People with TTM feel a strong urge to pull their hair, usually one strand at a time. They often pull their scalp, eyelashes, eyebrows, or pubic hair. An essential first step is assessing symptoms with the Trichotillomania Diagnostic Interview (TDI).
Anxiety often triggers the urge to pull hair; hypnotherapy can help individuals deal with that. This treatment involves entering the unconscious mind and asking people to identify ways to cope with their triggers. It could also help them uncover underlying stressors that may have caused the disorder in the first place. Cognitive behavioral therapy in the form of habit reversal training can also be beneficial for people with trichotillomania. It teaches them to identify situations that lead to hair pulling and replace the behavior with an alternative activity like clenching their fists or knitting. Studies have shown that this type of Trichotillomania therapy has high success rates for those with trichotillomania. In addition to behavioral therapies, many people have found relief and support by joining a specialized trichotillomania support group. Support groups allow members to learn from one another and share anecdotes about overcoming trichotillomania.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy is a short-term approach proven scientifically effective in treating trichotillomania. It teaches people to identify and change negative thought patterns that lead to hair-pulling behaviors. The therapist helps them realize that their actions are not a reflection of themselves but a reaction to anxiety or other emotional responses. CBT is also known as ‘thought challenge therapy’ and aims to transform unhelpful ways of thinking that may be causing distress. This includes addressing rational concerns realistically and challenging irrational beliefs, rumination, or catastrophizing. Using techniques like habit reversal training, increased awareness of triggers, replacing incompatible behaviors, and more, the therapist helps the patient develop better coping skills for their urges. This allows them to cope with situations that usually trigger a hair-pulling episode. They learn to replace their impulsive behavior with something else, such as picking up a fidget toy or writing in a journal.
People who pull their hair often feel ashamed or alone. Support groups, in person and online, help boost self-esteem and allow individuals to talk about their experiences with others suffering from trichotillomania. They can also learn helpful advice, like deep breathing and yoga, to alleviate stress and anxiety. A therapist will teach someone with trichotillomania to substitute other behaviors when they feel the urge to pull their hair. This might include clenching their fists, knitting, or using their body to express themselves rather than rubbing or pulling on their scalp and eyebrows. In addition, they will work to educate themselves and others about trichotillomania. This will reduce the internal stigma and help people understand that their behaviors are not their fault. It will also make it easier to seek treatment. The best option is to get treatment with a professional as soon as possible. Attempting to overcome this disorder on your own can make the symptoms worse.
A therapist can work with a family to help a child deal with the shame and embarrassment they might feel about their hair-pulling. Parents can also be taught to support their children through recovery with techniques encouraging positive self-talk and healthy coping skills. Another approach to treatment is Acceptance and Commitment Therapy (ACT). This form of treatment uses mindfulness to increase a person’s awareness of thoughts, feelings, and urges while learning to experience them without judgment. People with trichotillomania often report struggling to cope alone. To help them, a therapist can teach them to use person-first language in conversations about their pulling behaviors. This helps them to feel empowered instead of controlled by the tics. They can also learn to share their experiences with others who manage trich to reduce internal stigma and external embarrassment. In addition to professional therapy, a therapist can suggest supplemental strategies such as a specialized support group.