Tag Archives: Trichotillomania, trich, Ttm, hair pulling, self-monitoring, progress, Claudia Miles

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Reflections on Skin Picking and Hair Pulling - OCD Center of Los Angeles

Reflections on
Skin Picking and Hair Pulling

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Suffering usually relates to wanting things to be different from the way they are.

~ Allan Lokos

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Suffering

Everybody suffers. But much of our psychological suffering occurs as a result of our beliefs about how we think life “should”be, or how we would ideally like it to be. Often, it is our over-attachment to these beliefs that turns normal, everyday pain and discomfort into true suffering.

If you have Skin Picking Disorder or Trichotillomania, you may suffer needlessly as a result of this type of over-attachment to certain beliefs. An unwanted blemish or hair (or event or feeling) is not as you wish it would be, which leads to distress, which in turn leads to a picking or pulling episode. This not only worsens the physical consequences of these conditions, but leads to more psychological suffering in the form of hours (or days) of self-loathing during which you spend a great deal of time negatively evaluating yourself and your behavior.

Common negative thoughts might include “I should have been able to overcome the urge to pick or pull”, or “I look so ugly”, or “I am inadequate” or “I am hopeless”. Over time, and with much repetition, these types of thoughts become internalized into an overall negative belief system you have about yourself, which only increases your suffering.

The long-term goal of recovery is to develop more psychological flexibility by making room for all of the imperfections of real life, thus lessening the emotional suffering you experience. Life will never be 100% free of pain and suffering.  In fact, life is full of unavoidable pain, such as the pain we experience with serious illness or injury, or the death of a loved one. However, much of our psychological pain is self-created by thoughts and beliefs that are unhelpful, and which ultimately lead to picking and pulling setbacks.

If you do not measure up to what you think is acceptable, you may ultimately inhibit and prolong your recovery. Alternatively, by accepting all of life, including your imperfections, you will reduce your suffering, and move further down the road of recovery.

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1) How often do you get stuck in the trap of judging yourself and your picking and pulling behavior, and not allowing room for imperfection?

2) What specific thoughts do you have after a setback that might increase your suffering?

3) What thoughts might be more helpful in promoting your long-term recovery?

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Weekly Tip: When you experience negative self-talk, notice how this increases your suffering, and choose instead to fully accept yourself, including your imperfections.

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The OCD Center of Los Angeles is a private, outpatient clinic specializing in Cognitive-Behavioral Therapy (CBT) for the treatment of OCD, Skin Picking Disorder, Trichotillomania, and related conditions. We offer the following services:

  • Individual Therapy
  • Low-Fee Group Therapy
  • Online Therapy
  • Phone Therapy
  • Home Visits
  • Intensive Outpatient Program
We treat adults, adolescents, and children, and offer services six days a week, including evenings and Saturdays. For more information, please contact one of our client coordinators at (310) 824-5200 (ext. 4), or click here to email us.
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OCD Center of Los Angeles
http://ocdla.com

(310) 824-5200

Written by
Kelley Franke, BA and Tom Corboy, MFT

© 2016 OCD Center of Los Angeles

We will never share, rent or sell your personal information to third parties.

OCD Center of Los Angeles: 11620 Wilshire Blvd. #890, Los Angeles, California, 90025, United States

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The Big Picture

It is important to look at your overall pulling trend rather than the # of pull free days.  If pull free is your focus one bad day could bring you down, but if you look at the big picture, then you can put that one bad day in perspective with all of the good days.  I have been rating my pulling based on the system Claudia Miles describes in the following article.

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

There’s all this talk about CBT therapy being the “most” effective. I agree more with the “C” (cognitive) part than the “B” part (behavioral). The bottom line is, if you don’t change the way you look at hair pulling* (*applies to skin picking throughout) there is no lasting recovery. Just today someone told me, “I was doing better and having lower numbers* for several months. Then I started pulling more and more and felt hopeless, and now I’m back where I was.” (*Earlier in this blog I suggest people write down ONE number every day re their pulling or picking. Rate your pulling from 0 to 10, 0 being zero pulling, 10 being your worst day. That will be your “scale.” That will be the one and only way you know you are recovering. NOT the hair on your head or lashes or brows. JUST the numbers. And the goal is to move from month to month having overall lower numbers with the understanding that you will have some bad days and that real success is accepting those and moving on.)

The person above who did better for a while and then had some bad days and felt hopeless again and gave up, her story embodies all our stories. Whether the length of time you’ve done better is a few months, a few weeks, a few days, a few hours or a few minutes, and the return to increased pulling is a moment, a day or a week, that step backwards is everyone’s undoing. It was my story when I was pulling. Unless you can live through that moment and know it’s part of the process, CBT or meditation or any other method will fail You. Because recovery is, will be, two steps forward, one step back. It will be three steps forward, two steps back. It may be eight steps forward, five steps back. You have not “gone backward,” you have not “undone your progress.” Because progress won’t show on your head or your face (lashes, brows, skin) until later. Until you’ve done well, had that bad day or two, put it into context (the addiction trying to trick you into hopelessness so you will pull or pick), accepted it, checked not your hair or face right then but rather the general improvement in overall numbers, you CAN NOT RECOVER. Once you can see that those bad days will come and not let them deter you, your recovery is ASSURED.

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

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

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

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

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

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

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

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

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

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

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

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

Claudia Miles