Although there is much more readily available information about BFRBs, there are still many misconceptions about trichotillomania. One important misunderstanding is that trich falls under the umbrella of self harm. Therapists working with Trich (as well as those with Trich themselves) must understand that Trichotillomania is not self-harm but rather a self-soothing behavior. That is not to say that one does not experience harm as a result of doing it, but one can say the same of addicts. Yes the addiction causes harm, but it is done to feel good and is not known as a “self harming” behavior. This is a crucial psychological point when understanding and working with Trich and BFRBs, whether your own or your patients.
This is an interesting perspective on trichotillomania. I agree that trich is different than other forms of self-harm such as cutting and burning. In addition, the information referenced is outdated as this is an old post. Trich is now classified as a BFRB and not a self-harming behavior. Glitterseason I relate to your perspective as I am also a recovering cutter. I have not experienced the urge to cut in years. My battle with trichotillomania is completely different. As you said, it is more subconscious and can happen anywhere and in front of others, unlike cutting.
Ever since I first started read about Trichotillomania, it was always linked back to self harm. It was always explained as ‘more then a bad habit, it’s a form of self harm like cutting’. (Taken from ‘Love saved me from self harm’, Company Magazine, 2003) It is true that pulling your own hair out is an act of harming oneself, but is it really self harm or is it a disorder itself?
Self Harm classifications:
In 1986, Favazza (author of Bodies Under Siege: Self-mutilation and Body Modification in Culture and Psychiatry)distinguised self harm into three catorgaries; Major self harm (eg castration, which is rare and seen in psychotic patients mainly), Sterotypical Self Harm (eg head banging seen in autistic children) and Superficial or moderate self harm. This last category includes cutting, burning, skin picking, bone breaking, hitting, small overdoses and pulling your own hair out.
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