Harris Harrington describes and overviews the entire recovery process for Trichotillomania
In this article I go over the recovery process for overcoming trichotillomania. I used these techniques in my own recovery process from the disorder, which I suffered with for years. I cover this material in detail with sequenced exercises in my program The Hair Pulling Cure.
Give up the Struggle
To cure trichotillomania you must first stop trying to stop pulling. Give up the “struggle” of trying not to pull, of trying to stop your urges. It hurts me to see and hear about people who do the EXACT opposite of what they should do to stop pulling. In fact, most people make the disorder worse by punishing themselves, tying their hands, and trying to force the thought of pulling from their minds.
Instead, they make the disorder worse by increasing the urge to pull.
Try this: learn to be non-judgmentally mindful of your urges and of your ingrained habit. It doesn’t mean you are giving up hope. It means you are admitting that you can’t control everything. People with TTM have an excessive need for control, which ironically makes them feel even more out of control.
Overcoming Internal Obstacles
People with TTM (and almost any mental disorder for that matter) do things that actually perpetuate the problem and make it more severe. In order to overcome these internal obstacles, you must often do what feels WRONG. Something that doesn’t make sense at first is usually referred to as counterintuitive.
Here are a list of things you must do to overcome Trich that are counterintuitive and may not make sense at first:
- Be non-judgmental of pulling, and the urges you have
- Practice radical accpetance of Trich, and accept your self completely as a person
- Talk about your disorder with others instead of hiding
- Engage in activities that might make your bald spots show.
- Face your fears, instead of avoiding them.
- Practice relaxation daily
In my program I show you a lot of these simple, yet often misunderstood principles. They don’t make sense at first, but once you start practicing them, you will see results.
Habits can and will fade if you give them time
Although trichotillomania is designated as a mental disorder, it’s also a habit. Each time we engage in hair pulling, tugging, and even rubbing, we increase the habit. The habit takes on a life of its own.
There is a simple reason for this.
Neurons that are activated in our brains more frequently become more easy to activate later on. It’s like a well worn trail in the woods; it’s easier to walk down. What happens if you stop walking down the trail? Grass, trees and bushes grow over the trail so that you can’t walk down it. The same thing happens with hair pulling. When you start reducing the number of times you pull, the habit dies off. The neurons won’t fire as fast or efficiently as they do now. Right now this may be hard for you to imagine because it’s likely that you pull very often. But in time, if you apply the mindsets and techniques I teach, TTM can actually become a memory and not a current reality.
Are you a conscious or automatic puller?
You must realize if your pulling occurs in an automatic state or if you do it consciously. Neither type comes in a completely pure form, but 75 percent of trich sufferers pull our their hair in a mostly automatic or unfocused state of mind. What this means is they usually start and end pulling without being very aware of what they are doing. This is often described as being “in a trance”.
Conscious pullers tend to pull in a very focused manner, often selecting specific hairs, and may actually pull in front of a mirror with tweezers.
In my program I have you write down and note when specifically you pull, where you pull, how long you pull, what urges or feelings precede pulling, and what urges or feelings occur after you pull. When you undergo this observation and notetaking, you will become more aware of your disorder and can then make steps to put yourself in low risk situations. This is something called stimulus control.
Why we pull
People who pull our their hair do so to regulate an internal emotional state. They are either trying to escape boredom or anxiety.
It’s that simple
In other words, they are trying to regulate underarousal or overarousal.
Most people with trichotillomania have either an anxiety disorder, depression, or often times both. Anxiety, panic attacks, and depression are caused by too much stress. We pull to distract ourselves from this stress.
This is why I teach acceptance and relaxation principles. The cure for too much stress is relaxation. In our bodies we have a stress response and a relaxation response. When you activate the relaxation response, you can’t feel anxiety and depression. Relaxation should be practiced daily.
Another reason why pulling starts running out of control is because of the nature of habit. When we do something over and over again, certain neurons in our brain become insulated with fat. The nerve impulses travel faster. It’s like a well worn trail in the woods.
In order to stop pulling, you have to essentially carve a new trail, and create a new non-pulling habit. As you implement the pulling-reducing techniques in my program, the pulling habit will die off. Over time you won’t need to do as much pulling management. It will become a distant memory.
Stress, anxiety disorders, and depressive issues are extremely common in people with trich. Getting a handle on these states, and learning to tolerate a greater amount of discomfort are all things I address in my program. It’s very likely that you pull to escape these emotional states.
Acceptance is an often misunderstood mindset shift that is extremely critical for trich sufferers to undergo. The first key in acceptance, is unconditional self-acceptance. In our society, we are implicitly conditioned to base our self worth on external pillars such as our appearance, achievements, etc. This is a terrible mistake and often leads to self hatred, and illogical self-to-other comparisons.
Many people believe they understand acceptance, when they truthfully haven’t applied it to their lives. I give multiple specific exercises that will dramatically alter the way you view yourself and the world. These critical mindset shifts will allow you to diminish the pain and stress you unnecessarily put yourself through on a day-to-day basis.
In my program I also address relaxation. Anxiety and overarousal is the big enemy of the trich sufferer. Much pulling happens in extremely anxious states. I show you extremely effective relaxation techniques that will help eliminate this source of pulling.
Awareness and mindfulness
In my program I go through mindfulness techniques that are extremely critical in stopping trich in its tracks. When you become more mindful, you will greatly reduce unconscious pulling, which accounts for the majority of pulling episodes. I literally show you techniques that will stop pulling dead in its tracks. Mindfulness strategies are absolutely essentially in catching yourself in the act of pulling.
Once you have made the critical mindset shifts necessary for reducing stress, increasing self esteem, and acceptance, and once you have learned mindfulness and awareness, you can then occupy your hands when the urge to pull does strike.
A competing response is anything done with the pulling hand to keep it busy so that it is literally impossible to pull. Competing responses must be easy for you to perform, and preferably are not noticeable to anyone around you. The most common competing response is a clenched fist.
If you haven’t made the internal changes to reduce stress and other negative emotions, a competing response will be less effective. The inner work greatly enhances the competing response and makes it a powerful yet simple tool on the path to recovery.
When we pull for long enough, our pulling becomes associated with certain places and situations. If you pull while sitting on the couch watching TV, then any time the TV comes on, your mind subconsciously associates TV watching with pulling.
If you only pull in the privacy of your own room, then whenever the door closes, this will be a trigger or cue for your pulling to begin.
Some people pull in front of mirrors with tweezers. Any time they see tweezers, the chances of them pulling increases.
Stimulus control occurs after we have become aware of our pulling, when we pull, and where we pull. Once we have taken notes on this we now have the data we need to make intelligent stimulus control measures.
Stimulus control is about putting yourself in low risk pulling situations. For conscious pullers, getting rid of tweezers and avoiding mirrors is good. For unconscious pullers, avoiding chairs with armrests is a good measure.
If you only pull in private, then keep your door open so that other members of the household can see you pull.
Once again, these external techniques are secondary to the internal work.
In my video program I go over the internal and external techniques in a step-by-step manner so that you can eliminate hair pulling from your life.