Do you constantly pluck hairs from your head or your face when stressed? You might have a disorder called trichotillomania. We spoke with Dena Rabinowitz, PhD, founder of Cognitive Behavioral Psychology of NY, to find out what the disorder involves and how it’s typically treated. Following is a transcript of the video.
Dena Rabinowitz, PhD: Trichotillomania is compulsive hair pulling. Where people pull out their hair either from their head, their face, or anywhere on their body in response to either a habitual need to pull, a compulsive feeling, or anxiety.
When people with trichotillomania pull their hair, they’re often looking for different things. Some people look for the sensation. Some people like to see the hair. And some people actually will nibble off the end, the follicle.
The most common places that people pick their hair from in trichotillomania is their head. But we also see a lot of eyebrows and eyelashes. We can see arm hair, leg hair, and sometimes even pubic hair.
Most people aren’t born with trichotillomania. It’s something that can develop in childhood and adolescence, and it’s usually in response to some sort of trigger of anxiety or stress.
Trichotillomania isn’t dangerous, but it has some social consequences in that the more you pull your hair, the more bald patches and absence of hair you have, which can lead to social ostracization or criticism.
Treating trichotillomania involves a couple things. The first is we want to look at what is the pattern that people engage in this habit. Where do they pull the most? What causes it?
We often try to give people stress management, anxiety management tools, so that they’re less triggered to pull. And then we work on something called competing response and habit reversal. Which is a way of teaching people alternate behaviors that are more adaptive to help them relieve their stress instead of pulling their hair out.
There a lot of body-focused behaviors that can be compulsive. What makes something often maladaptive or more normative is the percent of people who do it and the amount of interference it causes.
So lots of people will bite their nails, pick at a scab, pick at their cuticles. It doesn’t mean it’s a problem. But when you do it at a frequency that it causes interference in your daily life and causes distress, either because you’re causing damage to the nail beds or you’re doing it so much that it causes social interference, then it really is a problem. And it’s similar to trichotillomania in that way.