How Acceptance and Commitment Therapy Can Help With Trichotillomania

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Trichotillomania impacts 1-4% of the population and can cause severe distress. Those who have it often experience isolation and depression because they feel ashamed about their symptoms. Some may even try to hide their hair pulling by wearing wigs or using makeup.

ACT can help reduce these painful emotional experiences and increase psychological flexibility. According to a recent randomized controlled experiment, trichotillomania can be successfully treated with ACT with habit reversal training.

Identifying Symptoms

Trichotillomania is a mental health condition that causes people to compulsively pull out their hair, typically from the scalp, eyelashes, eyebrows, or the pubic area. While many people who have this disorder grow out of it, some continue to have problems with their pulling into adulthood. Symptoms tend to occur during stress or when a person feels restless or anxious.

The most effective treatment for trichotillomania is habit reversal training, which helps individuals replace the hair-pulling behavior with other behaviors, such as clenching one’s fists. Other therapies that may be helpful include cognitive therapy, which can help individuals identify and examine beliefs they have about their hair-pulling that are unhelpful or unrealistic.

ACT is also flexible enough to be used with these other therapies. Research has shown that combining ACT and habit reversal training can effectively treat trichotillomania and other body-focused repetitive behaviors. A recent randomized control trial found that a 10-session ACT protocol was associated with significant reductions in hair-pulling severity, daily hairs drawn, and experiential avoidance, maintained at 3-month follow-up examinations.

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Understanding the Causes

Trichotillomania is more common in girls and young women, but boys and men can also suffer from it. It can seriously affect a person’s life, including problems with school and work and isolation from friends and family. People who experience hair loss may attempt to conceal it by using wigs or fashions that cover bald areas because they feel guilty or humiliated about it. Some even go so far as to self-mutilate by plucking at their skin or biting their lips.

The first step in overcoming this disorder is understanding what causes it. You can understand why you pull your hair and discover your triggers with the assistance of a therapist. It can also help you learn to accept and tolerate your feelings, impulses, and emotions rather than fight or try to change them.

ACT practitioners can also teach you how to observe your inner experiences objectively and use mindfulness techniques to gain psychological flexibility. This can allow you to choose values-based behaviors that support your well-being.

Changing Beliefs

People with trichotillomania often have negative beliefs about the hair-pulling habit. For example, they may believe it is “bad behavior” or that they will lose their looks if they don’t stop. This can make it difficult to seek treatment.

However, several treatments for trichotillomania can help with these negative beliefs and replace the harmful behaviors with healthier ones. One of the most effective is habit reversal training, which involves substituting the pulling behavior with another, such as clenching your fists when you feel the urge to pull your hair.

Other treatments for trichotillomania include cognitive behavioral therapy and ACT. During CBT, a therapist helps the person identify what internal and external triggers their hair-pulling behavior. The therapist then works with the patient to change those triggers. This can involve identifying and changing thoughts, beliefs, physical sensations, or emotions contributing to the behavior. This can be done individually or in group therapy sessions.

Reducing Stress

Trichotillomania is a very stressful disorder, and it can lead to severe consequences if left untreated. Treatment may include medication and behavior therapy. The most effective behavior therapy for trichotillomania is called habit reversal training, which involves substituting a different behavior, such as clenching your fists, for hair pulling when you feel the urge to do it.

ACT helps you distinguish your thoughts from your feelings and offers exercises such as “singing your distressing negative thoughts in silly voices.” You also learn to accept difficult emotions without trying to push them away or change them.

Encourage your teen to use healthier stress relief techniques, such as exercise, meditation, or prayer, to help deal with their anxiety. Also, please encourage them to seek treatment for their trichotillomania as soon as possible so they can avoid the serious ramifications of this condition. The sooner they get help, the better their prognosis is for recovery. Symptoms of trichotillomania typically begin in early adolescence.