Kicking off this topic to discuss a condition that I happen to have been afflicted with since age 8, which is an ongoing snake in my life.

Trichotillomania is a Body Focused Repetitive Disorder in which the afflicted have a compulsion to pull out their hair, which severity is more than just grooming as it impacts daily functioning to some extent. Compulsions come and go. Some people know they are doing it, some people do not. Some people can go without compulsions for years, which is the goal of treatment.

Estimates are that 1-10% of the population have the disorder. It affects 4x as many women as men, however this could be due to men not seeking treatment and thus not being counted.

Goal of this thread will be for sufferers to move to acceptance, and work together to develop strategies to avoid further pulling.

To get things started, feel free to use this topic for support for any Body Focused Repetitive Disorder. Trichotillomania meetups in meatspace generally function as such, bringing together Dermatillomania sufferers too.

I’ve documented my own journey with it somewhat on my own website, however in short:

  • I had many pull-free years in my life, notably when I lived by the maxim “if life is difficult, you are doing it wrong” — however, this maxim can easily be misapplied to running away from existential problems instead of confronting them.

  • Pulling returned after several years, after several traumatic things occurred to me, and many existential issues appeared, which I did not have the courage to face head on — notably, as I had no moral system of integrating the cruelty necessary to break free from obligations placed upon me that shackled me smaller and smaller into a type rope battle of impossible appeasement.

  • Eventually I decided I could not take it anymore, that my state of being was unsustainable, and broke away to build myself up again.

  • This involved willingly telling the first friend ever, that I have a hair pulling disorder. As I figured if a friend did not accept me despite this, then they were not a friend worth having. They were shocked I was so ashamed about it. And were very supportive. My shame vanished that day.

  • No longer bound by the shame of the disorder, it allowed me to start confronting it, rather than hiding from it. Allowing me to start seeking treatment, and going to support groups. This opened up another 2 years of pull-free.

  • The pulling has come back in 2017, as that was another difficult year. And I’m back in the battle with it.

The need for daily practice to build up good natural hormonal release of dopamine and serotonin, as well as the elimination of cognitive dissonance to reduce cortisol, if very important, but very hard to do. Hence why this forum is so darn important. #praxis facilitates the first, #philosophy facilitates the latter.

The hardest thing I’ve found about it all, is the desire to stop. Most of the time, when I am doing it, I actually want to regulated emotional/mental pain through transference into physical stimulus. The tension-release cycle of hair pulling facilitates this. It is very hard to break out of.

You can go 6 months, or even years, without pulling, but one day, you feel tense, and you pull a single hair, and bang, the flood gates of the mental highways are open again, and it is a spiral to baldness. Which the deteriorating condition furthers into growing self-hate.

Once you are in the cycle, sometimes shaving one’s head, removing the possibility of pulling works if you are lucky, but most of the time, as soon as hair is long enough, it repeats. The repeat seems to be if you haven’t solved the cause of the pulling.

The cause of the pulling sometimes can be dermatological - perhaps dandruff, perhaps a rash, perhaps some other unique skin/hair issue. Perhaps it is biological, some drugs work for hair pullers. Perhaps it is psychological. You have to figure out which one it could be in the latest instance, as it could be different than the last time.

There is an iOS app called TrichStop that seems useful for now. So I will be giving that more of a go in this cycle.

Posted this guide on Quora on how to overcome Trichotillomania