Heal Your Life Today

Merrill Black, L.C.S.W.
Psychotherapist/Reiki Master
The Temperance Center
453 White Plains Road
Suite 201
Eastchester, N.Y. 10709
Phone: (914) 793-2600
Email: merrill@healyourlife2day.com

Trichotillomania Treatment


An Overview Of Trichotillomania:
Trichotillomania (TTM) affects people of all ages, but commonly starts in late childhood/early puberty (around 11-13 years old).

However, trichotillomania can begin as early as infancy. Trichotillomania may develop in adulthood as well.

Trichotillomania is estimated to affect about 3 - 9 million people (about 1-3 percent of the population). Merrill specializes in treating clients who have trichotillomania at her practice in Eastchester, NY.

People with trichotillomania will pull hair from their scalp, eyelashes, eyebrows, and or other locations on their body. Pulling can range from being mild where it goes unnoticed by others, to more extreme where actual bald patches are created from the pulling. When the pulling is more extreme, often people will try to disguise the bald patches by wearing their hair differently, or wearing head coverings such as hats, scarves, and or wigs.

Generally people with trichotillomania are not trying to harm themselves. Instead it is often described as a pleasurable, self soothing activity, and or a way to calm themselves down. Often people describe feeling “urges to pull” and the pulling alleviates the tension they feel. Stress, anxiety, boredom, being over stimulated, and or depression do not cause trichotillomania. However, they can be contributing factors to someone wanting to pull their hair.

Some people will pull one hair at a time. Others will pull several hairs at once. Some people just discard their hair once it is pulled. Many people however will look at their hair after they pull. Some check to see the root, or the texture of the hair, or if they got the “right hair” or a “good hair”, or they may manipulate the hair, or rub the hair within their fingers, or around their mouth, and or on their body before they discard it.

In some cases people will eat the roots of the hair or the whole hair. When the whole hair is ingested there is a possibility that a hair ball (trichobezoar) could develop. A hair ball (trichobezoar) is rare but can be quite serious causing an intestinal blockage, and may require surgery. In an extreme case, it could be fatal.

Hair pulling can wax and wane through out a persons life. At Merrill’s practice in Eastchester, NY she educates her clients about their trichotillomania. Learning about their behaviors and patterns is all part of the therapeutic process.

How Does Trichotillomania Affect Someone?
Many people who have trichotillomania feel a sense of embarrassment or shame about their pulling. Having trichotillomania can affect their self esteem greatly. They often will hide from others that they have this problem and may avoid certain daily activities such as going to doctors, hairstylists, sports, socializing with friends, and or dating.

They often feel alone with this problem and can be upset with themselves that they have difficulty controlling their pulling. At Merrill’s practice in Eastchester, NY she helps her clients identify their feelings about having trichotillomania. One of the goals in therapy is to reduce their shame, learn to embrace themselves fully, and improve their self image.

When & Where Does Pulling Happen?
There are some common times and places that pulling occurs. Some of these can be while watching television, while on the computer or phone, reading, thinking, doing homework, while looking in the mirror, bedtime, in the early morning, when they are tired, bored, stressed, anxious, excited, and or when they are depressed.

Sometimes people are aware when they are pulling. There are other times that they are unaware of their pulling. At times they can go into a “zone” where the is a lack of awareness of how much they are pulling and for how long.

One of the goals at Merrill’s practice in Eastchester, NY is for the client to increase awareness about their pulling. When the client understands where and when their pulling happens, then it helps them to build in strategies to make different choices about their hair pulling.

Treatment For Trichotillomania:
The assessment process is an integral part of the treatment in order to see how the client’s trichotillomania plays out in their life. In Merrill’s practice (Eastchester, NY) she explores whether the client’s pulling is sensory, environmental, cognitive, and or emotional. Since everyone’s hair pulling manifests differently, it is important to develop a comprehensive individualized treatment plan that is suitable for that client.

Habit reversal, sensory substitution, modifying their environment, creating physical barriers to the pulling, cognitive therapy, relaxation training, reiki, hypnosis, self awareness, talk therapy, and medication (when indicated) are all used as tools in the therapy. This helps the client begin to understand and manage their pulling more effectively.

Ultimately, the goal is for the client become more aware and in control of their hair pulling. This usually allows them to feel more content within themselves. Thus, this enables them to live a more productive, happy, and full life.

You can get further information about trichotillomania from the TLC Foundation for Body-Focused Repetitive Behaviors.