The Problem with Perfectionism

Although there is no scientific evidence that Trichotillomania is associated with any particular personality, perfectionism appears to be extremely common and often provides a real roadblock to recovery in a number of different ways. One common problem is the false belief that in order to stop pulling, all urges to pull must cease. It is highly unlikely that urges to pull will ever completely vanish. While one can attempt to decrease urges to a manageable amount (such as through medication or naturally over time with relative abstinence from pulling), the main goal is to manage the urges in a different manner than before. It is sometimes a giant leap in recovery when the hair puller realizes that they don’t have to pull whenever they have the urge.

Another threat to recovery comes when the puller experiences success with not pulling, then has a setback. The perfectionist in them says it is all-or-nothing, so they might as well give up. Virtually everyone successful in recovery from hair pulling has times, perhaps during periods of great stress or illness, some degree of relapse. It is hard for many not to feel that they are starting over again. One hour of pulling can mean the total loss of hard-earned lashes or brows-a bad week may result in a large bare area on one’s scalp.

The amount of hair one has at any given moment is not synonymous with the degree of recovery. It is important to realize that all that has been learned about how to stop pulling is not lost in that hour or week. Each setback is simply a new challenge to be figured out. Recognizing through trial and error that, for instance, premenstrual times are uniquely difficult or that studying for final exams inevitably leads to total loss of control allows one to build upon or add to the techniques learned or medications taken.

Yet another roadblock may come when hair starts to grow back. It is bound to be uneven, asymmetrical, stubbly, gray, or in some other way bothersome to the puller. These hairs are, after all, for many, what triggers the pulling in the first place. The urges then become stronger than ever and the tendency to feel or look at these “wrong” hairs has to be avoided in favor of changing the cognition that drives them in the first place. A number of techniques individualized for each puller can be used at that time. For instance, a person who craves symmetry may need to practice asymmetry in a number of areas to eventually tolerate asymmetry of hair (especially of eyebrows in many cases.)

Rather than hiding all imperfections as the hair puller generally spends much time doing, practicing appearing deliberately imperfect, and experiencing the real lack of importance this has in life, can be a helpful step. This needs to be done in hierarchical stages with the imperfections least important to the puller shown first and the hardest revelations put at the top end of the list.

Recovery, then, is a complicated process fraught with barriers-hidden or overt, real or imagined. Overall, it requires giving you time, effort, assistance, and forbearance. What does the recovered hair puller look like? A woman or man with imperfect hair, urges to pull, possibly occasional bouts of pulling, who has healthy relationships and a positive self-image and identity as a whole, worthwhile human being.

Full Article: Barriers to Recovery from Hair Pulling By Carol Novak

Carol Novak, M.D., is the founder of the Pioneer Clinic, specializing in the treatment of Trichotillomania and Obsessive-Compulsive Disorder. She has treated approximately two hundred hair pullers.

Keep On Keepin’ On

I’m feeling good with two completely pull free days under my belt and 16 PF days on my scalp.  The urge to pull from my scalp has not returned.  This is a miracle after 10 years without a break from the gnawing irritation.

I am continuing the NAC at 3600mg.  I am lowering my inositol to 12g (from 18g) per day, as I am increasing my l-methionine.  The John Kender diet has also proven to be very helpful.  The days I did pull from my eyes, I saw a direct correlation to sugar the day before.

I have learned that my urge goes way up after caffeine, sugar, egg yolks, and peanut butter. I am still learning what I can eat and what triggers urges.  Keeping the food journal has been tedious, but enlightening.  It has also been hard to cut out caffeine and limit my sugar.

My sugar ‘withdrawal’ is starting to wear off and I’m not craving it so much.  The first two weeks were really tough.  I hoping that it will get even better, as I still day dream about chocolate and soda. It is so worth it though!  I’ve dreamed of a full head of hair and long lashes for twenty years. 🙂

A Changed Perspective

A Changed Perspective

recovery is a process

small steps

improvement not perfection

prepare for slips

don’t be discouraged

look for good days

strategies that work

rules to follow

make a plan

celebrate small victories

watch the numbers

go down

focus on the big picture

not the slips

stay strong

for the fight

is long and

requires perseverance

be your own advocate

when treatments fail

move on to

your next step

there is hope

and this will end

if you keep fighting

~August 2014


My Addiction-Explained

another day

I look in the mirror

still the same

no more hair than yesterday

block out the pain

as I watch myself

put on the makeup

under which I try to hide

the disguise can’t erase

the shame and embarrassment

this self-torture

brings upon me

I try to control my hands

that ravage destruction

on the few fragile lashes

that dare attempt to grow

in a war with myself

two pieces forever fight

no rest, no hope

in my self-made pain

I am a prisoner trapped within

I try to get free but

have no control as I am

pulled back by an invisible force

remission never lasts

always fall back

an endless cycle of

devastating hair pulling

twelve years

I have struggled

to overcome this addiction

much more than a bad habit

my compassionate compulsion

inviting misery and good pain

lies all lies I tell myself because

I cannot control this obsession

continuous treatment

therapy, doctors, MRIs

more medication than

I ever knew existed

nothing ever seems to help

no matter how hard I try

still I cannot break free

from this part of my life

haunted by alienation

like I’m some kind of freak

no one seems to understand

people say “just stop”

search for answers

strength, a way to

overcome this monster

that I hate

to the outsider

it seems so simple, but

it’s a complex disorder

called trichotillomania




something living inside me

continually grows

What can I do-

control seems unobtainable

it eats away at my life

I watch myself destroy all hope

hate this ugly part of me

wish I had never known it

I feel so alone

even though millions suffer

because society continues to neglect

allowing silence to prevail

I just want to be free

from my self-made pain

losing more than I gain

each time I give in

haunted by the mirror

my own worst enemy

falling deeper

surrounded by darkness

freedom is the light

I can see, but cannot reach

feeling lost as I wonder

Will I ever break this addiction