Impulse

I was reading one of my client’s profiles when I came across the term “trichotillomania” so i googled it. Now I am bothered by it. I remember when I was young my parents would always scold me to stop pulling my hair. Now that I am 30 I still find myself doing it subconsciously. I am generally a happy person and laid back kind of girl. I have a 3 year old son and am married for 5 and a half years now. I do not have any bare patch on my scalp but i can tell one area is thinner compared to the side where I dont pull hair. I do remember when I was young I did have lesser hair on one part in my scalp.

I only pull one strand at a time. I usually like to play with a single strand of hair first before I pull it to make sure i like how it feels tugging on my scalp. There is a sense of tension before pulling hair or when trying to resist the urge to pull hair. Once I find the one that feels right I hold on to it and will not let it go. I can control the urge but I feel sad if I let go and that is only for a minute or two then I am fine. There is a feeling of relief, satisfaction, and/or pleasure after acting on the impulse to pull hair. I usually do this when I am relaxed like watching TV or browsing the internet or sometimes even when I am driving.
There is also a presence of other associated behaviors such as inspecting the hair root, twirling the hair around my fingers and sometimes falling asleep at night and wake up in the middle of the night or the next morning with the strand still twirled around my fingers. Then when I get tired with it and i shred it into pieces. I feel like i have to shred it into pieces when I am done playing with it. I feel like it should not go to waste. Every now and then when my husband catches me playing with my hair he tries to steal the strand from my fingers and it annoys me but not to the point where I am just furious. I just find it annoying and wish he would just leave me alone with my hair.
I never wanted or ever desired to eat it.

I also suffered from Enuresis when I was young. I wet my bed until I was 12-13 but I dont do it when I am awake only at night time bed time. (This is just my self diagnosis base on my experience and what google says put together)

I’m sorry that a diagnostic label bothers you. I can’t, of course, provide a diagnosis on the basis of a letter. All I can tell you is that what you describe is consistent with what is called trichotillomania. But a name of a group of symptoms is intended to help professionals communicate with each other in order to decide what treatment, if any, might be helpful. No value judgment is attached.

Here’s the thing: Kids who are at all anxious tend to find something that soothes them. Some get attached to a blanket or a pacifier. Some bite their nails. Some twirl their hair. Some suck their thumbs. No one knows why a particular habit develops. The common denominator for all such habits, though, is anxiety. As children grow and develop internal coping skills, they are often persuaded to give up the lovey or habit that helped them stay calm. It’s a little harder when the “lovey” is a renewable resource like hair or nails. A mom can’t exactly wean a kid away from nail biting by gradually eliminating nails from the kid’s view. (Blankets can be gradually made smaller and smaller until they disappear.)

You’ve reduced your habit to something that is managable. You aren’t balding. You aren’t behaving in a way that hurts yourself or anyone else or that is socially unacceptable. As you said, you do it when you are relaxing it. I suspect there is something about doing it that helps you relax. It works for you. If you were seeing me, I’d ask you to think about whether the benefit of dropping the habit is worth the stress of trying. If you do think so, then we’d work on helping you find other satisfying ways to relax and perhaps to occupy your hands.

I wish you well.
Dr. Marie