How to approach recovery when you hair-pull or skin-pick

Trichotillomania is the Latin term for compulsive hair-pulling and dermotillomania is the name for skin picking. Although the term mania translates as madness, there is no madness, only a behaviour that has got out of hand. 

Hair-pulling or skin-picking doesn’t define you. It’s important to separate YOU, from your behaviour. As Fred Penzel says in his book The Hair Pulling Problem, "TTM (trichotillomania ) is a chronic biologically based problem - not a psychological problem. It has nothing to do with intelligence or upbringing. You did not ask for it and you didn’t cause it!"

When you know that this does not define you, you place your behaviour in its true perspective. You can now look at something you do, and not at someone you are.

Changing behaviours

It is so much easier to teach someone to do something differently than to be something different. You can acquire a skill with motivation to learn, coupled with practice and discipline. If you want to learn a musical instrument or practice a sport, you know that you can achieve a certain proficiency if you train consistently.

Let’s just highlight the important difference between what we do and who we are:

• You can teach someone to play an instrument (learn to do) but you can’t teach them to be friendly and attentive to the audience (learn to be).
• You can teach someone to bake a cake (learn to do) but you can’t teach them to care about their neighbours enough to offer them a slice (learn to be).

Do you see the idea? This means that you can learn the skills to stop/manage hair-pulling or skin-picking with patience, motivation and training.

Now let’s take a look at how you can help adopt an acceptance approach that will help you in this endeavour, how you can start your recovery and how cognitive behavioural hypnotherapy can be an excellent aide.

Acceptance

When you’ve decided to stop your compulsive behaviour, it is well worth reflecting on the truth of the statement: This is something I do, it doesn’t define me.

When you integrate this belief, you can look the behaviour square on with no fear or shame. You can accept that you hair-pull or skin-pick and love yourself unconditionally anyway. You can love and accept yourself despite the behaviour and with the behaviour.

When you accept yourself unconditionally you leave behind the rigid, narrow, strict, and frankly painful and icy cold belief that you can only be lovable if you stop hair-pulling or skin-picking. Holding this belief only adds insult to injury.

When you ignore your compulsive behaviour and pretend it’s not happening, through fear or shame you only add to your suffering.  You don’t need to insult yourself or suffer even more! Trust yourself. Accept yourself. Care for and about yourself!

In my practice, I find that clients who make the shift to one of acceptance and love for themselves can make the largest strides toward recovery. At the end of the day, it is more difficult and painful to shame yourself into change rather than love yourself into evolution.

How to kickstart your recovery

What follows is your first important step to kick-starting your recovery

Be curious

When you gain precise detailed knowledge about your behaviour, a pattern emerges and you can elaborate a plan. When I work with clients, ‘quick wins’ are often visible once we have examined their behaviour forensically.

Quick wins are changes in routine that disrupt the behavioural routine and set you firmly on the path to recovery. When you make these changes, another wonderful shift happens, you take a step back from your compulsion and with that, you start to take control. It’s no longer this thing that just seems to happen. You have evidence. You have knowledge and awareness. You can build your recovery programme.

On the contrary, if you don’t know when you engage in your compulsive behaviour, where or why, or what you’re feeling while you’re doing it or how long you tend to do it for, then it remains vague, out of focus and very tough if not impossible to treat.

You need to know your enemy to fight it!

Let’s take a look at a few of the questions you can ask yourself to start this knowledge base. I must say that it is always easier to do this exercise with a therapist as she is the outsider who invites you to take that necessary step back.

Gain precise knowledge of the time of day you pull/pick. Ask yourself these questions: 

• What time do I generally start this behaviour in my day? 
• When does it get worse in my day ? 
• When do I tend not to pull/pick in the day? 

Then add the physical locations:

• Which room am I in?
• Am I at home or work or somewhere else?

Go through each room and once the rooms have been identified, go into more detail and locate where specifically in that room. If at work, where at work and locate where specifically. Then add the moods you tend to be in when you engage in pulling or picking. Then go one step further and add the activities you are typically engaged in at the same time as you pull or pick.

All of this will lead to a summary which can give you these sentences: I tend to pull/pick in (physical space/room ) at (time of day ) when I feel (emotion/mood) and when I'm (activity).

Let’s recap

When you accept and love yourself despite and with your compulsive behaviour. When you accept the truth that you have this behaviour but you are not this behaviour. When you observe and note down your pulling/picking in a precise documented manner, you set yourself up for recovery.

How cognitive behavioural hypnotherapy can help

Cognitive behavioural hypnotherapy has its firm place in your recovery ‘package’. CBT and its use of precise, structured questioning, understanding and ‘unpicking’ of the relationship between your mood, your thoughts and your actions help you uncover the full extent of your ritualistic compulsive behaviour. 

Cognitive behavioural therapy provides easy-to-use tools to track and observe your behaviour and so gain more understanding and awareness. Hypnosis roots the belief deep in the unconscious, dreamy, imaginative and creative part of your mind that you can recover.

Positive hypnosis washes away the negative self-sabotaging and limiting thoughts that you can never stop. It helps you discover and use the force of positive, strong visualisation.

When you practice the CBT and hypnosis exercises with motivation and discipline, these tools and coping strategies become a part of your life. You free yourself from your compulsive behaviour and know not only physically and mentally but also emotionally that you are in control. However you decide to tackle your BFRB, remember that you can overcome this and free yourself from the dull weight of a behaviour that takes over your life.

A note: there are also other BFRB’s (body-focused repetitive disorders) and the information in this article can apply to these too.