Safely in the privacy of my office, after the usual pleasantries, most hair pullers and skin pickers lean forward and in a hushed tone ask, So, how do I stop pulling? What do I do? My answer is this: No matter what method you use, you will have to do one crucial thing: You must completely change your relationship with your pulling or picking. With almost no exceptions, pullers* have a bad child v. punishing adult relationship with their hair pulling You swear to stop & never do it again. Suddenly you are doing it again. Then the attacks begin:
What's wrong with you??!!
You are PATHETIC!
This is disgusting. I am disgusting.
Can you imagine what ___ would think if they knew?
It's ridiculous that I can't stop this silly habit.
I'm so ugly and awful.
No one will ever love me- and I don't deserve to be loved.
These attacks may continue at a subconscious level so that you are always feeling like a failure. You're a failure because you "should " be able to stop but you can't. You are filled with shame because you believe that your behavior is disgusting and pathetic and that if you had a shred of self-discipline you'd be able to stop. You fear people will find out, or that they may know, and you're sure they would be (or are) horrified. Because you wrongly believe they should be horrified.
All of this self-berating has to stop. It won't matter what technique you use or what therapy you try or what homeopathic formula you take or what hypnotherapist you see. Until you begin to understand on a deep level that Trich (or skin picking) is a disorder, that if self-control was all it took, millions would not suffer from this, that your worth as a human being is NOT diminished by having this problem, that you are not pathetic or disgusting AND that you deserve self-compassion not contempt, you simply cannot recover from Trich or skin picking.
If you are thinking, How can it be a disorder if I "do it to myself", you still don't understand the nature of TTM and skin picking. Let me ask you this: Do you believe anorexia and bulimia are real problems? If so, how do they differ when it comes to the idea that they are self-inflicted so don't count. And two, are you aware that you are responding to an urge, whether physical or psychological, when you pick or pull? If so, where do you think that urge comes from? That's the disorder!
So what does it take to find the kind of self-acceptance and self-compassion to be able to embark on your own recovery? The answer is: THAT is the work. Recovery is not "forcing yourself to stop pulling." It's shifting the way you feel about yourself.
Reading a book called Radical Acceptance by Tara Brach may help toward this goal. Attending TLC (Trich.org) conferences and retreats may help because once you meet others with Trich & truly see they are not gross or disgusting or horrid it's easier to consider that you are not either. Therapy, even CBT therapy, would be best used for this purpose before launching into practices like habit reversal training, journaling, record keeping, affirmations and relaxation exercises. Any attempts to stop pulling, if punctuated by a stream of cruel, mean, judgmental thoughts, will fail. It's as if you have a bully living inside you. This bully has no patience for being imperfect. This bully will convince you that even if you do have four good days and one bad day, that that bad day means you are a failure and you'll "never be able to stop." And when you consider the fact that recovery generally is two steps forward, one step back, that four good days out of five may be may be the best you've done in a long while, and that that fifth day (one step back) is an inevitable part of recovery, perhaps you can see that taunting and demeaning yourself for the very process that IS recovery will be the very thing that prevents recovery. I tell my clients, when you get to the point that you can have four good days and one bad day, and on that bad day acknowledge that, while you may feel bummed out or disappointed, you actually are doing really well and there's no reason that tomorrow can't be a good or better day, well THAT'S recovery.
If on that proverbial 5th bad day (maybe its a 5th hour, maybe a 5th bad week) you attack yourself, you tell yourself that SEE, that proves I can't recover, look, I failed again, that bully will have successfully undermined real success. And if you don't support yourself through the process (even that 5th bad day is part of the process) and if you undermine real success (any improvement is success and tolerating the "one step back" and continuing to encourage yourself after a bad day is a HUGE part of success) then your inner bully will win and you won't get where you want to be.
Until you can honestly say that you love yourself EVEN if you are pulling just like you would continue to love your child, best friend, spouse or anyone else you loved EVEN IF THEY HAD TTM or skin picking issues (and would feel compassion for them not disgust), attempts to succeed are highly unlikely to work.
Most pullers have conditional self-love. They love themselves if they don't pull. And if all support, worth, compassion and kindness is withdrawn unless you have a complete and total cessation of pulling instantly, you remain in a dynamic with yourself that is CAUSING you to fail. If, on the other hand, you can love yourself whether or not you are pulling, recovery, no matter what method you use, will be far easier than it presently is. In other words, you have to love the puller not the pulling. Then you're on your way!
