Written by S. Bowyer

 

hair pulling

 

 

     Trichotillomania is an impulse control disorder of picking oneself. Traditionally, it's considered a hair-pulling condition, however Trichotillomania can include other body-focused repetative behaviours (BFRBs) such as extreme wound picking, pulling eyelashes, biting nails past bleeding, and other mutilating actions. While it's not widely spoken about, the condition affects 2-4% of the population, which is three times the amount that suffer from anorexia. Average age of onset is said to be between 9 and 13  years. It's believed the first reported case was mentioned by Aristotle, and the name of the condition coined by a French dermatologist, Francios Herni Hallopeau in 1889.

 

    The Roots of My Trichotillomania by Douglas G MacKenzie sought to share the experience of the disorder with his readers, starting at very early onset, and through his life to an adult. His case began at the age of sixteen during exams, when he was highly stressed and focusing heavily on success. He recalls the moment that his obsession began. when he was reading a book.

     "I had been spending some time twisting hair with my fingers, wrapping individual hairs around my fingertips, and then with no forethought I yanked a hair out. It caused a strange sensation – none of the pain that you would imagine, but rather more of a slight high feeling," he writes.

     "I found that I pulled out a second hair, and then a third and a fourth, with what seemed like no volition at all on my part. I got really scared. I told myself not to pull another hair out, but as I continued reading I noticed that my left hand went up to my scalp again, found another hair and pulled it out. The neutral feeling I had when pulling out the first few hairs was replaced by fear and anger. I berated myself. I told myself to stop, that no good could come of this. I tried sitting on my hand but that didn’t work."

     His testimonial shares the great difficulty and shame that someone with Trichotillomania can feel. He has dropped university courses and jobs and avoided relationships because of his discomfort when people have seen the balding from the obsessive hair-pulling. His family thought he suffered alopeica before he came forth to tell them the real cause when his father confronted him with a collection of hair he'd found.

     Additional health problems can result, including infections where skin is disrupted through pulling or picking, RSI in hands from the hours of devoted picking, carpal tunnel syndrome, and in some cases trichophagia, where is where the person swallows the hair, causing a stomach hair ball that can extend to the intestine, which can be fatal. Some cases can be so severe they act out in their sleep, known as sleep-isolated trichotillomania.

     MacKenzie explains to his readers the many tricks he has used to try to limit his pulling, as many sufferers do, which included limiting hand freedom when he's indulging in activities that encourage his pulling. In his case, this was when he was reading a book.

     "I can honestly say that hair pulling destroyed my love of literature and of life itself back then," he recalls.

     "My greatest interest was literature and all I wanted was to study literature with the hope that I might become a writer someday."

     MacKenzie reported that his life became very difficult due to lack of self-esteem, self-loathing from the control issue, and feel alienated from feeling so strange. He notes that if it wasn't for the hair-pulling being an outlet he might have had a breakdown. His life seemed so lost until one day a friend gave him a gift.

     "One day my friend bought some clippers and gave me a short buzz cut. It was a revelation because it made my hair too short to pull. That day was the first time I hadn’t pulled hair out of my scalp for over a year. I still pulled hair out from my body every day."

     Mackensie Freeman, a sixth-grade sufferer told Gurl.com about her experience too. She started hair-pulling in fifth grade and has been honest about her condition since its onset.

     “I do it when I’m stressed. I do it when I’m bored. I do it when I have nothing to do with my hands…I don’t really find myself doing it when I’m super busy. I don’t really do it around my parents either but I’ll do it other times. Even if i’m writing something I’ll still do it!”

 

Mackensie Freeman

 

 

     Mackensie spends much of her time sharing her story, including at workshops for the Trichotillomania Learning Centre in Atlanta. She's attended their annual conference for the last five years. Through it all, she has made new friends and learnt about the strengths and weaknesses of herself and others with Trichotillomania.

     “I’ve been more conscious of myself, like learning to take care of myself,” Mackensie said. “I’ve learned not to go so overboard with stuff or not to sign up for too may things or my anxiety will go crazy!”

     Trichotillomania sufferers often use blocking methods to avoid pulling. Some of these includes keeping short hair cuts or wigs to hide bald spots and make their own hair less accessible. Barrier methods seem to be the most humane treatment for them as given the chance, episodes can last hours, where the patient will continue to pull beyond pain responses.

     Psychiatric treatments might include behaviour modification programs, hypnosis, psychiatric drugs, or Habit Reversal Training(HRT), which is considered the most successful with the condition. The person is taught to recognise when an episode is about to begin and how to redirect it to another action. Another promising treatment is Acceptance and Commitment Therapy(ACT), which centres around mindfulness training and learning to accept and act on negative feelings to gain better reaction within discomfort. The practice might include the patient making goals with their practitioner and working towards those, while staying in the now with openness with themselves, and the committed courage to face whatever feelings they have, without allowing themselves to hair-pull to feel better.

     In his book, Douglas MacKenzie states, "I have tried wearing gloves, wearing a hat, putting gel and other hair products in my hair. I have tried pulling an elastic band at my wrist every time I catch myself either pulling a hair out or having an urge to do so. I have tried sitting on my hands, keeping my left hand busy (it is almost always my left-hand that is the culprit). The best thing that works for me is shaving my hair so short that I cannot readily pull hairs out."

     The Roots of My Trichotillomania by Douglas G MacKenzie can be found on Amazon in both e-book and printed editions. It's a honest, no-frills explanation of his life and how Trichotillomania will always be a factor. The book grabbed me as very candid and direct. He addresses his change of attitude from horror in his younger years to an adult, where he now focuses on self-compassion and limiting his negative reactions to the pulling. Today, Mackenzie is a loving husband with three children, making peace with a condition he felt would ruin his life.

     "I was particularly moved by Suzanne Mouton-Odum’s words at the TLC workshop. Her key message was that trichotillomania in itself isn’t that big a thing. People with the disorder should tell themselves that it is just a thing that they do in order to regulate their systems. Most people have something that they do to relieve stress or to focus their energies. Some people bite their nails; other people develop ticks. Some people use alcohol; other people smoke or eat too much. Some people gamble; others use drugs. Some people get addicted to shopping or to sex. Compulsive hair pulling is just a thing people do. When we experience shame or self-loathing because of hair pulling it just doesn’t help. It makes things worse."

     "Always believe in yourself. You are no more crazy than the next person. You have a very unfortunate habit that marks you out as an individual, but you are no crazier than somebody who cannot stop biting their nails, or who nervously bites their lip. You just have a nervous habit and you need to accept that you have this problem."

     The Trichotillomania Learning Centre in California continue their work to gain awareness, and encouraging sufferers to get treatment. They aim through workshops, fundraisers, and outreach programs to remove the shame from the conditions, endorsing successful treatments, and give sufferers of Trichotillomania a voice. Schools and social outlets can order Awareness Kits, which include brochures, posters, literature, and other resources to help a caring representative educate their students about the condition effectively.

 

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