A frequent problem among those who pull their hair (as well as other obsessive-compulsive type disorders), is one involving the attitudes and behaviors of the significant others in their lives, i.e., husbands, wives, boyfriends, or girlfriends. You significant others can be of great help and support to the recovery process, or you can create many types of obstacles.

Of all the disorders belonging to the OCD family, trichotillomania is probably one of the least understood by both sufferers and practitioners alike. It has also been, for many years, among the most frustrating and difficult to treat for all parties concerned.

Speaking to you as both a clinical psychologist and a parent of a child with special needs, I now realize how easy it is to sit back and give other people advice on how to be objective about their child's problems. However, since I have spent the last two years learning to accept my own little boy's difficulties, I believe I may have a few insights to share with you, about what you should learn to accept in order to get a handle on these things.

Case 1: "Mrs. R___," I began, "Your daughter Marcie (nine years old) just isn't making the progress in her therapy that we had hoped she would. She hasn't been doing her homework, and it just seems that her heart isn't in it. I think she's just going through the motions, and is only coming here because she doesn't want you to get upset with her. 

Over the years, I have written a number of articles about the treatment and acceptance of Body-focused Repetitive Behaviors (trich, skin picking, or nail biting), or BFRBs as they are known. These are all very practical issues, to be sure, however, another practical issue I would like to inform you about has to do with getting your insurance company to cover the cost of treatment.

At the American Psychiatric Association (APA) conference in 1996, a paper was delivered on the treatment of obsessive compulsive disorder with inositol, one of the B-vitamins. It seemed to indicate that this might be a viable treatment for OCD. As someone who treats OCD and related disorders, I am always on the lookout for new approaches.

Recently, I looked back over the article I wrote on CBT for TTM a decade ago (The Cognitive-Behavioral Treatment of Trichotillomania) in the Spring 1992 issue of In Touch. As I looked it over, I couldn't help notice how much my understanding of the disorder has changed since then. I realize now how much more complicated it has turned out to be, and at the same time how much more we need to learn.

Trichotillomania (TTM) is a disorder in which individuals compulsively pull out their own hair to the point of noticeable hair loss. Hair may be pulled from any area of the body the head, eyebrows, eyelashes, the beard or mustache, the torso, arms or legs, or the pubic area.

TTM is, for a majority of sufferers, a disorder of shame, silent agony, inner grief, and isolation. It is one thing to lose your hair through some outside circumstance you do not appear to control such as alopecia (a disease that causes hair loss), normal pattern baldness, or chemotherapy.

When it comes to the issue of therapy for trichotillomania (TTM), a lot of time is spent discussing behavioral approaches, and how to stop pulling. As Dr. Charles Mansueto likes to point out, TTM and other Body-focused Repetitive Behaviors (BFRBs) have many inputs, and the treatment requires a comprehensive approach that deals with as many of them as possible.

Over the years, it has become apparent that prescription medications, as remedies for trichotillomania (TTM), have proved to be somewhat of a disappointment. These meds have been employed since the early 1990’s, and although they may be seen to work occasionally for some individuals, research indicates that their overall effectiveness is not great for the majority of sufferers. 

• Brush your hair or massage your scalp (check out the Vibrasonic Massage Brush, which is a battery-powered, vibrating brush)

• Brushing or massaging your dog or cat

• Practice origami.