Tips to stop pulling

Tasneem Abrahams
Jun 28th, 2015

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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:

Manage don’t Resist

The first idea to come to terms with is that, like all psychological disorders, trichotillomania is a chronic condition. This means that while they may have found pharmacological treatment for depression for example, the person who suffers from depression will need to always be aware of the signs and symptoms of the condition to prevent relapse. In the same way, even with the new and exciting treatments and therapies being discovered through research into trichotillomania and other body-focussed repetitive behaviors (bfrbs), individuals will still need to manage the disorder in the long term. So an important first tip is a recommended shift in perspective from ‘Resist the Urge to Pull’ to ‘Manage the Urge to Pull’. Managing the condition is a far less taxing and more sustainable way to stop pulling than simply trying to just resist the urge.

Seek medical/professional advice

It is unfortunate that many health professionals are still ignorant with regards to the existence of compulsive hair pulling as a DSM5 disorder, because it means that so many trich and other bfrb sufferers are hesitant to seek advice from their doctors for fear of judgement. However this landscape is slowly but surely beginning to change as research into bfrbs has been on the increase over the last decade. With the variety of treatment options from traditional to alternate health starting to surface, it is always advisable as a first step to consult with a health professional before embarking on any treatment on your own.

Support from a community

Hair pulling and skin picking are lonely disorders as those suffering from these bfrbs often suffer in silence for fear of rejection and being judged as being ‘weird’ or ‘crazy’. Trichotillomania therefore often goes undiagnosed and the individual with the disorder feels like they are alone. However with the advent of the digital generation, more and more people are taking to the cyber world to share their experiences, and as a result people who have suffered in silence for many years are realising that they are not ‘weird’ or ‘crazy’ and that there are many people the world over struggling with the same issues. Connecting with this virtual community can be beneficial because it offers one the option of seeking help and support with a degree of anonymity whilst still being able to share and vent the heavy feelings often bottled up in secrecy to an audience that understands.

Finding alternative behaviors

One of the methods used in cognitive behavioral therapy, which is utilised in the treatment program offered by Trichstop.com is something called Habit Reversal Training. While this method as a treatment should preferably carried out under the guidance of a trained therapist, one of the strategies of identifying alternate behaviors to pulling can be explored on your own. This entails substituting hair pulling with an action that makes it difficult to pull at the same time, for example fiddling with a fidget toy, doodling on a paper, or putting on hand lotion. The key is to think of actions you can do with your hands that is socially appropriate to the settings you usually pull, is something you are willing and able to do and that is easily doable.

Avoiding the triggers

It is important that you gain awareness of the situations, environments and events that act as triggers for hair pulling. Once you identify your triggers it may be possible to avoid these to prevent the urge to altogether. For example if you find that you always pull your hair the minute you are alone in front of a mirror, then perhaps it may help to never go to a public restroom on your own and to cover mirrors in your home.

Spiritual healing

Activities geared toward spiritual connectedness such as deep breathing, prayer and meditation is nothing new, but has become more ‘fashionable’ in recent times as the practice is embraced in the mainstream as we are started to realise that spirituality does not necessarily have to be synonymous with religion. Health and fitness practices of yoga, tai chi and guided meditation have been embraced in popular culture and many people with trichotillomania have reported that engaging in these activities have helped reduce the urge to pull by reducing stress and anxiety.

Diet and nutrition

Almost all the health problems we face in the modern world can be traced back to poor diet. We live in an age of speed and convenience, a principle which has unfortunately been applied to our food as well. The foods we eat are filled with preservative, often synthetic or genetically modified, and almost always contains too much refined sugar and salt. While changing ones diet may not ‘cure’ trichotillomania, a healthy diet will add strength and luster to the skin, hair, and nails. Strong beautiful hair may act as a deterrent to trichsters to pull, but it will also fortify the fuel feeding the brain, and the moods produced there, so the compulsion to pull will likely become easier to overcome as your mental outlook becomes stronger. Of vital importance in any good diet is water. So cut down on sugar and salt, eat a balanced meal that includes fresh fruit and vegetables and dring lots and lots of water.

Therapy

As mentioned above, increased research interest in trichotillomania has led to the discovery of the effectiveness of a variety of treatments. Established treatment modalities such as cognitive behavioral therapy has been shown to be effective in helping clients reduce or stop hair pulling. Fortunately more and more therapists are taking an interest in trichotillomania. Although resources catering for this still very newly categorised clinical condition is scarce, there are many online CBT options available from skype-based councelling to text-based therapy such as the one offered here at Trichstop.com.

Tasneem Abrahams

   

Tasneem is an Occupational Therapist, and a graduate of the TLC foundation for BFRBs professional training institute. Her experience in mental health includes working at Lentegeur Psychiatric hospital forensic unit (South Africa), Kingston Community Adult Learning Disability team (UK), Clinical Specialist for the Oasis Project Spelthorne Community Mental Health team (UK). Tasneem is a member of both the editorial team and the clinical staff on TrichStop, providing online therapy for people who suffer from Trichotillomania and other BFRBs.

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