Tasneem Abrahams

Mastering Hair Pulling

Awareness of Your Hair Pulling Can Help You Stop

Research shows self-monitoring and awareness devices can reduce hair pulling

Posted Nov 05, 2016

Trichotillomania has been gaining more awareness in recent times, thanks to the efforts of organizations such as the Body Focused Repetitive Behavior Foundation. Formerly known as the Trichotillomania Learning Centre, the organization was renamed to be more representative of other behaviors that fall under the same umbrella of clinical disorders, such as compulsive skin picking (excoriation disorder) and nail biting. This means that more people are seeking professional help.

Cognitive Behavioral Therapy for Hair Pulling

Research shows that cognitive behavioral therapy (CBT) to be the most effective treatment modality for BFRBs such as trichotillomania. CBT aims to alter undesirable behavior by identifying the precise factors that trigger hair pulling, skills are then learned to interrupt and redirect responses to those triggers. However, to identify what triggers pulling one needs to be aware of when and how you pull. Therapists will often require you to keep a pulling record, which you will use in sessions to identify your pulling patterns. This is essentially where you are required to document each time you pull and to record information such as location or context, what happened just prior to pulling and how you felt or what you were thinking, what was happening at the time of pulling, recording where on your body you pull, and how long you pulled for. However, keeping a pulling record is not an easy task, especially if you pull frequently throughout the day. In addition, some people start pulling without realizing they are doing it, known as automatic pulling. 

Using Technology for Self-Monitoring

Skinpick Online, used with permission
Source: Skinpick Online, used with permission

We live in an age where smart technology is integrated into every aspect of our lives. In recognizing the challenge of developing awareness of pulling, the team at Skinpick.com have developed a free self-monitoring app for mobile that will enable the patient to record their picking behaviors quickly, securely and on the go. As early as 2008, a pilot study was conducted using a prototype awareness enhancing and monitoring device aimed at increasing the effectiveness of habit reversal therapy. Habit reversal therapy (HRT) is a component of CBT, based on the notion that pulling follows an urge to perform the repetitive behavior and any feelings of discomfort will only be alleviated by engaging in the behavior itself. HRT draws conscious attention to the target behavior as it occurs in daily life, and helps the patient find strategies for immediately replacing the target behavior with healthier behaviors or minimizing exposure to triggers for the behavior. In the study,the monitoring device included a watch, bracelet, magnetic necklace, and a pager that was hard-wired for remote activation of a vibrating alert when hair pulling behaviors occurred, motivating participants to pull less or not at all. The results following participant observation indicated a marked reduction in trichotillomania behaviors when the device was in place. The device was very effective in enhancing awareness, monitoring and curbing hair pulling triggers and urges. While the Skinpick.com app does not alert the user to the behaviors, it does empower the user to engage in self-monitoring, which has also shown to have positive results in reducing severity of pulling. The App is available on Android and iOS mobile devices, and while it was specifically created for skin picking, it can just as easily be used to record hair pulling or nail biting. The App can be downloaded here >>

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