Tag Archives: trich

Long-Lasting Change

Five factors are necessary for long-lasting change.

We must:

• accept that we have a problem;

• want to solve the problem;

• identify a solution that works;

• implement this solution–do the work; and

• perform the necessary maintenance.

All of these factors must be in place before any long-lasting change will occur in anyone. For our self, we must honestly assess the problem and acknowledge the full repercussions it is causing in our life; then we must develop a sincere desire to change. This acceptance and “want to” are great starting points but accomplish little or nothing unless followed with proper action. We must find a solution that has been proven to solve this specific problem and do the work necessary to make that solution active in our life. And there is always maintenance; the old habits and things that caused the original problem are deeply rooted and do not simply disappear; we only acquire the new and more desirable traits with conscious, persistent practice.

These five factors also clarify why we cannot make another person change. When facing a true problem, the person with the problem must accept the reality of the problem and develop a genuine desire for change. If we recognize a problem affecting the life of a person we love, we examine our motives to see if it is really any of our business; if so, we try to objectively explain the situation and the facts as we see them but always realize that each person must find his or her own acceptance of the problem and the desire to find a solution. We cannot do it for them.

Prayer: Dear God, help me to clearly see what I must change so that I can live the life you want for me. Grant me the strength and guidance to make these changes.

Trich Thinking vs. Recovery Thinking

Trichotillomania Way of Thinking vs. Recovery Way of Thinking

1. T: I have to pull out my hair. R: I can do some thing else that is positive.

2. T: Pulling out my hair is fun. R: What is fun about being bald?

3. T: The white/kinky/thick/whatever hairs must go. R: All hairs are good hairs. I need them all for a healthy head of hair, etc.

4. T: I’ll just pull out one hair. R: This is a lie trich tells me. I can rarely just stop at one hair.

5. T: When I get that itchy or “trich sensation”, I have to pull my hair. R: I can wash my hair or scratch my head instead.

6. T: It’s ok to use the mirror to find good hairs to pull. R: Why would I want to pull out my hair and create more bald spots? I will stay away from the mirror and temptation.

7. T: It’s ok to use tweezers to get those small hairs. R: Again, why would I want to pull out new growth and create more bald spots? I will use my tweezers for the unwanted hairs only, then put them away.

8. T: When I’m stressed I need to pull out my hair. R: I can take deep breaths, meditate or go for a walk to relax my body, or I can destress with a nice bubble bath. I can do so many other healthy things to relax my body instead of pulling. Pulling really doesn’t help me to feel less stressed any way, because I know that by pulling I will be creating new bald spots. Everyone has stress in life. I must learn to be with my stress with out pulling out my hair.

9. T: When I’m bored I need to pull out my hair. R: Can’t I think of some thing more fun to do than pull out my hair when I’m bored? Why not do a hobby, a sport, a puzzle, a craft…any thing but pulling!

10. T: When I’m tired I need to pull out my hair. R: I can go to sleep instead. How many times do I stay up way past when my body tells me that I am tired, only to start pulling out my hair? I must go to bed!

11. T: When I’m depressed I need to pull out my hair. R: I can get help for my depression from a psychiatrist and/or therapist. Pulling out my hair will only increase my depression, because I feel sad when I have bald spots.

12. T: I have to make both brows look the same. R: Symmetry is not important. New growth is! In time, once my brows have had a chance to come back, both brows will look the same. By trying to make both brows even, I risk pulling more than I want to.

13. T: Now that my hair is filling in, I can lose a few hairs with out any noticeable damage. R: No I can’t! Once I start pulling, I have a hard time stopping. A few hairs a day over time will still lead to bald spots. Small or large amounts of pulling are both dangerous behaviors.

14. T: I’ll quit pulling tomorrow. R: You know what they say…”Tomorrow never comes!” I will make today the day that I stop pulling.

15. T: I can play with my hair this time with out pulling. R: Touching my hair leads to playing with my hair, playing with my hair leads to pulling. I will keep my hands down!

16. T: I love to play with the hairs after I pull them. R: Playing with the hairs only reinforces my trichotillomania, so I must not do this. I must break the trich rituals in order to be free of trichotillomania.

17. T: Some day my trich will go away, until
then I will continue to pull. R: Trich is for life. It will not magically go away. I have to work at my recovery in order to break free of this disorder.

18. T: I can learn to live with this longer hair, even if I am pulling right now. R: When I am pulling, it is hard to stop. I must cut my hair short so that I can get a break from the pulling. I have no urges when my hair is really short. I won’t risk more damage to my hair, which will take longer to grow back.

19. T: My hair will grow back, so I can pull out my hair today. R: Just because my hair will grow back doesn’t mean that I can keep pulling. Why would I want to postpone my regrowth and my recovery?

20: T: I’ll keep on pulling until I see significant damage in the mirror. R: It’s not ok to keep pulling! Any damage means that it will take longer before I get all my hair back. Trich makes excuses so that I keep pulling! This is one I have told myself often.

21. T: I have to check the mirror to see if my hair is regrowing. R: This is obsessive and obsessiveness leads to pulling. I take pictures of my hair now once a month and stay away from the mirror and obsessing.

22. T: Concentrating on individual hairs makes it fun to pull and keeps me in the trich way of thinking. R: I concentrate on thinking of my hair as a whole unit. I need all those hairs to make a full head of hair, a set of brows or a set of lashes.

23. T: I need to pull out my hair when I procrastinate. It bothers me that I am not doing what I need to do, which creates a stressful mood and then I want to pull. R: I can get up and do 5 minutes of what I need to do. I can do some thing for 5 minutes! Then once I am started, it will probably be easier to keep going and I will get what I need done and feel good about myself. Even if I quit after 5 minutes today, if I work 5 minutes on what needs doing each day, soon it will be done, therefore eliminating my stress and helping me to feel better about myself.

24. T: My hair will never grow back, so what is the point in trying to stop pulling! R: It takes 2 to 6 years for hair to grow back for some one who has pulled for 20 years or more, but the good news is it will come back, which is great!

25. T: I can’t tell any one about my hair pulling, because then they will think I’m crazy and stop liking me. R: By telling others about my trich, I will lose my shame and guilt associated with it. It is not my fault that I got trich or have a hard time dealing with it. By telling others, I see that having trich is no big deal. Every one has something! And most people are very understanding and supportive once they find out more about this disorder. This was the big surprise for me when I “came out”. Also in letting others know about my trich and have them accept me any way, helps me to accept and love myself.

26. T: My hands have to go to my head and pull! R: No they don’t! I can keep my hands busy with trich toys such as a koosh ball, silly putty, stress ball, grabbing both hands, holding any thing or doing some thing to keep my hands busy in a positive way instead of pulling, such as rug hooking or other crafts and hobbies.

27. T: Every thing that I do must be perfect, if it is not, then I get stressed out and want to pull out my hair. R: Every thing that I do does not have to be perfect! No one else is perfect and I don’t expect them to be, so why should I expect perfection from myself? I can lighten up and enjoy life!

28. T: If I stop pulling, who am I? R: I am still a person who has trich, only I am in recovery.

29. T: If I stop pulling, will I do some thing else that is equally destructive? R: I won’t replace my trich with another bad habit, if I realize that this is possible. I will work at replacing my trich with good behaviors and habits.

30. T: When I am on the phone I have to pull. R: I don’t have to stay on the phone with a person that is stressing me out. I can end the conversation and therefore end my need to pull. I can also play with the cord instead of pulling, when I have to be in this stressful situation and continue talking to this person.

31. T: I am a compulsive hair puller. R: I am so much more than a person that pulls out their hair. I am some one who enjoys hobbies, sports, leisure, relaxation, work and fun! I can choose what will define me and hair pulling is not what I want to be known for.

32. T: If I pull out my hair, I’m not worthy of love. R: Yes I am! I am worthy of love whether I pull out my hair or not. Hair pulling is not all that I am. I am worthy of love from others and from myself!

33. T: What is the point of trying to quit, when I will just start again? R: I know that everything takes time to learn and I will learn to not pull out my hair. I may have setbacks, but with each successful attempt at not pulling, I get closer to quitting pulling forever!

34. T: Trich is bad! R: Trich is good. When my hand goes to my hair, I know that some thing is not right with in me. I am either bored, tired, stressed, have dirty hair, am procrastinating, am depressed, etc. and I need to do some thing about it. Trich the is first to know, long before I know these things consciously.

35. T: I have an urge to pull, therefore I must pull! R: The urge to pull will pass if I do nothing at all. I will not die from this urge. It’s ok to get urges, but I don’t have to act on them. I can take a deep breath and relax.

36. T: I’ll never be able to stop pulling! I hate myself! R: I can learn to stop pulling by learning all that I can about trich and how it affects me. I can learn what my triggers are and what to do when I get them. I can learn that beating myself up for pulling and hating myself because of my pulling only makes my pulling worse. I can learn to use positive self-talk to help decrease the urge to pull. I can learn to love myself even if I continue to pull out my hair. I am worthwhile for who I am, not for how much hair I have.

37. T: I often pull with out realizing it and zone for a long time before I am aware of my pulling. How can I help myself if I don’t know I’m pulling? R: Awareness takes time and practice. In time, I will become aware of where my hands are and stop them before they start pulling. I will give myself the time and patience to learn the new behavior of awareness.

38. T: I’m the only one that does this. R: Nope. Millions of people pull out their hair, some where between 2 and 5% of the population pulls their hair. This covers all walks of life.

39. T: Slips are bad. R: Slips are a way of learning. I ask myself why I was pulling and then try to do something different next time to either avoid that situation or to change my response to that trigger, one that is positive and not negative like pulling.

40. T: Quitting pulling is too hard. R: Quitting pulling is not too hard if I take it in small steps, have patience with my recovery and give my recovery the time that it needs to succeed.

Sources: http://www.pallister.co.uk/uk-ttm-mb/messages/37/458.html?1203158711

http://dailystrength.org/c/Trichotillomania-Hair-Pulling/recs/1927-trichotillomania-way-thinking-vs

Climb Out of that Hole

Don’t let the weight of this world get you down. When you are in a hole, look up and ask for the help you need to climb out. Don’t stay stuck and wallow in self pity. Unfortunately this life is hard and we all have our struggles. Keep fighting and be thankful for the good things no matter how small. True joy comes from an attitude of gratitude. #tistheseason #speaklife #gracefortoday

Unconditional Love

Jesus loves me unconditionally. Therefore, I have not earned His love nor could I earn His love. I cannot be separated from His love.

When I obey Him, God will bless me. When I disobey Him, there will be consequences. Jesus may not like my behavior, but He always loves me.

Because I have experienced God’s love, I know that I am lovable. I know there are people who could love me too. Therefore, I am able to trust people who love me. I am confident in my worth based on the love of Jesus.

from Beauty for Ashes by Joyce Meyer

What Matters Most in Your Life

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What Comes First in Your Life?

Do you  value love most? God is love. By putting God first, everything else will fall into place. We will best love and support ourselves, our family and our friends. By choosing love, we put God first. He is a light in the darkness, our helper in the storm. If we seek Him first, He will help us and show us how to love others and how to take care of ourselves.

God loves us more than we can imagine and only wants the best for us. God does not cause bad things to happen. We live in a lost and broken world plagued with darkness. The good news is that light has overcome the darkness. This is not our home. and as the song says, “We are just taking the long way home”  (Steven Curtis Chapman-lyrics) There is something better. God sees the whole story beginning to end and He has defeated death. We only need to have faith. We can never earn His love. We are all broken in our own way. No one is perfect and God doesn’t expect us to be.

However, He knows our heart and true motives. If we honestly pursue God first and want His will for our lives, He will use all things for good. That terrible heartache, health problem, broken relationship, addiction, or other struggle is nothing compared to the power of God. In order to use that power to be an overcomer, we must have faith and rely on God’s strength to pull us through. We will never make it on our own.

I am going though a really hard time right now. After a while with stable moods, my bipolar disorder  is causing major issues in my life. My previously helpful medication and treatment plan have not worked to push this mania away. It crept up over a year ago. There have been ups and downs, but for the most part I have been hypomanic. Stress and other triggers cause it to flare up. This is the case these last few weeks. I am battling anxiety, struggling to sleep, my mind is scattered, memory disabled, and thoughts are constantly racing.  Although I try to contain them, my words keep spilling out. I try to do what I know works. I set A schedule, try and get enough sleep, prioritize tasks, spend time with God, and avoid triggers such as caffine. If I suddenly get the urge to organize everything, I need to step back and think about my thinking. Why do I suddenly have a desire to do the chores I usually put off because I dislike them so much?

I know I need to put God first. They only way for me to get better is to rely on Him. He loves me and wants what is best for me. When my mind is scattered and I struggle to make good choices. God leads me along the right path and carries me when I am too week to walk.

God also helps me through others. My family loves and supports me. I try to listen to their advice and accept their help. Normally, I try  to do everything myself. Obviously that has not worked. I need to let go of my pride and take care of myself. I know I will come through this and be better for it. My pain serves A purpose and I will persevere!

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How Do We Put God

First, ask God to help you put him, ask him to help you see what to do, and to guide your steps

Have faith that God keep His promises. You are loved more than you know. You are forgiven through grace. Trust that He wants what is best for you and that if you rely on Him, you will overcome your struggles and find true joy.

Eliminating obstacles such as, desires for fortune and fame, work overload, addiction, or other temptations by confessing them to God.

In place of sin, struggle, and heartache, we are to rely fully on Christ. We do this by being accountable to a Godly friend, spending time in God’s Word and prayer every day, attending and becoming involved with church worship regularly, and listening to Godly music and messages are a few ways to put on Christ. A little bit of sin can add up to making provision for the flesh, so putting on Christ will add up to making provision for the Holy Spirit.

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Prayer: You are Holy, Lord. Thank you for the Blood of Jesus to wash us and cleanse us from sin. As a born again believer I ask You to help me to put off these things that hinder my life from being completely surrendered to You and show me the ways to put on Christ so that I may please You. Amen.

“Long Way Home”
by Steven Curtis Chapman | from the album re:creation

I set out on a great adventure
The day my Father started leading me home
Said theres gonna be mountians to climb
And valleys were gonna go through

But I had no way of knowing
Just how hard this journey could be
Cause the mountians are steeper
And the valleys are deeper than I ever would had dreamed

But I know were gonna make it
And I know were gonna get there soon
And I know sometimes it seems like, were going the wrong way
But its just the long way home

Some rocks on my shoes
Fears I wish I could lose
That make the mountians so hard to climb
And my heart gets so heavy with the weight of the world sometimes

There’s a bag of regrets,
Should’ve beens, and not yets
That keep on dragging around
And I can hardly wait till the day I get to lay them all down

I know that day is coming
I know its gonna be here soon
I won’t turn back even if the whole world says I’m going the wrong way
Cause its just the long way home

When we cant take another step
The Father will pick us up and carry us in His arms
And even on the best days, He says to remember were not home yet
So don’t get too comfortable
Cause we are just pilgrams passing through

I know that day is coming
I know were gonna be there soon
I keep on singing and believing
What all of my songs say

Cause our God has made a promise
And I know everything He says is true
He promised He would never ever leave us
He’s gonna lead us
He’ll lead us home

Every single step of the long way home
So keep on, were gonna make it
Were just taking the long way home
So keep on, were gonna make it
I know, were gonna make it
Its just the long way home

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The Power of Faith and Prayer


“Truly I tell you, if anyone says to this mountain, ‘Go, throw yourself into the sea,’ and does not doubt in their heart but believes that what they say will happen, it will be done for them. Therefore I tell you, whatever you ask for in prayer, believe that you have received it, and it will be yours.
Mark 11:23‭-‬24 NIV

https://bible.com/bible/111/mrk.11.23-24.NIV

I Am Human. I Need Help.

It was close to midnight when I drove into an empty mall parking lot. The sound and sight of rain is distinct in my memory. “Where are you, God?” I shouted, pain coiling itself around my heart, torment gripping my mind. “Where are you?” I sobbed again. I parked my car and began to write the truth in my journal: I am absolutely terrified. My life is completely out of control. God, I need help.

Fourteen years ago I was struggling with an eating disorder (among other things, hello). But in that parking lot, I finally pressed beyond denial and admitted to myself and to God that I had a problem I couldn’t fix. I wasn’t ready to admit the same to others, but at least the pressure of pretending began to lift.

It took a few years for me to open my pain to close friends, and for my life to actually change, but I gained a level of freedom that night as I gave myself permission to say it, to write it: I am human. I am broken. I need help.

Brokenness opens a path for obedience. Not because it’s more spiritual to be jacked up across fourteen areas of life, but because of the humility it takes to engage in an honest relationship between the Holy Spirit and us. It takes guts to say, “I don’t have it all together and I’m not going to wait until I have it all together. Jesus, I need you now. Where are you? Can you please come to me now?”

He has all wisdom. He has all power. He is at peace with our humanity, with our brokenness. He comes to us in our pain, not in our pretense. He gives grace to the humble, but he resists the proud. And the Holy Trinity is the only force able to transform our lives completely, for good.

How I hated those first few times I risked taking off my mask. How I loathed giving up control of my environment and of how others saw me. How I despised living in that grey space between who I was and who I wanted to be. Denial was so much easier – at least my coping mechanisms were familiar, and pretending I had it all together was so much better than sitting in the ugly truth.

But truth-telling started the process of freedom. I began walking wholeheartedly towards integrity. And this opened my heart to receive the truth of the word of God as well. This opened me up to a life in the Spirit.

Jesus said, “If you abide in my word, you are my disciples indeed. And you shall know the truth, and the truth shall set you free.” And when we make the simple, albeit difficult, decision to be honest with where we are, we can obey Jesus at each step of our discipleship journey, on our way to where we’re going. We tap into the power of the Holy Spirit and, by His grace, we can respond to our past with His love, remain present where we are, and look to the future with hope.

Humility in obedience is hard; but, oh, my friend, you’re worth it. Eugene Peterson, in his book, A Long Obedience in the Same Direction:

“I Am Human. I Need Help.”

It was close to midnight when I drove into an empty mall parking lot. The sound and sight of rain is distinct in my memory. “Where are you, God?” I shouted, pain coiling itself around my heart, torment gripping my mind. “Where are you?” I sobbed again. I parked my car and began to write the truth in my journal: I am absolutely terrified. My life is completely out of control. God, I need help.

Fourteen years ago I was struggling with an eating disorder (among other things, hello). But in that parking lot, I finally pressed beyond denial and admitted to myself and to God that I had a problem I couldn’t fix. I wasn’t ready to admit the same to others, but at least the pressure of pretending began to lift.

It took a few years for me to open my pain to close friends, and for my life to actually change, but I gained a level of freedom that night as I gave myself permission to say it, to write it: I am human. I am broken. I need help.

Brokenness opens a path for obedience. Not because it’s more spiritual to be jacked up across fourteen areas of life, but because of the humility it takes to engage in an honest relationship between the Holy Spirit and us. It takes guts to say, “I don’t have it all together and I’m not going to wait until I have it all together. Jesus, I need you now. Where are you? Can you please come to me now?”

He has all wisdom. He has all power. He is at peace with our humanity, with our brokenness. He comes to us in our pain, not in our pretense. He gives grace to the humble, but he resists the proud. And the Holy Trinity is the only force able to transform our lives completely, for good.

How I hated those first few times I risked taking off my mask. How I loathed giving up control of my environment and of how others saw me. How I despised living in that grey space between who I was and who I wanted to be. Denial was so much easier – at least my coping mechanisms were familiar, and pretending I had it all together was so much better than sitting in the ugly truth.

But truth-telling started the process of freedom. I began walking wholeheartedly towards integrity. And this opened my heart to receive the truth of the word of God as well. This opened me up to a life in the Spirit.

Jesus said, “If you abide in my word, you are my disciples indeed. And you shall know the truth, and the truth shall set you free.” And when we make the simple, albeit difficult, decision to be honest with where we are, we can obey Jesus at each step of our discipleship journey, on our way to where we’re going. We tap into the power of the Holy Spirit and, by His grace, we can respond to our past with His love, remain present where we are, and look to the future with hope.

Humility in obedience is hard; but, oh, my friend, you’re worth it. Eugene Peterson, in his book, A Long Obedience in the

Same Direction: Discipleship in an Instant Society, said, “And yet I decide, every day, to set aside what I can do best and attempt what I do very clumsily–open myself to the frustrations and failures of loving, daring to believe that failing in love is better than succeeding in pride.” Yes and Amen.

PRACTICE: What thoughts come into your mind as you think about leaning into the grey space of where you are now and where you want to be? Are you uncomfortable, afraid, lonely, angry? Share your thoughts with the Lord. He wants to hear you. Discipleship in an Instant Society, said, “And yet I decide, every day, to set aside what I can do best and attempt what I do very clumsily–open myself to the frustrations and failures of loving, daring to believe that failing in love is better than succeeding in pride.” Yes and Amen.

PRACTICE: What thoughts come into your mind as you think about leaning into the grey space of where you are now and where you want to be? Are you uncomfortable, afraid, lonely, angry? Share your thoughts with the Lord. He wants to hear you.

WHO am I?

I am Mommy to four very special kids. They are 10, 6, 4, and 2. I have been married to my soul mate and father of my children for almost 11 years. I was an elementary teacher and am now a tutor for students with a wide range of needs. I love helping others and tutoring is one way I can do that. It is also the reason I started my blog.

I have lived with trichotillomania since age 6. In the past 24 years I have tried every treatment, strategy, medication, and therapy. I still pull, but I use strategies I know work for me. I do hope to overcome this demon, but its presence in my life will not keep me from loving myself and enjoying life. Everyone is fighting some battle or has hurts that we do not see. It is learning to live despite these trials that I find very important.

Personally, I seek recovery while still accepting the reality of trich. There is no right or wrong way to view or live with trich. I simply blog about my experience in hopes of helping others feel less alone.

ACT Therapy: Acceptance

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ACCEPTANCE: allowing urges, emotions, thoughts and feelings to occur without attempts to control them.

Acceptance does NOT mean a hopeless acceptance of the fact you have trichotillomania.

ACT is an acceptance-based, behaviorally oriented therapy.  It was first proposed by Hayes et. al. (1999), but I believe Dr. Woods is the first to study treating ttm with ACT.

ACT Therapy � TLC Retreat Notes
Credit Sue Price notes – TLC Conference Session

TLC Retreat Session September 2002
Acceptance and Commitment Therapy
Douglas Woods, Ph.D.

Why work on acceptance? Dr.Woods conducted an online study which showed that pullers who are less accepting of private events tend to have stronger urges to pull and more severe pulling. [I found the concept of “private events” confusing at first. From what I can tell, it’s anything that happens inside you that you experience privately. As he said: thoughts, feelings, emotions, urges].

People follow rules not experience. He cited a study where people played a slot machine that was rigged to never pay off for the player. The people who were told that the machine WOULD pay off eventually, played longer than the people who were not told anything. The point is, people follow rules over their experience.

Where this fits in with trich: the rule is, “if you feel bad, get rid of it.” This is what society teaches us. This works well in many situations (if the kids are too noisy, send them outside; if someone is tailgating you, change lanes, etc.).  But this does not work with private events such as feelings. Trying to just get rid of bad feelings, urges, etc. does not work long term. But we keep doing this anyway because that’s the rule we’ve been taught.

ACT breaks down rules by emphasizing experiential exercises over verbal rules. The idea is that the person accepts that while the rule they’ve been taught is “get rid of it”, their experience shows that this has not worked, and then they can learn a willingness to experience those private events. [Side note: the addiction book that I’ve found so helpful makes similar points: that our society teaches us that feeling bad is intolerable, to be avoided, and if you feel bad you must do something to stop feeling bad RIGHT AWAY. This is the kind of thinking that fosters addiction, and changing this way of thinking and being willing to FEEL bad is a major part of combating addiction.]

Steps to Acceptance

1. Creative Hopelessness

Focuses on getting the person to see that attempts to stop, alter or avoid private events such as thoughts, emotions or feelings have been unsuccessful. Pulling is often another way to avoid or control private events. He asked us to think about an uncomfortable private event that we’re dealing with right now. He asked how we tried to deal with it. The common answers people gave were: avoided thinking about it, distracting themselves from it, and denial. We confirmed that none of these things work long term in dealing with the private event. It comes back.

2. Willingness

Focuses on getting the participant to be willing to experience negative or uncomfortable private events. If trying to control private events is the problem, willingness to experience uncomfortable feelings may be a solution.

– Willingness is not the same as “wanting”. He had a “Joe the Bum” metaphor (acknowledging that “bum” is not PC.) Say you are having a party that all your neighbors are invited to, and everyone is having a great time. Then Joe the Bum shows up. You don’t want him there, nobody likes him, he’s dirty, he’s smelly. But if you spend your time trying to physically keep him out, you won’t be enjoying your party. But if you are WILLING to accept that he’s there and not fight it, even though you don’t WANT him there, you can still enjoy your party.

– Willingness is all or nothing

3. Diffusion

He said that even if urges etc. are not originally language-based, they become so because WE are language-based. (There was a lot of clinical stuff he went over making this point.) We need to understand language for what it is, and that words are powerful only because we let them be. This step is about de-literalizing private events. We did two exercises to illustrate this.

First he asked us what we associate with the word “milk”. We said white, cold, frothy, things like that. Then he has us say, out loud,”milkmilkmilkmilkmilkmilkmilk. . .” over and over. (Try it, it’s physically not easy to keep this up!) Picture an entire room of us saying it over and over, and he had us keep it up for what seemed like forever. When he finally stopped us, he said, “I bet you’re not thinking of that white frothy stuff anymore.”

The idea is that “milk” made us think of the white frothy stuff, but only because of what WE associate with that word. By repeating the word over and over, we de-literalized it. It became just a word, the letters m-i-l-k. Similarly, an urge that’s felt as “I need to pull” can be de-literalized by repeating “I need to pull I need to pull I need to pull” until they are just words, not something that must be acted on. Those words don’t have power unless we give it to them.

The second exercise is to imagine you are watching a parade and a band is marching by. Imagine that your thoughts, whatever’s bothering you, are written up on cards that the band members are carrying. And just watch those “thoughts on cards” go past you.  Acknowledge them but separate yourself from them.

4. Understanding the Self

Who are “you?” Who is your “self?”

– Conceptualized Self: who do we say we are? What do we stand for? How do we see ourselves? (we typically think of this as our only self, and defend it)

– Knowing Self: the “self” that is experiencing events as they are occurring

– Observing Self: the “self” that has always been and always will be. He made an analogy to a chessboard: I am the board, not the game that is happening on it. Whatever happens on the board does not have to affect me.

5. Valuing

– You have the ability to choose your behavior. You must choose to move in your valued direction.

– What do you value? What do you want your life to stand for?

– Need to make psychological room for private events while you move your life in the valued direction.

[I think an example of what he means by the last item is: a valued direction for me, is not pulling. By trying to move my life in that valued direction, I will have uncomfortable private events and I need to accept this and be ready for this.

He also said:

-Committed Action Invites Obstacles (disguised as private events)

– The Journey in the Valued Direction involves fear and action. So I take it as, anything I do to move my life in a direction I value(trich-related or not) can bring up private events that will be uncomfortable. He is saying “choose to move in your valued direction” while experiencing these private events.]

**The idea is to combine acceptance techniques with other behavior therapy procedures. A clinical study showed this is effective, based on five different measures of pretreatment and post treatment hair pulling.

For more info, this book is very helpful:

Trichotillomania: An ACT-enhanced Behavior Therapy Approach Therapist Guide (Treatments That Work), March 31, 2008, by Douglas W Woods and Michael P Twohig