Question about girlfriend's trich

[medhelpforum1]

As you can see, my g/f has trich. For those of you who don't know, trich is a disorder in which a person has a compulsive urge to pull their hair out, one strand at a time (at least in my g/f's case.) Fortunately her case is mild, and in terms of cosmetics, she appears to have thin hair, but there are no bald spots.

My question is about how to help her. She's been seeking counseling for it and has good days and bad...every now and then she's able to go about 2 or 3 weeks without pulling. In observing her and questioning her about it, I've concluded that she doesn't really have any desire to stop pulling, aside from its cosmetic impact. In other words, if pulling had no cosmetic implications, she wouldn't want to stop at all. It feels good to her. Thus, when she doesn't pull, it's because she successfully resists the urge of wanting to pull, not because she doesn't want to.

Does anyone know of a way to help her actually not want to pull? I feel like the only way she will be able to successfully quit in the long run is if her desire to pull goes away, but I have no idea how to accomplish this. Clearly cosmetic damage is not a sufficient incentive to prevent her from wanting to pull. How do I help her?

[Roger Gould, M.D.]

Your observations are quite useful, and on the mark...Yes she wants to continue because in some way pulling her hair diminishes her anxiety.  The best she can do for herself is to start seeing her symptom as something she does not want to give up because she thinks she needs it.  At the point of every urge, she should ask herself what she is anxious about, and then start trying to work on that consciously and constructively.  That is the best approach, and you and her therapist might help her carry that out...

[onroute]

Just a note and I am not a doctor...but go on the websites and learn about this.  I hope your girlfriend does as well....if not you do it.

I assume she has seen the doctor about this and you said she is seeing a psychologist so I would hope that would help in time.  Maybe go see the same psychologist for yourself and get some understanding.  My husband is going with me for my self-destructive ways cause he is very concerned and talks to me a lot and helps me.  Talking about it is important and telling her how YOU FEEL about this is also important.

Some people WITH the problem cannot see the seriousness of it but others around them see clearly...and that is why we need each other.

Dont let this go without help.....and I just thought of something that you could do and that is :::::::::::::: tell her if she pulled her hair out over two weeks period how much would she lose and in two more weeks and in two months and add that up for a whol year or more.... just a thought.............but I think there is more to this than we know.

[heff1]

I'm a 42 year old attractive female suffering from trich since 9. My story plays out similar to your friend. I sought behavioral treatment at Mass General's OCD department in my 30's which helped but I wasn't able to completely stop. You're thinking is correct about her experiencing a sense of "relief" which feels good but it's not a pleasurable sensation. Trust me when I say she feels shame 100% of the time. Her self esteem is damaged way beyond what you see. Trich is all about denial on many levels and the fact you're aware of the problem tells me you've gained her trust and are in a postion to help her through this. Kudos to you for wanting to be part of the solution.  

Here's my 2 cents...Purchase online or any book store Dr. Nancy Keuthen's book "Help for Hair Pullers" to gain a comprehensive understanding of the condition and most importantly the possible triggers.
Purchase the newly released book by Dr. Keith Ablow "Living the Truth" for your friend. This book is written by a well know psychiatrist identifying "distracting" behaviors like ADD and OCD that he believes are triggered by childhood experiences that manifest a predisposed condition into a self-destructive protective behavior such as trich. His book helps the reader process back to that incident as an adult and guides how to seek effective help.

Trich is stll new to many doctors, finding the appropriate psychiatrist is 90% of your friends obstacle to breaking the pulling habit.  Your g/f may be younger and have an attractive youthful glow that compensates for her thin hair enabling her to put off the work thats necessary to stop pulling, takes intense discipline to break any habit. However, as women age their hair naturally thins, this will worsen her condition and she'll become more self conscience as time goes on. Help her now and you'll save her years of anxiety and shame if she can "focus" on finding the real trigger to her pulling. Once she identifies the trigger, she'll conquer this thing and get her life back. Trich has negatively effected my life in ways I never could have imagined when I was an adolescent secretly pulling my hair out. It's a serious distactor for not facing reality, it's loss of control, it breeds secrets and anxiety attacks. Hair will grow back once she stops pulling. However, the damage over the years to her self esteem will take a lot of work and self love to repair. On a good note... she can definitely overcome this, be whole again, trust me.

I wish you the best and commend your efforts...don't quit.

[TammyR1216]

Hi, I just read your post. Although I should be talking to a Dr. I am just coming to terms that I have a problem with pulling out my hairs, mainy facial hairs or eyebrows. I also pick out pubic hairs. The strange thing is I also enjoy picking the hairs out of my husbands face. Beard, mustache, eyebrows. Does this fall into the Trich thing? I have never heard that phrase. I also have a compulsive need to pick pimples and blackheads or anything of the sort. I am scarring up my face and my husbands. I have these "sessions" where I feel a need to do this. I get very aggressive towards the people I want to pick and feel very satisfied while doing it. I am just trying to figure out why I am like this. I am 30 years old and have been doing this since around 10-11. Its progressingly getting worse. any advise would be appreciated. thank you.

[heff1]

Not being a doctor, I can only guess you have an obsessive compulsive disorder. The hair pulling disorder's technical name is tricholtillomania, trich for short. I was in my thirties reading a womans mag article about hair pulling before I knew there was a name for it. It was then I began seeking treatment. Until that point I thought I had ADD  because I lose things a lot. ADD and OCD have similar traits but are treated differently. My advice to you is get the books I mentioned and start looking for a professional that understands OCD or even better... trichotillomania.  You're young enough to regrow any hair loss and there is definitely an underlying anxiety driving you that should be examined. You can break this habit, it will improve your life tremendously to regain all the time spent "picking and pulling". I still catch myself occasionally pulling when I'm in stressful situations but it's getting less and less as I work things out. I'll be free of this condition soon...you can too ;) Knowing you have a problem is half the battle...you're on your way!

[TammyR1216]

Heff1,
Thank you very much for your imput. I am heading to barnes and nobles this afternoon.
Good luck on your journey also.
Tammy

[heff1]

Thank you. It helps to talk about it with others. Think of trich as a recurring cold sore.  You'll never be cured of the predisposition but you can control the climate that triggers the outbreak to a point it's a non-issue in your life.  The doctor's advise in this forum is excellent and it can be as simple as asking yourself "what am I anxious about at this moment?" then changing focus to the real issue. Behavioral therapy will help you tremendously change gears. A bout of depression commonly hits the person with trich in the adolescent years which is tough because it may effect school but today is a little different then my day because so many anti-depressants are available that can help a child through the depression period so it doesn't throw them off the college track.  Don't beat yourself up if you have have relapses, happens to everyone. Just keep in mind 6 months not pulling is better than pulling every week and eventually it will get less and less till you're pull free.  I know you'll be ok, knowledge is power...no turning back now ;)