Hypnotherapy and Hair Pulling (Trichotillomania)

Hair pulling, (Trichotillomania), is the most common cause of hair loss in children. First described in 1889, trichotillomania results in alopecia or hair loss, caused by the repeated pulling of one’s hair from, most often the head, followed by the eyelashes and eye brows. But the hair of any part of the body may be pulled and multiple sites may be involved. The individual with trichotillomania will have bald spots on the head or missing eyelashes or eyebrows.

There is an immense amount of embarrassment and denial associated with trichotillomania. It is common for individuals with this disorder to deny their behavior and attempt to hide their hair loss. The hair loss may be disguised by wearing wigs, hats, scarves or hair clips, or by applying make-up or even by tattooing. The act of hair pulling is a private one. Rarely does the hair pulling occur in the presence of another, except for close family members. Because of this fact, social alienation is common in hair pulling.

The hair pulling may occur either when the individual is relaxed or under stress. For some individuals with trichotillomania, certain situations, such as watching TV, lying in bed, or talking on the phone, will trigger the behavior. The individual either may focus intensely on the hair pulling or the pulling may be done unconsciously. Immediately before pulling hair, the individual with trichotillomania feels a mounting tension. This tension is relieved as a hair root is successfully pulled. Since a tingling sensation is felt upon successfully pulling a hair follicle completely from its root, a neurodermatologic connection may reinforce hair pulling as a means of tension relief. When the hair root remains intact and the hair shaft is broken, this sensation is not felt and the patient may repetitively pull hairs until successful. After pulling the hair, patient may carefully examine the hair root, and the hair bulb may be rubbed along the lips for further stimulation. The hairs may be ingested by some patients.

Hypnosis has been used in treatment of childhood trichotillomania with considerable success. The Erickson approach of hypnosis helps the child to substitute hair pulling for a stroking behavior. Other approaches to hypnosis in hair pulling teach the child that he or she has control over events in his or her life, including hair pulling.

In addition, hypnosis is extremely effective both in reducing, and in teaching the child how to self reduce, stress levels that may be a significant contributing factor to the hair pulling.

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