Trichotillomania: The Inside-Outs
of Compulsive Hair Pulling

by Abby Leora Rohrer

I recently read this from a practitioner who treats trichotillomania sufferers,

"It is not necessary for you to find or know
the cause of your hair pulling."

Whoa! While this sounds good on the surface, there's a big problem with it. The issue is that when hair pullers stop pulling without discovering and resolving the reasons why they began, they often go on to perform more self-harming behaviors. Sometimes those behaviors are much more dangerous than hair pulling.

Also, if you don't learn the cause of your pulling, how can you be sure that the problem has been solved and you will never pull again? You'll always be powerless with your trichotillomania and with those upon whom you rely to help you stop pulling.

Feeling powerless almost always leads to more hair pulling. This is why my goal is to empower you by continually providing you with the real inside scoop about trichotillomania. So let's get started!

It's crucial to understand that for many, trichotillomania, becomes a best friend. Over time, like many close relationships, it both comforts and wounds.  Too often, hair pullers, parents and professionals simply want to get rid of the problem without listening to what is being revealed by trichotillomania.
On average, for my students, compulsive hair pulling meets 50-75 important needs. Here is a very brief list of how trichotillomania meets just one of a hair puller's most crucial needs. 

Unlike many other relationships in a puller's life, hair pulling:

Delivers 100% unconditional acceptance.

Over 90% of the hair pullers with whom I’ve been in contact agree with this. Those of you who don’t pull, need to understand this: For someone who’s been pulling for six months, hair pulling is fast becoming a primary relationship, nothing less! For those who’ve been pulling longer, it already is a primary relationship, even possibly the primary relationship in the hair puller’s life. Many of my adult women students, who have husbands and children, still define trichotillomania as their PRIMARY relationship. Unfortunately, this is the nature of a serious addiction.

Never abandons the hair puller. It is always welcoming
and never lets you down. Hair pulling delivers on its ‘promises’.

Unlike many of our parents, spouses and even in our own inner lives, when hair pulling promises to help, it delivers! It will “zone you out”, create an adrenaline rush, or  just shove your uncomfortable feelings into the background. It delivers just what a hair puller needs whenever it it needed.

Is the ONE place where many hair pullers feel
they can be totally themselves. It has no ‘hard-to-meet’ or uncomfortable expectations of the hair puller other than
going for one more pull, which feels good and is easy to do.

Hair pulling allows the hair puller to totally be him/herself, to be self-focused without criticism. It doesn’t require the puller to shapeshift or change to please anyone else. If you’re anxious, angry, ashamed, guilty or afraid, it doesn’t make you change how you feel to accommodate or “care-take” it.

Paid attention to us.

Some hair pullers were ‘lost’ children in families where there was neglect, problems or chaos. Parents don’t always realize that in the midst of a troubled marriage or divorce, both parents are in emotional turmoil. When the adults are facing big financial troubles, they are also in emotional turmoil. As parents, you may be on auto-pilot for awhile, doing your best to survive, but your highly sensitive child may feel lost and alone and need a way to comfort herself and to be “seen” and nurtured. Believe it or not, hair pulling does the job.

Makes the intolerable, tolerable.

Again, many hair pullers are highly-sensitive types who feel/felt trapped in unhappy family situations with no way out. We believed we had to find a way survive without going crazy. For some the difficulty came from living with an ill, depressed or raging family member. Others suffered too many losses or tragedies in a family in which feeling and finishing feelings was not allowed. The important thing to note is that for highly-sensitive hair pullers, pulling makes life tolerable. Please don’t minimize this!

If you’re an adult hair puller, you may notice that when you face relationship problems with your spouse or boss, your hair pulling intensifies. If you live with someone who forces their opinions on you or has little tolerance for you to voice your own thoughts and feelings, your hair pulling will increase. You may also find that during times of high-stress and crisis, your hair pulling diminishes because, as you step up to the plate, you feel more empowered, more engaged, more connected with your truth and less in need of the crutch that hair pulling provides.

Allows the hair puller to feel included and even popular
in at least one place in life.

For the hair pulling child or teen who feels terribly left out of the loop either in the family or with peers, trich can soothe the inner pain and allow the puller to get through the day and go on to the next day. It offers distraction, a way to dull the terrible inner pain.