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Treatment of Hair Pulling (Trichotillomania) with Hypnosis

Avoidance of triggers and self-soothing behaviors often are helpful.

Key points

  • Trichotillomania often starts around puberty and is triggered by stress.
  • Many people with trichotillomania feel ashamed of their behavior, and this causes them to have lower self-esteem.
  • Hypnosis can help trigger a relaxation response to help patients better cope with their stress.
Azmeyart Design/Pixabay
Source: Azmeyart Design/Pixabay

Teenagers (and occasionally younger children) can develop a habit of pulling their hair from their scalp, eyebrows, or eyelashes. This habit is known medically as trichotillomania and sometimes called “trich.”

The behavior often starts around puberty and can be triggered by stress. People affected by trichotillomania sometimes feel anxiety if they cannot pull their hair, which is relieved once it is pulled. Some people even report feeling addicted to pulling their hair.

Often, enough hair is pulled that it is visible to others, such as a bald spot on the head or missing eyelashes. Many people with trichotillomania feel ashamed of their behavior, and this causes them to have lower self-esteem.

Treatment of trichotillomania involves teaching patients to avoid their triggers of this behavior and substitute another self-soothing behavior. Hypnosis can be very useful with both of these approaches.

The hypnotic state can also be used to teach patients how to employ the "Helping Hand" technique to stop trichotillomania. With this method, when patients raise a hand with the intent of pulling their hair, their other hand is taught to gently grasp the opposite wrist and pull down the hand.

Prevention of Triggers of Hair Pulling

Since stress is the most common trigger of trichotillomania, patients benefit from dealing better with their stress.

Hypnosis can be used to identify the stressors in patients’ lives, including by interviewing their subconscious. Once patients can better define their stressors, they are in a position to address them more effectively. For example, a 14-year-old pulling her hair found out that this started when her dog passed away. After processing her grief through discussion with her therapist, her need to pull her hair was resolved.

Another trigger of trichotillomania can be a certain location, such as school or lying in bed. For example, a patient may have found school to be a stressful environment and started pulling his hair there to calm himself. After that, he always pulled his hair at school, even when he was not stressed. Hypnosis can be used to disrupt the association of a location with the need to pull hair.

Introducing a New Self-Soothing Behavior

Since hair pulling can be very soothing for some patients, it is important to teach them another way of self-soothing before asking them to stop their hair pulling.

Hypnosis can help trigger a relaxation response to help patients better cope with their stress. The relaxation can be achieved when patients learn how to use hypnosis to shift their mindset to a calmer state quickly.

Further, during hypnosis, slow, deep breathing (involving the diaphragm) can enhance the soothing response. Such deep breathing causes the body to release soothing chemicals into the bloodstream.

Positive self-talk can also help patients feel better. For example, patients might tell themselves, “I can be calm,” “I want to feel peaceful,” or “I will become more comfortable once I relax.”

Takeaway

Trichotillomania can be resolved using hypnosis for the purpose of reducing the effects of its triggers and employment of alternative self-soothing strategies.

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