotillomania and particularly when she has had a bout of compulsive hair pulling. She talks about the guilt and anger she feels toward herself, but at the same time she feels like she doesn't want to let this behavior to take control over her life. She talks about not wanting to be "that girl" who mopes about and is "obsessed with [my] hair". This dilemma that Emma feels is one that so many people struggling with body-focussed repeptive behaviors experience.
The road to recovery can be long and full of setbacks. So how do you know it's getting better? The Trichotillomania Learning Centre (TLC) created a video with the theme “I knew it was getting better when…." to capture the important role a supportive community plays in the rocky road to dealing with body-focussed repetitive behaviors such as trichotillomania and excoriation disorder. TLCplays such a significant role in the lives of those living with these conditions. They have always been at the forefront of research and advancement in knowledge about the disorder and work very hard at trying to find the treatments that work. But most importantly TLC provides the support that those sufferring with BFRBs and their loved ones so desperately need to keep them going on this extremely difficult journey.
There is hope
As some of the participants in the video describe, they knew they or a loved one was getting better when:
In 2014 Ms Reneta Slikboer, a PhD candidate from the Swinbourne University of Technology in Australia, embarked on her Doctoral research with a focus on understanding trichotillomania. The aim of the study was to understand the psychological mechanisms that contribute to maintaining trichotillomania and how they predict symptom severity. Previously thought to be a rare condition, it is now estimated that about 1% of the population experiences this disorder. Recognized for the first time as a clinical condition in 2013 in the diagnostic and statistical manual (DSM5), researechers are now sitting up and taking notice of condition that can be severly debilitating for many sufferers. According to Reneta:
This year, the annual Trichotillomania Learning Centre (TLC) Body-Focussed Repetitive Behavior (BFRB) conference was held 10-12 April in Arlington, Virginia. The conference aims to highlight new research, challenges and advancements in the field of BFRBs such as trichotillomania. The conference entails a jam packed program of inspirational speakers, lectures and an opportunity to meet others with the same condition. The conference is aimed at all ages and even younger children and teenagers are welcome, with special programs specifically for this group. One of the highlights of the conference is the closing session open mic. This is when these young attendees are welcomed up on the stage to share spontaneously any message they would like to convey to the audience.
Trichotillomania or compulsive hair pulling disorder, is often thought to be an unconscious or automatic behavior, whereby the individual may be unaware he or she is pulling their hair until they have already started. Once the action has been initiated, the person finds it difficult to stop, despite feeling ashamed or guilty and being aware of the potentially damaging effect it might have on their hair follicles. This can then perpetuate the cycle whereby the person may then further experience the urge to pull in response to the shame and guilt that goes with this condition. When hair pulling is done in a compulsive manner which the person is unable to stop, it is no longer considered a bad habit, and is referred to as trichotillomania - classified as a form of impulse control disorder.
When you just have a habit of pulling at your hair, you can choose to stop at any time. But when the urge to pull becomes too irresistible, it is possible a clinical condition has developed. One of the criteria for diagnosis of compulsive hair pulling disorder in the Diagnostic and Statistical Manual (DSM5) is that the individual is unable to stop despite one or more attempts to resist engaging in the behavior. So if having trichotillomania means you have not been able to stop pulling does this means you will never be able to stop?! No it doesn't. We outline a few basic tips from other hair pullers on how to stop pulling:
Like any other mental or physical condition, what we eat plays a significant role in our risk factors, our prognosis and the severity of our symptoms. Anecdotally society has always recognised the link between food and emotions, linking certain foods with love and romance, comfort food, foods that give you a pick-me-up and even celebratory foods. So intuitively we know that what we eat is more than just nourishment and should therefore come as no surprise that what you eat may have an impact on hair pulling. Of course there is no one shoe fits all ideal diet, but we let's take a look at some of the general guidelines to consider that may help you reduce your hair pulling:
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