Trichotillomania: How to stop pulling out your hair

Considered a type of body focused repetitive behaviour (BFRB), here we explore what trichotillomania is and how hypnotherapy helps.

What is trichotillomania?

Trichotillomania (TTM), commonly known as 'hair pulling', is an impulse disorder, a compulsive habit that is similar to thumb-sucking or nail-biting. It often starts in adolescence, around age 12 when changes are happening in the brain and in the body. Studies show that 90% of reported sufferers are women but this may be because men are less likely to seek help.

The areas affected are usually the scalp, eyebrows, eyelashes, beard or other parts of the body. As with any habit, the reward is a momentary sense of satisfaction or instant gratification that relieves some sort of internal conflict, such as stress, anxiety, boredom or self-doubt. The majority of people who pull out their hair are unaware of the habit as it is generated unconsciously and they usually find themselves doing it absent-mindedly.

Typically, a person will only discover they have pulled out a strand of hair after the event, and might ask themselves, "Why did I do that?" They may feel a little embarrassed or ashamed of the habit, which increases the tension around hair pulling. The habit gets reinforced every time the behaviour is repeated.

Some people go to great lengths to cover up the damage and the habit, like wearing scarves or saying they have a skin condition if someone asks.

What causes a person to pull out their own hair?

The underlying causes of TTM are psychological. Whenever tension, stress, anxiety, boredom or some other negative emotion builds up, there is an urge for relief. The act of tugging the unfortunate hair from the root takes the attention away from the underlying negative emotion but it doesn’t actually relieve the emotion - it just buries it.

It’s a bit like when someone eats junk food when they are anxious, the anxiety doesn’t disappear, it just gets pushed down and they end up putting on weight and becoming unhealthy. TTM might be considered a form of self-harm. When the hair puller is feeling anxious, the hand will unconsciously move up towards the damage site as they seek the next victim of harm, the unfortunate solitary hair.

Poison Ivy

The plant Poison Ivy contains toxins that, if brushed against the skin, causes an itchy, irritating, painful rash that is only relieved momentarily by scratching, but scratching makes it worse. The rash can last for two to three weeks. The only way to recover is to stop scratching, but this is very difficult when scratching brings temporary relief.

The person has to learn how to stop scratching and sit with the discomfort, knowing that it will pass. Sufferers have discovered that blowing on the skin six times can cause some relief, just as blowing out through the mouth slowly six times when feeling anxious can lead to calmness. In the same way, a person can learn how to stop hair pulling, retrain the brain and feel empowered with the help of hypnotherapy.

Sit with your feelings

There is a range of positive coping methods that help to deal with unpleasant emotions. Learning how to sit with our emotions, acknowledge them and be willing to feel them is key to dealing with the underlying cause of trichotillomania.

Once you identify the cause, you can begin to plan ahead and have a strategy to overcome it.

How can you stop pulling out your hair?

Remember, the habit is not your fault. It’s generated by the unconscious mind as a means of releasing tension of some sort. The steps below will help you to start to notice the triggers and the times when it happens, and then interrupt the pattern and change the behaviour.

Step 1: Keep a habit journal

Keep a habit journal for a week and write down every time you become aware of the habit.

Step 2: Use an elastic band

Keep an elastic band on your wrist, and snap it every time you discover yourself doing the habit. This will make your brain pay attention and become aware of what’s going on for you at the time.

Step 3: Plan ahead

Write a list of times when you are more likely to do it, and plan ahead for a counter-strategy, like squeezing a stress ball, and/or doing the 'Yawn, Stretch, Relax' exercise. Here’s how you do it: force a slow yawn, stretch your body, roll your shoulders, move your head from side to side, stroke your arm in a self-soothing way and think of something you value deeply.

Step 4: Be objective

Be objective about the habit and every time you notice the urge or the behaviour, point it out and say what’s happening, out loud or under your breath, for example: “Howard is feeling bored, (stressed, anxious or whatever) and is about to pull out his hair, he doesn’t need to do that, it will give him a bald patch.”

Step 5: Rate the urge

Rate every urge on a scale between zero and 10, where 10 is totally uncontrollable and zero is no urge at all. You will probably be able to stop easily between zero and five, but anything over five is a bit more difficult and takes practice. Notice that the number you come up with will directly relate to the feeling of discomfort - the emotion that underlies the habit.

Step 6: Gamify the experience

See the act of stopping pulling out your hair as a computer game that you want to win. The urge is the villain who hides in various places. It jumps out when you least expect it and pulls out your hair. The hair itself is the victim. It screams “Help me” every time your hand goes up towards the hair follicle. You are the Hero, it’s your job to hear the scream, help save the hair and deal with the urge before serious harm is done. Every time you overcome the urge you win that level. When you have finally stopped pulling out your hair for good, you win the game.

Why do you want to stop pulling out your hair? What would be the benefits? How will you feel when you remember that pulling out your hair was something you used to do? Think about what success will mean to you.

How can hypnotherapy help?

Overcoming TTM requires a bit of self-exploration and reflection. You will need to get to know yourself and what drives the unconscious habit. Hypnosis works with the part of the mind responsible for hair pulling and can help you to stop the habit of hair pulling quicker. 

Don’t let trichotillomania cause any more embarrassment or anxiety. Hypnosis helps you to enter a deeply relaxed state of mind. When you are in this state, your subconscious is open to suggestion and new associations are formed easily. Using hypnotherapy techniques, we can interrupt the old destructive pattern and replace it with a new positive pattern of thought and behaviour. 

Book your appointment now and give your hair a holiday. For TTM or any other habit, get in touch and find out more about how hypnotherapy works.