The main feature of trichotillomania is the recurrent pulling out of one’s own hair which results in noticeable hair loss. Sites of pulling hair may include any region of the body in which hair may grow (including axillary, pubic and perirectal regions), with the most common sites being the scalp, eyebrows and eyelashes.
Hair pulling may occur in brief episodes scattered throughout the day or in less frequent but more sustained periods that can continue for hours.
Stressful circumstances frequently increase hair-pulling behaviour but increased hair pulling can also occur in states of relaxation and distraction (for example, reading a book or watching television.) An increased sense of tension is present immediately before pulling the hair out.
Cognitive Behaviour Therapy (CBT/REBT) and Trichotillomania
CBT currently has the largest amount of research carried out on its effectiveness. CBT/REBT focuses on what people think, how those thoughts affect them emotionally and how they ultimately behave.
When someone is distressed or anxious, the way they see and evaluate themselves can become negative. CBT/REBT therapists work alongside the person to help them begin to see the link between negative thoughts and mood. This empowers people to assert control over negative emotions and to change the way they behave.
CBT/REBT can be delivered at a number of levels of intensity, meaning it can be useful to those who have only just started feeling anxious as well as those with longstanding anxiety problems. CBT is delivered by a trained therapist, usually in a clinical setting.
This form of therapy focuses on the ‘here and now’ and is not overly concerned with finding the initial cause of anxiety. Once the problem has been explored, the therapist will help you examine your thought and behaviour patterns and help you to work on ways of changing these.