Tag Archives: trich

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


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 TTM.

Why work on acceptance? He 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

When God Doesn’t Move the Mountain

Why can’t I  stop pulling my hair?

Why do I still have manic episodes?

Why does this cloud of depression try to consume me?

 I know God can heal me. The creator of the universe can do anything. So I wonder, will He ever heal me? I pray and pray and try to fight through His strength. Some days are better than others, but the bottom line is that these strongholds are the anchors trying to drag me down.  I am the child of the one true King and nothing the devil throws at me will change my unwavering faith and love for my God, my Savior, and my closest Friend.

Through my most recent manic episode that lasted about four months, I have begged for healing.  Through my prayers and seeking God through His Word, I keep getting the same message.  There is a purpose for my pain. God will use me and my struggles in His time. I know His plans are perfect and He is preparing me for what lies ahead.

In 2 Corinthians, Paul talks about his disability. Paul is the guy with an insurmountable faith. He commanded people to be healed in the name of Jesus, and they were healed instantly. He told a demon to flee simply  because he was annoyed, and the demon fled. Paul clearly lacks no faith. He’s the guy that could say to a mountain, “move,” and it would have to move. He says:

“…I was given the gift of a handicap to keep me in constant touch with my limitations. Satan’s angel did his best to get me down; what he in fact did was push me to my knees. No danger then of walking around high and mighty! At first I didn’t think of it as a gift, and begged God to remove it. Three times I did that, and then He told me,

‘My grace is enough; it’s all you need. My strength comes into its own in your weakness.’

Once I heard that, I was glad to let it happen. I quit focusing on the handicap and began appreciating the gift.”  {2 Corinthians 12:7-12}

The poster child of faith could not pray his own disability away. Three times he prayed, using a level of faith that is hard to wrap my mind around…and God still said no. God wanted Paul to rely on His grace to make it through, not on Paul’s own ability. God wanted to bring Paul to his knees so that he would have to rely on Him to get by.

But sometimes God says no.

You don’t have to tell yourself that the faith you just tried so hard to muster up, so intensely that it made you physically sick, wasn’t enough. That if you could just try a little harder, you could make God change the situation. That you could somehow control God.

Because, surprisingly, it’s incredibly comforting to know that God can say no. And he does, often. There’s strength in knowing we can’t control His decisions, and that the outcome does not always, in fact, depend on our level of faith.

And there’s strength in knowing that sometimes God doesn’t move the mountains, simply because He wants us to rely on Him to climb them.


A Beginner’s Guide to Treating Trichotillomania

Clinical Psychologist

I often tell my colleagues that trichotillomania (hair pulling disorder) represents the wild west of psychological disorders. Unfortunately, it remains one of the least researched and most misunderstood disorders in the DSM. Additionally, there is a lot of pseudoscience, snake oil, and plain old quackery on the internet about the best way to treat it.

In this article, I will highlight what we do know about scientifically supported treatments for trichotillomania. As a disclaimer, this is only an introduction to treating trichotillomania and is not intended to formally train clinicians. Lastly, I will not be reviewing medical treatments for trichotillomania (you can learn more about those here).

Historical Treatments


Photo by Gregory Parker

The first scientifically based treatment for trichotillomania was Habit Reversal Training (HRT) (Azrin, Nunn, & Frantz, 1980; Duke, Keeley, Geffken, & Storch, 2010). During HRT, individuals become more aware of their hair pulling behavior and practice interrupting the behavior by engaging in incompatible behaviors. For example, people who use their hands to pull from their scalp might practice reaching down towards one’s knees. While HRT has been effective in the treatment of tics and Tourette’s Disorder, it doesn’t work for everyone who has trichotillomania and also has a high rate of relapse. Why? As I described in a previous article, trichotillomania is a very heterogeneous disorder and affects each person differently. A “one size fits all” treatment just won’t work for trichotillomania.

Modern Treatments

Recently, researchers have developed more comprehensive approaches to treating trichotillomania. Dr. Charles Mansueto pioneered the Comprehensive Behavioral Model (ComB) for trichotillomania (Mansueto, Stemberger, Thomas, & Golomb, 1997). In ComB, clinicians first understand the function of hair pulling. Does it relieve stress? Does it end boredom? Does it reduce anger and frustration? Next, clinicians identify the main types of hair pulling. Some individuals pull for sensory stimulation (trying to find the hair that feels just right), others due to specific thoughts (I have to get rid of all the grey hairs), etc. Lastly, clinicians create treatments that address all aspects of trichotillomania including emotional regulation (learning more adaptive ways of dealing with stress, anger, boredom), physical habits (using HRT and objects to stop motor behavior), and environmental interventions (covering mirrors, getting rid of tweezers).

While research is underway to evaluate Mansueto’s ComB model, other researchers have found support for this approach to treating trichotillomania. In a recent pilot study, Dr. Nancy Keuthen and her colleagues found that Dialectical Behavior Therapy (DBT) was effective at reducing trichotillomania symptoms for at least 3 months (Keuthen et al., 2010). DBT is a form of cognitive behavior therapy that focuses on learning new ways of regulating one’s emotions. Additionally, in a review of all published scientific treatment studies on trichotillomania, Dr. Michael Walther and his colleagues concluded that behavior therapy (HRT), emotional regulation, and acceptance together represent the most promising treatment for trichotillomania (Walther, Ricketts, Conelea, & Woods, 2010). Furthermore, Dr. Martin Franklin and his colleagues have demonstrated that this comprehensive approach to behavior therapy not only works for adults, but it can help children as young as 7 (Franklin, Edson, & Freeman, 2010).

So what does this all mean? To the best of our scientific knowledge, effective trichotillomania treatment includes three things:

  1. An increased awareness of when, where, and why hair pulling occurs.
  2. An effort to control or change hair pulling behavior.
  3. Emotional regulation training to find alternative ways of dealing with negative feelings.

Here’s how I use these scientific findings to treat trichotillomania.

Increasing Awareness

Photo by Wim Mulder

Before creating a treatment plan, I collaborate with my clients to understand the unique patterns of their hair pulling. This usually includes a 1-2 week record of all hair pulling episodes. I ask each client to record the following information after each hair pulling episode:

  • What part of the body was the hair pulled from?
  • Where was the person when they pulled their hair?
  • What time was it when the person pulled their hair?
  • Was an instrument (e.g. tweezers) used to help pull hair?
  • What was the person doing while they pulled their hair?
  • What was the person feeling before, during, and after the hair pulling?
  • What was the person thinking before, during, and after the hair pulling?
  • Was anyone else present during the hair pulling?
  • What did the person do with their hair after they pulled it? (Sidenote: You’ll want to look out for individuals who swallow their hair, this could lead to a potentially lethal condition known as a trichobezoar and will need immediate medical attention).

Changing Hair Pulling Behavior & Emotional Regulation

Photo by Aimee Quiggle

A key component of Dr. Manysueto’s ComB model is the SCAMP Intervention. SCAMP stands for Sensory, Cognitive, Affective, Motor, and Place. Once my client and I have a firm understanding of the hair pulling behavior, I use the SCAMP Intervention to create a customized treatment plan.

Sensory: For individuals who seek sensory activation on their scalp, we might use brushes, combs, pens, massages, or ice to ease sensations. For hands, individuals can get manicures, use lotions, or file their nails. For the face, bath oils, baths, facial scrubs, or a loofah could be used.

Cognitive: Often specific thoughts can lead to hair pulling. Common thoughts include, “My hair has to look perfect”, “I need to get rid of that blemish”, “I’ll just pull a little”, “I’ve already pulled once, so why try holding back?” Here, individuals practice thinking in more realistic way (e.g. “It’s okay to be imperfect”, “The best way to fix it is to let it heal”, and “A slip-up is not a failure, any progress is helpful”).

Affective: When specific emotions lead one to pull their hair, the best way to address this problem is learn more effective ways of regulating your nervous system. To become more relaxed, individuals can use diaphragmatic (belly) breathing, progressive muscle relaxation, practice meditation, listen to white noise, use a heating pad, drink a warm beverage, take a slow relaxing walk, use an eye/face gel mask, or take a long bath. To address intensity and pain, individuals can stick their fingers in frozen ice cream, put their face in a bowl of ice water, suck on a lemon, snap a rubber band on your wrist, take a cold shower, go for a fast run, or chew a large wad of gum. To deal with boredom, individuals can learn about a topic of interest on the internet, write in a journal, draw, play a musical instrument, read a book, paint, take photographs, do a crossword puzzle, and garden.

Motor: In addition to HRT, physical barriers can often help reduce hair pulling. For example, rubber fingers, band-aids, sleep masks, head wraps, glasses, hats, gloves, thumb braces, and tape can all be used to create barriers to hair pulling. Also, changing the condition of your hair and hands can help (e.g. wetting hair, placing Vaseline on your eyelids/brows, wearing false nails, using hand lotion). Objects such as loud bracelets, elbow braces, and perfume can increase awareness of hair pulling. Fiddling toys can sometimes provide alternatives to hair pulling (e.g. koosh balls, silly putty, clay, knitting). For oral rituals, chewing gum, eating sunflower seeds, chewing raw pasta, chewing a toothpick, and eating gummy bears can help.

Place: Comprehensive interventions should also target the environment in which hair pulling takes place. Individuals can try changing light levels, covering mirrors, getting rid of tweezers (or placing them in the freezer), using sticky notes, keeping certain doors open (to decrease privacy), rearranging furniture, and sitting in different positions.

Monitoring Progress and Revising Treatment

As a client and clinician begin treatment, it’s important to keep a daily log of the hair pulling episodes and the attempted interventions. Some interventions will work right away, others will need to be fine tuned, and some will lose their effectiveness over time. The client and clinician must work together, constantly monitoring and reevaluating the treatment until a plan is developed that fits the needs of the client. This process could take weeks or months. Additionally, since trichotillomania changes as we age, treatments that worked at one phase of life may not work in another.

Advice for Treatment Seekers and Treatment Providers

As you can tell, treating trichotillomania is a complex and long process. It takes a lot of time, courage, and motivation on the part of the individual and a lot of training and experience on the part of the clinician. If you are someone who is suffering from trichotillomania, make sure that your clinician is using scientifically supported treatments. Ask them about the type of treatment they are using. If you don’t hear anything about increasing awareness, changing behaviors, or emotional regulation, their treatment may not be based on science. If they start using personal testimonials and wild theories to backup their treatment, or say their treatment cannot be evaluated by science, run away – they’re probably selling you snake oil.

I recommend using the Trichotillomania Learning Center’s list of health care providers to find individuals trained in scientifically supported treatments. If you are a health care provider wanting to learn more about these treatments, I highly recommend attending a Trichotillomania Learning Center Professional Training Institute and browsing through their clinical resources.


Azrin, N. H., Nunn, R. G., & Frantz, S. E. (1980). Treatment of hair-pulling (trichotillomania): A comparative study of habit reversal and negative practice training. Journal of Behavior Therapy and Experimental Psychiatry, 11, 13-20.

Duke, D., Keeley, M., Geffken, G., & Storch, E. (2010). Trichotillomania: a current review. Clinical Psychology Review, 30, 181-193.

Franklin, M. E., Edson, A. L., & Freeman, J. B. (2010). Behavior therapy for pediatric trichotillomania: Exploring the effects of age on treatment outcome. Child and Adolescent Psychiatry and Mental Health, 4, 18.

Keuthen, N. J., Rothbaum, B. O., Welch, S. S., Taylor, C., Falkenstein, M., Heekin, M., Jordan, C. A., et al. (2010). Pilot trial of dialectical behavior therapy-enhanced habit reversal for trichotillomania. Depression and Anxiety, 27(10), 953-959.

Mansueto, C. S., Townsley-Stemberger, R. M., McCombs-Thomas, A., & Goldfinger-Golomb, R. (1997). Trichotillomania: A comprehensive behavioral model. Clinical Psychology Review, 17, 567-577.

Walther, M. R., Ricketts, E. J., Conelea, C. A., & Woods, D. W. (2010). Recent Advances in the Understanding and Treatment of Trichotillomania. Journal of Cognitive Psychotherapy, 24(1), 46-64.

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Suffering Produces Perseverance

I no longer wish I never had trich or bipolar disorder. Although both come full of pain and suffering, there is another side. Working through my struggles has made me the person I am today. I don’t know if I would have have the same faith, spirit of perseverance, or compassion. I think my best traits have been developed through my pain. God did not cause my suffering, but He will use it for good.

I still hope to be pull free, but I am happy now as I am. My moods are relatively stable and I have settled on a set of meds that works for me. I still pull, but it does not rule my life. Yes, I do spend a considerable amount of time practicing awareness and coping strategies. However, I do not feel like less of a person because I do this or because I am missing some hair. Everyone has some form of struggle in their life. Learning to use that suffering for good is the key to moving through it and finding a purpose for your pain. I read this devotional earlier today and thought that it lined up so well with the verse that has been on my heart, Romans 5:3-4.

Your Pain Often Reveals God’s Purpose for You


Your pain often reveals God’s purpose for you. God never wastes a hurt! If you’ve gone through a hurt, he wants you to help other people going through that same hurt. He wants you to share it. God can use the problems in your life to give you a ministry to others. In fact, the very thing you’re most ashamed of in your life and resent the most could become your greatest ministry in helping other people.
Who can better help somebody going through a bankruptcy than somebody who went through a bankruptcy? Who can better help somebody struggling with an addiction than somebody who’s struggled with an addiction? Who can better help parents of a special needs child than parents who raised a special needs child? Who can better help somebody who’s lost a child than somebody who lost a child?
The very thing you hate the most in your life is what God wants to use for good in your life.
The Bible says in 2 Corinthians 1, verses 4 and 6, “God comforts us in all our troubles so that we can comfort others. When we are weighed down with troubles, it is for your comfort and salvation! For when we ourselves are comforted, we will certainly comfort you. Then you can patiently endure the same things” (NLT).
This is called redemptive suffering. Redemptive suffering is when you go through a problem or a pain for the benefit of others.
This is what Jesus did. When Jesus died on the cross, he didn’t deserve to die. He went through that pain for your benefit so that you can be saved and go to Heaven.
There are many different causes for the problems, pains, and suffering in your life. Sometimes the stuff that happens you bring on yourself. When you make stupid decisions, then it causes pain in your life. If you go out and overspend and buy things you can’t afford and presume on the future, and then you go deeply in debt and lose your house, you can’t say, “God, why did you let me lose my house?” You can’t blame God for your bad choices.
But in some of your problems, you’re innocent. You’ve been hurt by the pain, stupidity, and sins of other people. And some of the pain in your life is for redemptive suffering. God often allows us to go through a problem so that we can then help others.


Conflict in Relationships

img_5156Any type of stress, anxiety, anger, or conflict makes my pulling worse. It is a self-soothing behavior that helps me calm down and often dissociate from my feelings. Over the past few years, I have been working to use helpful strategies that help me relax without pulling my hair (which only leaves me feeling worse in the end).
As a high stress person, I have suffered with anxiety for most of my life. It still plagues me at times, but I have learned strategies to calm my mind and body. Taking a quick break from the situation, praying, practicing deep breathing, and trying to find a more positive outlook are some simple tools that have helped me.

If I catch myself being negative or getting stressed out, I try to take a step back and look at the situation objectively. In the past, I would catastrophize my situation. Now, I can identify those feelings and look for the truth.

  • Are my concerns based on truth?
  • Can I do anything about this?
  • Is there a more positive outlook I can strive for?
  •  If the worst case senario does play out, is it really that bad?

Beyond my stress and anxiety is anger that can cause relationship problems. The following article presents 3 ways to create conflict (and therein, 3 ways to avoid it). I know I am guilty of these and am making it a priority to avoid them. Reducing conflicts in our relationships, greatly increases our overall well-being.


Three Sure Ways to Create Conflict

By Rick Warren

“Any fool can start arguments; the honorable thing is to stay out of them” (Proverbs 20:3 TEV).

Wise people are peacemakers, not troublemakers. Wise people don’t carry a chip on their shoulder. They’re not always looking for a fight, and they don’t intentionally antagonize other people.

The fact is, if you’re around anybody for any length of time, you’ll figure out what that person does that irritates you, and you file that information in the back of your mind as a tool to use when you get in an argument. It becomes a personal “weapon of mass destruction”! When you get in an argument, and that person says something that hurts, offends, or slights you in any way, then you pull out the big gun. You push the hot button. And it works every time!

You know what the Bible calls that? Foolishness! You’re not getting any closer to the resolution. You’re not helping the relationship. In fact, you’re hurting it. It is not wise.

Proverbs 20:3 says, “Any fool can start arguments; the honorable thing is to stay out of them” (TEV).

We all use tools, tricks of the trade, and skills in relationships that are actually counter productive. They’re hurtful, they’re harmful, and they don’t get you what you want out of relationships. In fact, they get you the exact opposite behavior. But when we lack wisdom, we use them anyway.

There are many of these tools, but here are just a few:

1. Comparing. Never compare your wife, your husband, your kids, your boss, or anybody else, because everybody’s unique. Comparing antagonizes anger.

2. Condemning. When you start laying on the guilt in a relationship, all you’re going to do is get the exact opposite of what you expect. It doesn’t work. It’s foolish.

3. Contradicting. William James, the famous psychologist said, “Wisdom is the art of knowing what to overlook.” There’s some stuff you just need to overlook.

The Bible says in Proverbs 14:29, “A wise man controls his temper. He knows that anger causes mistakes” (TLB). Have you ever said or done anything stupid out of anger? Yes? Because when you get angry, your intelligence goes out the window. When you get angry, you say and do foolish things that are actually self-defeating.

Did you ever think about the fact that there is only one letter difference between “anger” and “danger”? When you get angry, you are in dangerous territory. You are about to hurt others — and yourself — with your own anger.




Studies show that Inositol helps many Trichotillomania suffers. I find that it reduces the urge to pull, which helps with my focused pulling. The Inositol also increases my awareness, which decreases my unfocused pulling.

Leading Trichotillomania specialist Dr. Penzel’s wrote, Inositol and OCD. He recommends the following regimen to begin Inositol: 

(1 teaspoon=2 grams, and be sure to use a measuring spoon) for an adult:

Week 1 – 1 teaspoon/2x per day
Week 2 – 1 teaspoon/3x per day
Week 3 – 1.5 teaspoons/3x per day
Week 4 – 2 teaspoons/3x per day
Week 5 – 2.5 teaspoons/3x per day
Week 6 – 3 teaspoons/3x per day

Following this regimen, I worked my way up and now take 18g each day. I do this by mixing 3 teaspoons (1 tablespoon) of inositol in water 3 times a day. I have found the Jarrow brand powder (shown above) to dissolve well. It is available on amazon for reasonable price. I mix it with warm water as it dissolves better that way. You can add it to fruit juice or other sweetened drink. I simply mix the powder with ~3oz of warm water and drink plain as it has a mild sweet taste that I actually like. In addition to Inositol, l I take 1800mg of  NAC, which I started several months before the Inositol. I did not see much progress with that alone, therefore I added the Inositol. If you are considering both supplements, choose one to start with, otherwise you will not know which is helping and or causing side effects.

I have taken Inositol on and off for 2 years. When I first started the recommended regimen over 6 weeks, I noticed many GI side effects. When I unexpectedly became pregnant a couple months later, I had to lower my dose because it increased my nausea. That did not help so I discontinued the Inositol until my morning sickness passed. Reassured by my OB that Inositol is safe while pregnant and breastfeeding, I slowly reintroduced the Inositol. I only took 1-2 because it aggravated epigastric pain I had while pregnant. The lower dose helped a bit, but not nearly as well as the recommended 3 TBSP. Now that I am back to 3 TBSP per day (which I take in one large dose at night to help my insomnia), I am definitely feeling the benefits. It decreases my urges and makes me more aware of pulling.

Here’s more details information I copied from the article about Inositol use for trich sufferers, written by trich specialist Fred Penzel:

“Obviously, before you run out and try anything new, you should always consult your physician. If your physician recommends trying this, you might also want to mention the following information to him or her:

  1. It cannot be taken together with Lithium, as it seems to block its action.
  2. The chief side effects of inositol are gas and diarrhea. Some people get this for the first few days and then it clears up. Many of those taking it never have this side effect, and some only get it when they take more than a particular amount.
  3. I have heard reports that caffeine lowers inositol levels in the body, so if you are a heavy coffee drinker, you might consider cutting down or eliminating this from your diet. Actually, stimulants such as caffeine can sometimes contribute to anxiety, jitteriness, etc.
  4. It should be purchased in powdered form, and taken dissolved in water or fruit juice. It has a sweet taste, and is chemically related to sugar. If it is allowed to stand for about 10 minutes after mixing it, it seems to dissolve better. Vigorous mixing for a few minutes also helps. If it still doesn’t dissolve well (not all brands do), stir it up and drink it quickly before it settles. The use of powder is recommended, as the larger doses required could require taking as many as 36, 500 mg. capsules per day.
  5. Inositol is a water-soluble vitamin, so although the doses appear to be large, it will not build up to toxic levels in the body. Whatever the body doesn’t use is excreted. The average person normally takes in about 1 gram of inositol each day via the food they eat. There are no reports of any harm associated with the long-term use of inositol. Some of our patients have been taking it as long as eight years now, with no problems.6. It can be built up according to the following schedule (1 teaspoon=2 grams, and be

sure to use a measuring spoon) for an adult:

  • Week 1 – 1 teaspoon/2x per day
  • Week 2 – 1 teaspoon/3x per day
  • Week 3 – 1.5 teaspoons/3x per day
  • Week 4 – 2 teaspoons/3x per day
  • Week 5 – 2.5 teaspoons/3x per day
  • Week 6 – 3 teaspoons/3x per day

A child can be built up to 3 teaspoons per day over the same six-week period. Dosages for adolescents can be adjusted according to weight. In either case, it is best to allow side effects to be the guide. If they begin to occur, it is not considered wise to increase the dosage unless they subside.

Once a person has reached either the maximum dosage, or the greatest amount they are able to tolerate, it is best to try staying six weeks at that level to see if there is any noticeable improvement. If there is none by the end of that time, it should probably be discontinued. As with any treatment, those who are absolutely positive that it will help are only setting themselves up, and may wind up more than disappointed. Everything works for someone, but nothing works for everyone.”


Trich Thinking Vs. Recovery Thinking

This is a post that I read on the UK Trichotillomania Support Site which originated at a site called Daily Strength and I have to emphasise is not my own, but it is a great resource.

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


Please visit the site for more information, or for support if you think you have any form of Trichotillomania. This can be pulling from any area, large or small amounts, which I will post more about soon.


Small Victories

I made it 10 days without pulling my hair!


We are often hardest on ourselves so after pulling a few hairs, I’m giving myself the same advice I would offer another trichsters who stopped pulling for any length of time and then pull again.

Don’t stop celebrating that victory just because you slipped up.


Although it seems like all that work was for nothing, it’s not in vain. Every time you resisted the urge to pull was a small victory, another step closer to recovery. You are building strength and training yourself not to pull.

It’s a long hard process, but you’ve already done a lot of the work. You are learning ways to be aware and self-sooth without pulling. It didn’t start overnight so it will also take time to fully stop. Next time it will be that much easier. 💜



Persistence not Perfection

Trichy Insights

Let’s strengthen those weak muscles!  

Just persist until you are successful!

My solace tonight as I persist in my journey to recovery from trich comes from comments of some of the people on the Fairlight Bulletin Board posted on Amanda’s Trichotillomania Guide.

Definition of Success

I just wanted to add another observation to all that has been said about making a commitment to not pulling. Think of it as exercise. When I started walking a couple of months ago, I thought a mile was forever. Now that I’ve been walking regularly, my stamina has increased, and a mile goes by quickly. I can’t run a marathon (yet!), but I am stronger. In the same way, as we practice not pulling, we’re building “muscles” that make it easier not to pull. The first couple of weeks are horrible, but then it gets easier–if you persist. I’ve slipped a couple of times…

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