*This may be triggering for those with trichotillomania*
Trichotillomania (pronounced trick-o-till-o-mania), sometimes called ‘trich’ for short, is the compulsive need to pull one’s hair out. It’s similar to dermatillomania, which is ‘skin-picking’, again a compulsive behaviour. Both of these come under the umbrella of ‘Body-Focused Repetitive Behaviour’ (BFRB).
I have trichotillomania and have done all my adult life. I don’t talk about it often at all. Most people would have no idea I struggle with this.
It could almost be described as a ‘habit’, yet it’s more powerful than that. It has similarities to Obsessive Compulsive Disorder (OCD), in that the person displaying this behaviour cannot stop – they obsess over it, and cannot stop themselves… it serves the purpose of relieving anxiety quite often, bringing a sense of comfort similar to that brought about by the rituals of OCD.
I will freely admit that two times since starting to write this piece, I have stopped typing and I’ve started picking at my hair. It’s the most powerful addiction. I don’t know a huge amount about trichotillomania, why it happens or any facts and figures. All I know is the feeling from my own perspective. If you’d like more information I’m sure there are sites out there with more knowledge than I have. The NHS website has some information, and I’ll look out other websites for future posts. But if you want to know how it feels from a personal perspective – the reasons, and the consequences of hair-pulling, then that’s the purpose of this post.
When I first started, it was purely pulling out hairs from my scalp, often with a pair of tweezers. It would seem a very bizarre thing to do, and I would agree it’s not something that commonly makes sense. But to me, the hairs felt ‘wrong’. They felt like they didn’t belong. Anyone with trich would tell you that – they’d often be the thicker, more coarse hairs… sorry to be crude, but imagine pubic hairs on your head – those sorts. It seemed to be my experience that thicker hairs had the ‘juicy roots’ on the end. That will sound weird to most people, but if you have trich you know what I’m talking about.
Some people do things like biting the root off and eating it, or even eating the hairs. I admit this is not something I do, so I don’t understand this aspect of trich. But it doesn’t make any less sense than pulling the hairs out in the first place. It’s no more peculiar. It’s part of the compulsion.
Finding the right sort of hairs, with the root, was the aim. It felt more satisfying to pull those hairs out. Any that didn’t have the root, or were ‘acceptable’ hairs felt like a waste. I used to pull out so many hairs, and collect a pile of them. The carpet would get covered in them, and whilst I was trying to hide what I was doing I’d sit, trying to pick them all up with sellotape, so nobody would notice. Of course eventually people would notice, as I developed a small bald patch near the top of my head. I passed it off as my hair getting caught in a hairband or something. But eventually I told the truth. I don’t remember how I had that discussion. I don’t even know how old I was. I had to change my hairstyle to disguise the bald patch.
I also had to develop ways to try and stop myself pulling hairs out. I looked up techniques – some people said to put plasters on your fingers – which might work if it weren’t for the fact I used to use tweezers! I guess in today’s world things like ‘fidget cubes / spinners’ would help, to keep your hands busy. I’ve just ordered one, in the hope it might help. Any way to keep your hands busy – colouring, a stress ball, sewing etc. I’ve also tied my hair back, or even worn a hat in the hope it would stop me doing it.
Trichotillomania isn’t just pulling hairs out from the scalp. People pull hairs basically from anywhere hair grows…. eyebrows, eyelashes, face, arms, legs, underarms, private areas – anywhere. It will affect people differently. I have pulled hairs from different areas – one time I plucked my eyebrows too much, but thankfully they grew back over the years. I have my limits – some areas are too sensitive – for me, eyelashes are a no-no, but for many people this is somewhere they often pull from. Some have been left with no eyelashes, and some with no eyebrows. So people should pause before commenting on how ‘fake’ some girls look, with their false eyelashes, their eyebrows drawn on, and even their wigs – this could be because they struggle with trichotillomania.
The funny thing is that I’ve become desensitised to plucking hairs out. I’ve watched people pluck their eyebrows, and wince doing it… and they do it really fast, to avoid pain. I don’t experience the pain in that way. I can actually pull out hairs in slow-motion, gently tugging them until they pop out from the tension. And yes, while there is a small amount of pain, it is tolerable. I can sit there, pulling hairs out and showing no sign of discomfort. Nobody would even know I was doing it if they only saw my face, and not the source. It’s like a low-grade pain, which is almost comforting. It’s like a drawn-out but low-level form of self-harm.
But that’s not the reason I do it. I’ll come to that. But first I want to tell you of a change I experienced a few years ago. I started to notice split-ends on my hair. I feel I read somewhere that the way to get rid of them is to cut a certain measurement above the split. Starting to do that was a mistake. It’s become even more addictive than just pulling hairs out. I can now sit for ages searching for split-ends, and cutting above them – leaving me with shorter strands of hair, which hairdressers have commented on before …. I don’t currently visit the hairdressers for this reason. I cut my own hair. When a hair is so damaged it would mean cutting really high up, I’ll just pull that hair out. So my trichotillomania is now a combination of pulling and cutting (though I have just read that compulsive hair cutting is called trichotemnomania – you learn something new every day!), but either way it still serves the same purpose.
It is a need for things to be ‘perfect’. It’s the endless search for perfection that can never be attained. I always thought if I could get enough of these split-ends, they’d run out. They haven’t. So now whenever I feel bored, anxious, or I’m trying to avoid something, I’ll sift through my hairs, looking for split-ends to cut. It distracts me. So many times I’ve tried to write this piece and been unable to complete it, because the obsession with these split-ends takes over. The only reason I’m able to write it now, is I’m currently with people, and I won’t do it in front of others. It’s usually if I’m watching television, or if I’m thinking about something – say for example a blog post. If I’m sat worrying about life I’ll do it. It’s a nervous behaviour. Sometimes though I’m unaware I’m doing it until I’m doing it.
Other times I HAVE to do it. I feel compelled to do it, and can’t relax until I have. I think it lowers an anxiety in me. It feels like something I can ‘control’ – even though it actually has complete control over me.
I don’t understand the real reasons I do it. I’m sure some psychological expert could explain the theories behind this behaviour – I’ve never really explored it with anyone. I’ve just accepted it as a part of my life.
I don’t know how I will ever stop. I read somewhere it’s more addictive than smoking. I guess it’s like nail-biting, but combined with taking drugs. I’ve done neither so I wouldn’t know! But it’s got the ‘habit’ aspect, and the ‘addiction / compulsion’ aspect.
I am a bit of an ‘obsessive’ person, in some ways. It comes with finding it hard to let go of anything. I ruminate. And when I ruminate I pick at my hair. Some would say the answer is to keep busy. They’re probably right. But I can imagine twenty years from now, catching sight of a split-end and feeling that same pull I feel today. It feels that powerful a compulsion, I don’t ever see myself recovering from it. But I would guess the key is to learn to sit with the uncomfortable feelings – that’s what I can hear the CBT therapists saying in my head. The thought of resisting the urge to do it is troubling, because I know how intense the need is. It is harder to not do than to not self-harm. It would feel (and DOES feel, because I have tried) uncomfortable. This is something I have to learn to tolerate. But it will be a constant battle if I want to beat this.
I’m writing this section of this post several days after the first part, as the compulsion was too much, so I never got it finished. At the time of writing this, at 9pm on the hottest day of the year so far, I am sat wearing a winter hat, with all of my hair tucked into it, so that I can’t fiddle with my hair. I am feeling the lure of the thoughts to pull hairs out, and cut hairs… it’s always there. It’s got a lot worse since the start of this year. It feels like I’m permanently resisting the compulsion. I feel it in my chest as a tugging sensation… as if my heart is screaming ‘LET ME GET RID OF THE HAIRS!!’… and after therapy recently, something I realised is that when I get that feeling in my chest area, it’s actually the voice of my emotional mind. So for whatever reason my emotional mind is crying out to be heard. I would therefore assume I need to listen to it, and try to understand why it feels the need to do this behaviour. I know that I want to do it to ‘comfort’ myself. So perhaps I need to look at why I need that comfort and how else I can replicate that.
The trouble with cutting hairs and pulling hairs out, is I’m left with short hairs – even when I pluck the hairs out they will regrow, and I feel them on my scalp as prickly bits… unfortunately this is a feeling I can’t stand, and lately I’ve reverted to using tweezers to pluck those regrowing hairs out. This has left me with a small bald patch once again, along the parting in my hair. It may seem small compared to what a lot of people with trichotillomania experience, but this is how it starts. I’ve had to change my hairstyle again, to cover it, but the thought is constantly in my head… I want to keep going with it. I want to get rid of the rest of the short hairs. I don’t want to end up bald on the top of my head though, so hopefully that thought can help me resist the urge. It is a battle to fight the compulsion, whilst endlessly obsessing over it. I hardly have a moment of peace… well, when I’m busy I might not think of it, but whenever I stop it takes over.
My hair has got a lot sparser on the top, and in my fringe. It probably looked a lot healthier a couple of years ago. I don’t know if it’ll ever get back to how it was. It will take me sitting through some very uncomfortable feelings. I will have to say ‘There are short hairs on my head…. and that’s okay’…. ‘There are thick, coarse hairs on my head…. and that’s okay’…. ‘There are WHITE hairs on my head…. and that’s okay’… ‘There are split-ends on my head… and that’s okay’. It may not sound like a big deal to others, but if you have trichotillomania you’ll know how difficult this will be.
I’ve had this problem for so many years now, that those who knew about it had forgotten it was even a problem for me. When I had to explain why I was wearing a winter hat in spring, whilst it felt like summer, they had forgotten I do that. It’s not something I talk about. I’ve hardly mentioned it to a mental health professional either – not for a very long time. Even my closest friends don’t know I have this. Most of the time it’s not that evident, as it’s widespread, so doesn’t leave a noticeable patch… this doesn’t mean it’s not a troublesome thing to deal with. I’m usually embarrassed by my hair, as when it’s humid it goes frizzy, which means people will be able to see the shorter bits of hair. A woman’s hair is often seen as a sign of femininity and beauty, and I feel mine is far below perfect… it just adds to the pile of things I hate about my physical appearance. Most things I can’t do anything to change, but I guess in some warped way I feel I can improve my hair by getting rid of the imperfections…. though rational thought tells me I’m only making my hair worse, and I should work to nourish it… condition it, and preserve it. That’s a simple notion to someone not inflicted with this condition. To someone already caught in the obsession of it, it’s a lot harder to break and go with rational thought. The compulsion is more powerful than any amount of logic.
Having trichotillomania makes me feel very ashamed. Even sharing photos of my scalp I feel disgusting. But I’m doing so to illustrate the condition – many have it much worse than me, but even with such a small area affected, the feeling of disgust and shame is immense. Even when wearing a hat, I’m still painfully aware of what lies under it. And that feeling of disgust feeds into a vicious circle, where I want to pull hairs out, to relieve the anxiety and self-hatred from having this problem. I’m really hating myself for what I’ve done to my hair at the moment…
It’s taken weeks to get this post finished. And at the point of writing this paragraph, on a different day, I’m sat with my hair tied up, with a hat covering all of it, because seeing hairs is triggering. And being able to get to my hair risks me pulling too many out. It is a really difficult condition to cope with, though I do my best. I think it has worsened because of a period of downtime where I’ve had too much time to think, to worry, to reflect, and to be ‘bored’… these are the times it happens the most. It’s a nervous behaviour, a compulsion, and a comfort to me. And life hasn’t felt too good these past few weeks and months. So I’ve needed that comfort.
I don’t often see trichotillomania talked about. I might not have given a great deal of information on it, but wanted to share my experiences and feelings on the subject. I will do more posts on this soon. I just want people with this condition to know you’re not alone. I understand your struggle. There are many people out there with trichotillomania, you just don’t hear much about them. I hope more people will find the courage to speak out about it. It makes sense to me. You might think people will think you’re silly, or even crazy for pulling out your own hair…. that it won’t make sense to them. But it does to me, and to others who also do it. Besides, it’s ‘mental illness’, and mental illness has a habit of not making sense to those who don’t have it. It doesn’t matter what they think. What’s important is reaching out to each other, to know we’re not alone with it. I hope this post is a start. Thank you for reading.