Tag Archives: trich

Medications

Medications for Body-Focused Repetitive Behaviors

 

by Jon E. Grant, MD, JD, MPH, Scientific Advisory Board Chair
Professor of Psychiatry and Behavioral Neuroscience, University of Chicago

If you are considering taking medication for BFRBs, please understand that no drug is currently approved by the Food and Drug Administration for these behaviors, that there is limited research on the use of medications for these behaviors, and that the medications often have side effects. Having said that, many individuals benefit from medications. They may find a reduction in their urges, an increased ability to resist their behaviors, and/or less obsessional thinking about their hair or skin. In most cases, medications appear most helpful when used in combination with ongoing behavior therapy.

Individuals who pull their hair or pick their skin should receive a thorough physical examination to rule out potential medical problems, such as skin disorders. In addition, individuals who eat their hair should inform their doctors of this behavior as it may lead to serious health problems.

Because no single treatment will work for everyone, a complete psychiatric assessment will aid in identifying which medication may be helpful. This assessment should include information about the BFRB (for example, does the person find the behavior pleasurable, does the individual pull or pick because they feel depressed, etc.), other mental health problems of the individual (including drug and alcohol problems), current medications and allergies, any previous trials of medication, and psychiatric problems within the family.

Women who choose to take medication either during pregnancy or during the period when they will be breast-feeding should discuss carefully the side effects of all medications (including the risks of possible birth defects) with their physician.

Clomipramine (Anafranil)
Selective Serotonin Reuptake Inhibitors (SSRIs)
Other Antidepressants
Naltrexone (Revia)
Neuroleptics
Lithium
Other Agents/ Supplements
General Considerations
Considerations for Children and Adolescents

Clomipramine (Anafranil)

The first study for trichotillomania found that clomipramine (Anafranil), a medication affecting the brain neurotransmitters serotonin and norepinephrine, was beneficial in treating hair pulling in a small number of adults. Clomipramine has both antidepressant and anti-obsessional properties. Therefore, this may be a potentially beneficial medication for those who have trichotillomania in addition to depression or obsessive compulsive disorder (OCD). Clomipramine is approved for pediatric OCD and therefore could be used in children with both OCD and trichotillomania. There have been no studies examining the use of clomipramine in skin picking, but given its benefits in hair pulling, this is also considered a potentially beneficial option for picking as well.

Clomipramine, however, may result in multiple side effects such as dry mouth, constipation, blurred vision, sexual dysfunction and weight gain. In addition, clomipramine may cause fine tremor and muscle twitching. Starting at a low dose such as 25 mg at night and slowly titrating the dose over several weeks to 150 to 250 mg/day reduces the likelihood of side effects. Clomipramine should not be used if a patient has a history of cardiac conduction disturbance or a central nervous system illness that might compromise memory. At 300 mg/day, clomipramine can cause seizures in about 2% of subjects. Clomipramine should not be used with medications such as fluoxetine or paroxetine that inhibit P450 isozymes, for they inhibit clomipramine hepatic metabolism, cause elevated serum clomipramine, and desmethylated clomipramine levels. If it becomes necessary to use these medications in combination, clomipramine levels should be monitored frequently by blood tests and by performing periodic EKGs on the person.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Several studies have examined SSRIs in treating trichotillomania and skin picking. The SSRIs include: fluoxetine (Prozac), fluvoxamine (Luvox), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro), and paroxetine (Paxil). These medications are FDA-approved for the treatment of depression or OCD or both.

Only fluoxetine (Prozac) has been rigorously studied in hair pulling and skin picking. Although the results have looked somewhat promising for using fluoxetine in skin picking, the results for trichotillomania have been largely no better than for a placebo. The other SSRIs have been used in smaller, less controlled studied and have demonstrated some limited benefits in some studies and no benefits in other studies. Individuals may report a range of improvement from dramatic reduction in behavior to no change. In general, the improvement is modest but may only last several months. These medications may be helpful in individuals with pulling or picking who also suffer from anxiety, depression or OCD.

Although the SSRIs are generally well tolerated, they may produce gastrointestinal distress, sedation, mild anxiety, headache, constipation, increased urinary frequency, weight gain, and sexual dysfunction. Fluvoxamine (Luvox) is a potent P450 1A2 inhibitor, and drug-drug interactions should be considered before it is prescribed. Given paroxetine’s (Paxil’s) relatively short half-life, the potential for flu-like SSRI discontinuation symptoms exist, particularly with abrupt cessation of high dosages of the drug. As with other anti-depressants, warnings exist for the potential association between SSRIs and suicidal thoughts and behaviors.

Other Antidepressants

Other antidepressants have been tried in the treatment of trichotillomania and skin picking. Although the data are sparse, case reports discuss the possible benefits from a range of antidepressants – amitriptyline (Elavil), imipramine (Tofranil), venlafaxine (Effexor), and doxepin (Sinequan). These medications have shown benefit for the treatment of depression and anxiety, but given the limited data for their use in trichotillomania and skin picking, these medications should not be considered first-line treatment.

Naltrexone (Revia)

Naltrexone, an opioid antagonist, is approved by the FDA for the treatment of alcohol dependence and opiate dependence. Naltrexone has been examined in two controlled studies of trichotillomania and demonstrated some potential benefit in one and none in the other. Because naltrexone reduces urges to engage in pleasurable behaviors, it may be best for those individuals who pull or pick due to strong urges and find the behavior pleasurable. It should also be considered in individuals with trichotillomania or skin picking who suffer from alcoholism, and possibly in individuals with a family history of alcohol use disorders.

Although generally well tolerated, naltrexone may cause nausea, insomnia, muscle aches, and headaches. Liver enzyme elevations are possible, especially in patients taking non-steroidal anti-inflammatory drugs, and therefore liver enzymes should be frequently monitored.

Neuroleptics

Dopamine-blocking neuroleptics have also been examined in the treatment of trichotillomania and skin picking. The rationale for their use is due to a possible link between repetitive behaviors and tic disorders such as Tourette’s disorder. A controlled study of olanzapine (Zyprexa) found that the medication was significantly more effective than a placebo in reducing hair pulling. Other neuroleptics – risperidone (Risperdal), quetiapine (Seroquel), ziprasidone (Geodon), and aripiprazole (Abilify) – may also be beneficial but there have been no controlled studies of these medications.

Neuroleptics may result in a range of side effects: extrapyramidal side effects (Parkinson-like tremor, rigidity, bradykinesia), akathesia, dysphoria, sedation, tardive dyskinesia, weight gain, and development of diabetes and high cholesterol.

Lithium

Lithium, a medication approved for the treatment of bipolar disorder, has shown some benefit in individuals with trichotillomania in uncontrolled studies. Lithium may be beneficial to those who are generally impulsive or have considerable emotional instability. Lithium may be an attractive medication option for individuals with trichotillomania or skin picking who also suffer from bipolar disorder.

Lithium can produce significant side effects. Common side effects of lithium include nausea, loss of appetite, mild diarrhea, dizziness, hand tremors, weight gain, hypothyroidism (low levels of thyroid hormone), increased white blood cell count, acne, and skin rashes. Individuals should tell their doctor immediately if they develop lack of coordination, muscle weakness, slurred speech, nausea, vomiting, diarrhea, confusion, or an increase in tremors or shaking. These symptoms may be a sign of having too much lithium in the body, which requires medical attention. With long-term use of lithium, kidney damage may also occur, but it is rare. In order to minimize risk, your healthcare provider will periodically measure kidney function and lithium levels with a simple blood test.

Other Agents

A variety of other medications have shown early promise in the treatment of trichotillomania and skin picking.

Medications that affect the neurotransmitter, glutamate, may be beneficial. Glutamate appears to have a role in the area of the brain involved in compulsive, repetitive behaviors. These medications include lamotrigine (lamictal) (FDA-approved for bipolar disorder), riluzole (Rilutek) (FDA-approved for ALS), and the amino acid N-Acetyl Cysteine. These medications, however, are not all alike and the studies suggest there may be important differences. One study of lamotrigine in skin picking found that it was not more beneficial than placebo. Although studies of riluzole have not been performed in trichotillomania or skin picking, a study in OCD found that it was no different from placebo. N-actetyle cysteine, however, was studied in trichotillomania and in adults appeared to be very promising although the study in children was no productive. N-acetyl cysteine may be beneficial alone or in combination with an SSRI (link to NAC article).

Inositol, a B-vitamin and an isomer of glucose, has also been used in the treatment of trichotillomania and skin picking. A controlled study has demonstrated improvement in OCD using inositol, but controlled studies are lacking for hair pulling and picking (link to inositol article)

General Considerations

A reasonable medication strategy is to employ a systematic trial of a specific medication while monitoring side effects. The choice of which agent to use can be based on known side effects, co-occurring disorders such as depression or OCD or alcoholism, or what has possibly worked for family members. Rating scales can be used to assess the degree of hair pulling or skin picking as well as global measure of improvement. The dose of the medication should be built up over time until complete benefit is obtained or to the maximum or best-tolerated dose. An appropriate period of time should be allowed (8-12 weeks or longer) before deciding whether a benefit has been achieved. If the benefit is only partial, the medication can either be changed or another medication can be added. Always consult your physician before abruptly stopping a medication. Also, individuals should be informed that medications appear most helpful when used in combination with ongoing behavior therapy.

Considerations for Children and Adolescents

In the case of adolescents, the general recommendation is first to use behavioral therapies before considering medication and then only use medication in severe cases. Many medications may cause suicidal thoughts in children and adolescents and therefore medications must be used very cautiously in this population and suicidal thinking should be monitored frequently.

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.