1. Let it go.
Whether it’s a critical remark from someone that is gnawing at your insides or an added task that you took upon yourself and now it’s causing you to feel overwhelmed, just let it go. There are few matters that are worth losing sleep over. And there are few things that can’t wait until tomorrow. Or next week. Or even longer. Your health is more important than holding onto what is stressing you out.
If you supervise others, practice the art of delegation and allow others to share the load. Know what you do best and hand off the rest to others who can do those jobs better than you. You are only one person. Cut the drama by cutting your schedule.
2. Sleep on it.
Your mom might have told you years ago to “sleep on it” when you were faced with making a difficult decision. That’s great advice when it comes to not only important decision-making, but to anything that might overwhelm you, such as responding to an accusatory email or angry voice message, or committing to one more task that will leave you overextended.
Studies show that the brain actually processes situations more thoroughly while you sleep. That means you wake up with a fresh – and often less emotional – perspective. Sleeping on it is the breather that will help you gain perspective and cool the heat of your emotions so you don’t overcommit to something spontaneously or out of guilt.
3. Commit to the three E’s.
I call them the Essential E’s: Eat right, exercise regularly, and embrace sleep. Fueling your body with protein and nutritious food, exercising to release those feel-good endorphins (as well as keep your heart healthier), and embracing opportunities to take a power nap or get a good seven-eight hours of sleep each night will keep you feeling fresh, rather than fatigued and overwhelmed.
When you eat right, exercise regularly, and get enough sleep, you can be at the top of your game and cope so much better when the drama of life hits. When we are emotionally spent, it’s usually because we are physically and nutritionally spent as well.
4. Stay out of it.
We often start feeling overwhelmed when we’ve extended ourselves a little too far when it comes to helping others. It’s called enabling – or “rescuing” – and women are great at it. But just because something happens in your sphere of influence doesn’t mean you are the one to run to the rescue and fix it. Just because you are made aware of something doesn’t mean God is assigning it to you. Much drama – and feelings of anxiety – can be avoided when you get in the habit of running your schedule past God first. It looks like this:
2) Seek God’s guidance
3) Stay out of it unless God gives you a clear indication to step into it. We often reverse that. We think I will do this unless God stops me. If you’re already overscheduled, think this way instead: The answer is no unless God says “go.”
5. Trust God to control what you can’t.
My friend, Donna, learned recently that the more she rests and trusts, the more God goes to bat for her. She had just learned of her mother’s sudden death in a car accident and felt the pull to leave her business to travel and be with her family and help make final arrangements. But although her heart was saying You need to go, her head was saying It’s a busy month, you can’t leave… you have to be here to keep things running smoothly. In the midst of the mental battle, she listened closely for God’s voice: Trust Me. Go do what you need to do.
Donna left her business in the hands of capable people and trusted God with the rest. When she returned a month later, she discovered her business experienced its highest grossing month on record! Then when she stepped away from her business a second time – this time for two months after receiving a breast cancer diagnosis – her business experienced its best two months ever, financially. God was affirming to her, again, the principle that He can take care of more while we rest than we can while we stress!
6. Stop trying to please everyone.
I’m sure at one point you knew clearly who the priority people were in your life. But that can get fuzzy when we are trying to please too many people, which is often the case when we begin to feel overwhelmed.
So stop being a people-pleaser and realize who matter the most in your life. Who are the people who will cry the most at your funeral? Put them first. Make everyone else take a number and wait in line. In short, that’s the simplest way to live without regrets. Priority people get the first and best of your time. Everyone else will simply have to learn to wait.
7. Pray it through.
When you start to feel overwhelmed, talk to God about it. Just giving Him your concerns will help usher peace into your life and give you a little more clarity. Philippians 4:6-7 says, “Don’t worry about anything; instead, pray about everything. Tell God what you need, and thank him for all he has done. Then you will experience God’s peace, which exceeds anything we can understand…” (NLT).
You can experience that peace, not a feeling of being overwhelmed, when you pray about what is pressuring you. Praying is equivalent to taking an intermission. It quiets your soul, clears your mind, and teaches you to leave your concerns with God, who is better at taking care of them anyway.
8. Get outdoors.
There is something therapeutic about getting outdoors, breathing the fresh air, and noticing the beauty of creation (even if it’s just some trees that line the sidewalk outside your office building).
Getting out into nature reminds us that “the earth is the Lord’s, and everything in it” (Psalm 24:1) and it makes us realize that the petty things of this earth that overwhelm us don’t really matter in the scope of eternity.
9. Reduce the clutter.
Do you realize that just by cleaning off your desk, getting rid of too many clothes in your closet, or clearing the kitchen counter can help you feel less overwhelmed? Everyone needs a clean, clear space to think, work and exist. Where is yours?
When there is less clutter, there are less choices to make and less time spent trying to find things that get lost in the mess. How many times have you lost your keys right as you are trying to leave the house? Keeping all belongings in a designated space will prevent this issue, and save you the frustration of misplacing important items. Simplify your work or living space. It brings peace.
10. Go off the grid.
Imagine spending a whole day (or maybe even a week!) being inaccessible – no internet, no interruptions, no demands. Just you and the quiet. Most high-level business people need this at least one or two weeks a year in order to maintain their creativity, energy, and overall sanity. But you and I can try it in smaller chunks – like for an hour or two a day – if that’s what it takes to ease your anxiety.
The world won’t stop if you do. You’ll just get the rest you need so you can perform better when you return to your desk, computer, or cellphone. Go off the grid by carving out time periods when you cannot be reached. Shut down your computer. Turn off your cellphone. Rediscover quiet and recollect your thoughts.
We often believe that we must respond to every request, every email, and every text or voice message immediately. That not only leaves us feeling overwhelmed, but it trains others to expect us to be at their beck and call. Practice the art of being inaccessible (so you can quietly reflect) and trust God that when you take the time to rest He won’t punish you for it by making you miss important opportunities.
By Cindi McMenamin
is a national speaker who helps women strengthen their walk with God and their relationships. She is the author of 15 books, including the best-selling When Women Walk Alone (more than 125,000 copies sold), When You’re Running on Empty, and her newest book, Drama Free, upon which this article is based. For more on her speaking ministry, books, or free articles to strengthen your soul, marriage, or parenting, see her website www.StrengthForTheSoul.com.
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 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!
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.
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
“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
ACCEPTANCE: allowing urges, emotions, thoughts and feelings to occur without attempts to control them.
Acceptance does NOT mean a hopeless acceptance of the fact you have trichotillomania.
ACT is an acceptance-based, behaviorally oriented therapy. It was first proposed by Hayes et. al. (1999), but I believe Dr. Woods is the first to study treating ttm with ACT.
ACT Therapy � TLC Retreat Notes
Credit Sue Price notes – TLC Conference Session
TLC Retreat Session September 2002
Acceptance and Commitment Therapy
Douglas Woods, Ph.D.
Why work on acceptance? Dr.Woods conducted an online study which showed that pullers who are less accepting of private events tend to have stronger urges to pull and more severe pulling. [I found the concept of “private events” confusing at first. From what I can tell, it’s anything that happens inside you that you experience privately. As he said: thoughts, feelings, emotions, urges].
People follow rules not experience. He cited a study where people played a slot machine that was rigged to never pay off for the player. The people who were told that the machine WOULD pay off eventually, played longer than the people who were not told anything. The point is, people follow rules over their experience.
Where this fits in with trich: the rule is, “if you feel bad, get rid of it.” This is what society teaches us. This works well in many situations (if the kids are too noisy, send them outside; if someone is tailgating you, change lanes, etc.). But this does not work with private events such as feelings. Trying to just get rid of bad feelings, urges, etc. does not work long term. But we keep doing this anyway because that’s the rule we’ve been taught.
ACT breaks down rules by emphasizing experiential exercises over verbal rules. The idea is that the person accepts that while the rule they’ve been taught is “get rid of it”, their experience shows that this has not worked, and then they can learn a willingness to experience those private events. [Side note: the addiction book that I’ve found so helpful makes similar points: that our society teaches us that feeling bad is intolerable, to be avoided, and if you feel bad you must do something to stop feeling bad RIGHT AWAY. This is the kind of thinking that fosters addiction, and changing this way of thinking and being willing to FEEL bad is a major part of combating addiction.]
Steps to Acceptance
1. Creative Hopelessness
Focuses on getting the person to see that attempts to stop, alter or avoid private events such as thoughts, emotions or feelings have been unsuccessful. Pulling is often another way to avoid or control private events. He asked us to think about an uncomfortable private event that we’re dealing with right now. He asked how we tried to deal with it. The common answers people gave were: avoided thinking about it, distracting themselves from it, and denial. We confirmed that none of these things work long term in dealing with the private event. It comes back.
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
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.
– 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:
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).
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.
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:
- An increased awareness of when, where, and why hair pulling occurs.
- An effort to control or change hair pulling behavior.
- Emotional regulation training to find alternative ways of dealing with negative feelings.
Here’s how I use these scientific findings to treat trichotillomania.
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.
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.
BY RICK WARREN — NOVEMBER 25, 2014
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.
Any 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.
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.
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.