I am new to this message board and am grateful there are others here sharing their stories.
I first learned about trichotillomania many years ago when I noticed my older sister liked to pick at her skin. Then I realized she was pulling out hair from her knuckles. She also began to pull out hair from her scalp, usually when she was relaxed and watching TV. This started probably when she was in her mid-20s.
She's 44 now and I still see her pulling. I believe that the pulling has increased. In the past couple of years, I have observed that she also pulls her pubic hair. The first time I saw her pull her pubic hair, I felt grossed out because we were eating dinner. When I said something to her about it, she seemed very embarrassed, possibly hurt. She stopped for 5 minutes, then went back to pulling. So then I realized that it seems that she cannot stop pulling. I have not said anything to her about it since then. However, part of me wants to say something because it is becoming a hygienic issue (she pulls, then handles or serves food to the family, but does not wash her hands or clean the pulled hair from the table).
I want to be supportive of my sister, but I am not sure how to broach the topic. She has some other OCD behaviors and perfectionism as well that make it very difficult to discuss anything that can be construed as criticism. If she feels anything less than an unachievable standard, she will instantly shut down to feedback from others. We have encouraged therapy for her, but only attended one session and she seems unwilling to commit to the process.
I have seen her discarded to-do lists lying around over the years. For the past 2 decades, "stop pulling" is usually written on the list. I feel this is something that she wants to stop doing, but is probably "stuck" or doesn't know how. As someone who does not pull, I don't personally know what this feeling is like so that I can better understand it.
Sometimes I read many articles about trich and want to forward them to her, but I feel this would only make her embarrassed again.
If anyone has any advice, I would appreciate it. I only want to help.