Tag Archives: self-acceptance

What Causes the Urge to Pull

Here is another great blog post from Trichotillomania therapist and 20 year pull-free trichster, Claudia Miles (my role model).

As a psychotherapist who’s worked with hundreds of hair pullers, and as someone who personally suffered from daily hair pulling until I was 27 and has been pull free for 20 years, I know all too well the pain, shame and despair that pullers experience. I also know firsthand the frustration and hopelessness of trying *everything* to stop with no success. Or worse, having short-lived success–a day, a week, maybe even a month–and suddenly without warning you find yourself pulling again.

Maybe you pull your head hair, or your brows or lashes, or other body hair. My clients tend to be equally divided in that nearly half pull head hair and nearly half pull brows and/or lashes, a small number pull both, and the remainder pull from various areas on the body.

For those who don’t have Trich, also known as a “body focused repetitive disorder” (BFRD, and don’t understand it, but are close to someone who does, their own frustration and sadness about their child’s, friend’s, sibling’s or partner’s suffering may lead them to make constant suggestions (have you tried __ or ___), say to you, “Stop pulling, Honey,” if they see you do it, or try to “convince” you to stop by “reminding” you: “But Honey you have such pretty
hair..” “You don’t want to be bald, do you?” “Remember how upset you were about your lashes when you went to that dinner party, school dance, work, saw yourself in a picture, your friend asked you about it?”

As if you don’t already more desperately want to stop than anyone else could ever imagine. What’s hard to explain even to yourself is why you keep doing it, or why you do it at all. Why stopping seems so impossible when the behavior itself makes no sense. It just seems “crazy” or “gross” or you may feel “weak” and “pathetic”.

What others don’t know, and what you may not know, is that for people with Trich, hair pulling is a self-soothing mechanism (not an attempt to cause harm to yourself), and it feels pleasurable. It’s not an addiction to pain. The other even more important thing is that you are being prompted to pull by a physical urge that can best be compared to an itch. When people have an itch, they tend to respond to it without thinking or even being aware they are doing so. That’s why, if you have poison oak or chicken pox, you may not want to scratch, the doc may even say not to scratch, but the moment your attention is diverted (you’re watching TV or you’re on the phone), you “find yourself scratching.” And at that point, the need to “complete or finish” scratching is extremely compelling, even if you don’t want to. This comparison may help your spouse or parent or even you yourself to understand a little better what it is that causes you to start pulling in any particular moment. Either a physical or neurological urge occurs in a split second, as if you had an itch, and without conscious awareness you respond automatically. That’s why you may not have any idea of a precipitating factor.

Now, if it were that simple, it might well be easier to treat. But it’s important for pullers and their families to understand that this is not a willful behavior. Most people know what it’s like to respond to an itch and begin scratching, sometimes for a minute or more, before you realize what you’re doing. And most people also understand that, once you start scratching, poison oak for example, the craving to do so can overtake you, even though you know you shouldn’t. Most folks also know that, when at its itchiest, you may find yourself scratching, stop doing so, tell yourself, OK, I’m not going to scratch anymore, go back to
your movie, and find yourself scratching again and again. Imagine if this urge was daily and constant. Imagine if it resulted in hair loss. Yet no matter what you did, you would suddenly and repeatedly “find” yourself doing it. That’s, in short, what is happening to pullers. And because it as relieving to someone with Trich as it is for anyone to scratch an itch, you continue the behavior even when you’re aware. It is extremely important to understand that you (the puller) are not “crazy.” And anyone who experienced these urges, which occur in a microseconds, would respond the same way.

There are however, two other factors that come into play. I believe these urges have a cause that goes beyond that physical urge, and that are psyche comes to play a part in the constancy and intensity of these urges. Most people describe hair pulling as occurring in or even causing a “trance-like” state. This trance-like state kind of numbs one out emotionally, just like using a substance of some kind and also much like eating excessive amounts of carbs and sugar. This is why lots of people who have issues with weight may be engaging in what is called “emotional eating.” One may crave carbs and sugar in a way that feels like “regular” hunger. You may feel like you have to have a muffin or donut or cookie or hunk of sourdough bread. Yet underneath that craving, outside your present awareness, it may be fear or loneliness or shame that in a sense causes those cravings to happen. And once fulfilled, the emptiness or loneliness or shame is covered up.. Numbed out. So people tend to think that “their only problem is overeating.” Otherwise everything is fine. And this is exactly the same for hair pullers. The act of pulling numbs the longing or dis-ease, so it’s easy to believe that if I could just stop pulling, everything would be fine.

I work with people to get beneath this fallacy, generally dealing with issues like perfectionism, a lack of self love and self acceptance, or rather, a self-acceptance that is conditional. If they make a mistake, don’t finish their endless to do lists, aren’t thin enough, productive enough, accomplished enough or smart enough (which they rarely if ever think they are), they see themselves as unworthy, “lazy,” weak or just not good enough- And self love or acceptance is undeserved. That’s why many clients I see who have Trich and who generally also have this overly harsh, critical, perfectionistic attitude toward themselves tend to seek external validation since they are unable to give it to themselves. And this causes a pattern of people pleasing behaviors that also lead to living an inauthentic life, a life where one is not true to one’s self (since others’ opinions of their lives tend to be more important than their own.

Once my clients are able to access some of the painful feelings beneath the urges, and begin to experience greater self-acceptance and self love, two things happen: They begin to lead lives that are more authentic and true to themselves, and their urges to pull begin to diminish. And using mindfulness and learning to embrace gradual reduction rather than instant total cessation of pulling, they are able to slowly let go of some, most or all of tbeir hair pulling.

 

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How To: Recover from Hair Pulling

You CAN Recover From. Hair Pulling in 2014: Here is How

By Claudia found at http://helpforhairpullers.blogspot.com/?m=0

There’s all this talk about CBT therapy being the “most” effective. I agree more with the “C” (cognitive) part than the “B” part (behavioral). The bottom line is, if you don’t change the way you look at hair pulling* (*applies to skin picking throughout) there is no lasting recovery. Just today someone told me, “I was doing better and having lower numbers* for several months. Then I started pulling more and more and felt hopeless, and now I’m back where I was.” (*Earlier in this blog I suggest people write down ONE number every day re their pulling or picking. Rate your pulling from 0 to 10, 0 being zero pulling, 10 being your worst day. That will be your “scale.” That will be the one and only way you know you are recovering. NOT the hair on your head or lashes or brows. JUST the numbers. And the goal is to move from month to month having overall lower numbers with the understanding that you will have some bad days and that real success is accepting those and moving on.)The person above who did better for a while and then had some bad days and felt hopeless again and gave up, her story embodies all our stories. Whether the length of time you’ve done better is a few months, a few weeks, a few days, a few hours or a few minutes, and the return to increased pulling is a moment, a day or a week, that step backwards is everyone’s undoing. It was my story when I was pulling. Unless you can live through that moment and know it’s part of the process, CBT or meditation or any other method will fail You. Because recovery is, will be, two steps forward, one step back. It will be three steps forward, two steps back. It may be eight steps forward, five steps back. You have not “gone backward,” you have not “undone your progress.” Because progress won’t show on your head or your face (lashes, brows, skin) until later. Until you’ve done well, had that bad day or two, put it into context (the addiction trying to trick you into hopelessness so you will pull or pick), accepted it, checked not your hair or face right then but rather the general improvement in overall numbers, you CAN NOT RECOVER. Once you can see that those bad days will come and not let them deter you, your recovery is ASSURED.

Prepare for that. Because as you learn to live without the comfort of pulling to turn to, the part of your psyche where your addiction is lodged, will get scared. For food addicts it is scary not to have comfort food to turn to. And that fear will inevitably cause, urge, cajole and tempt you to binge on something in the midst of changing over to healthy eating and moderation. With pulling that fear will cause you to have a few binge pulling days. And if at that time you say, “Forget it. I can’t do this. I messed up. I failed, I’ll never lose the weight,” YOU WILL GIVE UP. You will say, as we all have, what’s the point? It doesn’t matter. I’ve ruined it.

Ah but you have not. Because you won’t stop suddenly and completely. You’ll stop gradually. And you’ll have bad days in there. And if you learn not to judge them or panic or tell yourself, SEE I have failed, THEN you will have succeeded. Eventually you won’t have to have those bad days. But the problem isn’t those bad days. It’s allowing those INEVITABLE bad days to stop you.

Because this will take a year. A year on the path. And then your hair will grow back. Your skin will heal. And if you demand this take three months, well it just won’t happen at all. I know a year is a long time. But so is FOREVER. Do you want to pull one more year or forever?

During this year your motivation simply cannot be about how you look or your hair growing in but about feeling good about yourself. About feeling whole. Saying “fuck it I’m ugly” is the addiction talking. Saying “there is no point” is the addiction talking. Saying “I don’t care” is the addiction talking.

The only way to avoid that is to understand that at the beginning you must focus on feeling good or at least better about yourself because you are working on the pulling. And writing down a number every day and focusing on improving the numbers and seeing them get lower each month that goes by, will keep you motivated. Knowing that you could feel proud the next day or next week is motivation. Knowing that judging yourself along the way is simply the addiction talking will keep you motivated.

It is NOT YOUR FAULT you have Trich or skin picking disorder. But it is your responsibility to face it. When you say, “I don’t care” to give yourself temporary permission to pull you are lying to yourself. Of course you care. That doesn’t mean you can always stop in that moment but you care. Pulling for all intents and purposes is an addiction. And you are a slave to it. So care about THAT.
It’s NOT, I am bad, what’s wrong with me, it’s more, This is costing me a lot and is keeping you from living the life you want. That’s why I care.

Above all else do not beat yourself up. Do not ask yourself WHY over and over again or What is wrong with me??. (Answer: Because you have trich or CSP. There is no other reason.)

One cannot recover without shifting the center of motivation from hair to how I feel about myself, how this affects my life. Because the hair takes time to grow. If it’s about the hair everyone fails. Because it’s too easy to say that, well it looks like shit now so I may as well pull.

That is pretty much why people can’t recover: Well my hair or lashes and brows or face looks like shit anyway (thus there will be no immediate payoff) so I might as well pull.

Imagine a person who weighs 350 lbs trying to lose weight. All they have is the scale to help them to see they are losing weight. They can’t see it on their body right away. All you’ll have for now is those numbers going down. This person who weighs 350 lbs must be proud that they are undertaking the journey. No new clothes shopping now perhaps. Maybe they don’t feel pretty. But they are achieving a goal. Of lower numbers on the scale. And they can and must feel good about in order to keep going.

At the end of this thing you will have your hair. But at first make it your business to have lower numbers one month to the next and prepare for those inevitable bad days and they need not take you down.

I KNOW that you can recover from pulling. And believe me, I never thought I could either. But now I know different. The only substitute for pulling is self-acceptance and self-love, self-care and setting boundaries. Read Radical Acceptance. Read Codependent No More. And since it should be said, Take a day or night off just for you. Exercise. Eat healthy good. Sleep well. Say NO once in a while. Don’t remain friends with people who are takers. Don’t wait till you stop pulling to live life and to enjoy life. I’ll be happy to answer questions here if you have them.