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Trichotillomania (Hair Pulling)

What is Trichotillomania (Hair-Pulling Disorder)?

Trichotillomania, commonly referred to as “trich” or hair-pulling disorder, is a chronic condition that falls under body-focused repetitive behaviors (BFRBs). It is characterized by the repeated pulling out of one’s hair, leading to hair loss and significant emotional distress. Despite a strong desire to stop, individuals often feel unable to control the behavior, which may impact their physical health, self-esteem, and quality of life.

Understanding the Impact of Trichotillomania

Trichotillomania often affects various areas of life, including physical health, emotional well-being, and social interactions. Key aspects include:

  • Physical Effects: Hair loss, scalp irritation, infections, and in rare cases, the formation of trichobezoars (hairballs in the digestive tract).
  • Emotional and Social Impact: Feelings of shame, embarrassment, or guilt often lead to avoiding social interactions, salons, or medical appointments.
  • Psychological Effects: Increased risk for anxiety, depression, and other co-occurring mental health conditions.

Comprehensive Treatment for Trichotillomania

At The Center for Emotional Health (CEH), we provide compassionate, evidence-based care designed to help individuals overcome trichotillomania and regain control of their lives. Our specialized treatment incorporates scientifically supported therapies to address the unique challenges of hair-pulling behaviors.

Evidence-Based Treatment Approaches

At The Center for Emotional Health (CEH), we provide compassionate, evidence-based care designed to help individuals overcome trichotillomania and regain control of their lives. Our specialized treatment incorporates scientifically supported therapies to address the unique challenges of hair-pulling behaviors.

Habit Reversal Training (HRT):

HRT focuses on:

  • Awareness Training: Helping individuals identify triggers, patterns, and urges associated with hair pulling.
  • Stimulus Control: Modifying environments to reduce urges and promote healthier behaviors.
  • Competing Response Training: Teaching alternative, less damaging actions to replace hair pulling.

Comprehensive Behavioral Treatment (ComB):

ComB addresses the physical, emotional, and environmental factors contributing to trichotillomania. A detailed examination of the factors influencing hair-pulling behavior and traditional cognitive behavioral therapy (CBT) interventions are provided with attention to:

  • Sensory Experiences: How physical sensations impact hair pulling.
  • Cognitive Patterns: The role of thoughts and beliefs.
  • Emotional Responses: The connection between emotions and the behavior.
  • Motor Behaviors: The actions involved in hair pulling and level of awareness.
  • Environmental Factors: How surroundings and context play a role.

Integrative Behavioral Therapy (IBT): Enhancing Psychological Flexibility

IBT combines elements of cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), and dialectical behavioral therapy (DBT) skills.

Steps in IBT for BFRBs include:

  • Building self-understanding:
    Gain awareness through mindfulness and identification of the behavior chain.
  • Narrowing down the MAP:
    Address the external and contextual antecedents that lead to BFRB symptoms, including:

    • Movement and Automaticity – build mindful body awareness and self-observation skills.
    • Awareness of Vulnerabilities – reduce underlying vulnerabilities.
    • People, Places, and Spaces – Respond effectively to the environment.
  • Working with the TIMES:
    Change one’s relationship to internal discomforts which have prompted BFRB symptoms:

    • Thoughts, Images, Memories – Foster a healthy relationship with oneself.
    • Emotions – Build emotion regulation, distress tolerance, and self-compassion.
    • Sensations – Observe, allow, and redirect discomforts.
  • Thriving with a BFRB:
    Build confidence, overcome difficult situations, and master BFRB skills to live a full, meaningful life.

Support and Resources for Long-Term Success

  • The BFRB Recovery Workbook
    Authored by CEH Founder Dr. Marla Deibler and Dr. Renae Reinardy, this workbook offers actionable tools and strategies to support recovery from trichotillomania, excoriation (skin picking) disorder, and other BFRBs.

  • Community Support Groups
    Join our free monthly support groups, where individuals impacted by trichotillomania and other BFRBs can connect, share experiences, and receive ongoing encouragement in a judgment-free space.

Request Your Appointment

Take the first step toward better mental health. Whether in person or through telehealth, The Center for Emotional Health is here to support you every step of the way. Contact us today with any questions and to schedule your appointment.