Happy New Year, All! A new year can inspire many a puller* (*puller or picker) to resolve that "This year I will stop pulling." This can be a set-up for failure however because recovery from Trich & CSP is gradual. It is common for behavioral progress to be characterized by taking three steps forward and two steps back. Also, it's very challenging to commit NOT to do something, especially something that is actually a response to an urge and often happens unconsciously. A better resolution to make is this: This year I commit to being on the path of recovery from Trichotillomania or Compulsive Skin Picking (CSP). Here is a list of things that can lay the groundwork for lifelong recovery. Committing to do any of these things means committing to recovery.
1) Learn about mindfulness meditation. Even if you never have a serious meditation practice, the concepts of mindfulness will allow you to shift your thinking about pulling. I recommend Miracle of Mindfulness by Thich Nhat Hanh. Or if you live somewhere that has a Zen Center (many cities do) most offer weekly talks on mindfulness throughout the week. Try Googling your city and the words mindfulness meditation classes or talks. You can also download some free talks or instruction. Here is one link from UCLA. http://marc.ucla.edu/body.cfm?id=22
2) Practice Self Acceptance. The best book I've ever found on the topic is Radical Acceptance by Tara Brach, Ph.D. You can get the audio version. She has recorded additional audio versions to complement the book. Most folks with Trich & CSP practice "conditional" self-acceptance (or self love). They attack themselves for having a condition over which they presently have no control. They blame themselves for pulling & picking even though these things are done in response to a physiological urge. So long as your self-acceptance is conditional, you are in a Catch-22 situation. If you pull, you hate yourself. If you hate yourself you pull. And since you will pull or pick even as you are recovering, you must learn to love and accept yourself during the process. Tara Brach's book explains exactly how to do this, so I highly recommend it.
3) Change Self-Talk Related to Pulling or Picking. In the post just before this one I outline specifically how to do this. This must be done before one makes progress with behavior reduction or cessation. There are many ways we give ourselves permission to pull, mostly by lying to ourselves. If you change the self talk without worrying about changing the behavior, the behavior will actually change.
4) Don't Fight the Urge, Use Visualization and Breathing to Reduce the Urge. Trying to fight a very strong urge is extremely difficult. If you are pulling and you have a strong urge, rate that urge from 0 to 10. 0 is no urge, 10 is your strongest urge. Maybe a 3 or 4 is an urge you could resist while an 8, 9 or 10 is impossible. Take a few minutes and focus on inhaling and exhaling but say to yourself, With each inhalation I am taking in warmth, calm, soothing energy. With each exhalation I feel my urge lessening. Imagine as you do this the urge is lessening. Say to yourself, With each inhalation I am becoming more relaxed, with each exhalation I feel my urges lessening, just a tiny bit each time. If your urge is a nine, imagine it becoming an 8.5. Then imagine it going down to an 8. Continue on this way until you get the urge down at least a few points lower. Don't try to force yourself not to pull. Just visualize lessening the urge. Maybe you'll do this exercise before you sit down at the computer or before you start reading or studying. Maybe you'll do it in the middle of a pulling session. Even if you continue pulling after you do the exercise, you will almost certainly pull less than if you had not done it.
5) Practice Saying No. Most hair pullers & skin pickers overcommit because they mistakenly think that saying No is selfish or being a good parent or spouse means always saying yes. The pulling or picking is a way of numbing out the resentment that comes from being a caretaker. Sometimes it requires going to therapy to address this issue. However one thing I always recommend for people who overcommit is to practice saying, "Maybe. I need to check my calendar and I'll get back to you in an hour (or tomorrow morning). That way you can spend some time thinking about whether you really DO have time to take on the commitment & whether you will feel resentful if you say yes. If you will feel resentful chances are your pulling will increase. Much pulling and picking is related to this kind of resentment.
6) Start taking N-Acetyl Cysteine if you aren't already taking it. NAC is an amino acid available without a prescription & is the only thing ever proven in a scientific double blind research study to have a measurable impact in reducing pulling. The studies have only been completed in regard to hair pulling, although there is anecdotal evidence it can help skin pickers. You can read my 2011 post on NAC which has a link to the actual study and discusses the dose to take or go to the TLC website at
www.Trich.org and read about it there.
These are just a few steps you can take to begin the journey of Trich and CSP recovery. I will add more things to the list during the next post. If you have any questions for me about recovery, please email me at claudiamilesmft@gmail.com. I will answer questions on the blog anonymously. No one's name or initials will be used.
Let 2012 be the year you commit to recovery.
Thank you for your post. I am considering seeing a practitioner in my city for support group, but cost is $25 week with three months commitment. I'm unemployed so this is not something I can afford... is there any resources for those who cannot afford expensive treatment?
ReplyDeleteHi,
DeleteI'm hoping that maybe your employment is situation has changed? so you can get to the support group you mention since a group that requires a commitment (and even a group where you have to pay something) can be better than anything else. Often when groups are free or drop-in, people just don't show up regularly. However, there are online support groups that are free. I know there was a group on Yahoo (but I don't know the exact address). Also, TLC (The Trichotillomania Learning Center) at www.trich.org does list support groups by city, and many support groups ARE free. Even if you've looked before, keep looking since new groups are starting all the time. Or if your employment situation changes, saving to get into the group you mention sounds worthwhile. Thanks for writing!
Thank you so much for this blog! I've been suffering with trich for such a long time, but have been able to somewhat control it and hide it. Ironically, as I feel I'm doing better in my life in general, I feel my trich has gotten worse. I woke up in middle of the night last night with a deep sense of terror and shame at myself and was unable to fall back asleep. Your posts really helped both to explain why my trich might be aggravated at this point in my life, and they also really helped me refocus back to compassion and mindfulness. We trichsters really have an opportunity to practice unconditional love on a deep level I suppose.
ReplyDeleteThanks so much for your comment. I'm glad to hear that things in your life are going better, first of all. Obviously that's great news. I don't think hair pulling is necessarily related to something specific going on in one's life (for example, your relationship and work life might be good), but I think it can be related to one's feelings of self-acceptance. Issues relating to boundaries can also trigger pulling (this could be anything from not being able to say no to extra work, to someone close to you who feels left out if you don't share more than you want to, to feeling responsible for someone else's happiness-- and more of course. But back to the trich, I think the paradox is that when you can truly recognize you are OK-- worthy, lovable, beautiful, good enough--whether or not you pull...when your self-worth becomes something separate from the amount of pulling you've done (or hair you have), that's when you are truly able to change. It's a lot of pressure to feel you are always "failing." It's important to look at recovery as a gradual process. Rate each day from 0 to 10, 10 being your worst day pulling, 0 being 0 pulling, and write it down. Perhaps one month you'll be able to see that you have lots of 7s and 8s, and a few 9s and 10s, and the next month you will have 5s and 6s, and just two 9s. That is gradual progress, but there's no real way to be aware of that unless you write down a number every day to refer to later. That way when you do have a couple bad days, you can look at your calendar and see that, overall, you have improved, and that the most important thing right then is to say, OK I had a bad day. It happens. But if I can still stay committed to recovery, even after a bad day, that's the best progress possible. I guarantee you it is the best progress possible, because it's those occasional really bad days that cause people to give up. I appreciate your idea that trichsters have this opportunity to practice conditional love, but on the flip side it's also frustrating! However, it's crucial to understand that trich is a condition, not you "not having will power." The more you fight yourself-- "I MUST stop STOP IT.. I have to stop doing this!!!!"--the worse things get, because you aren't acknowledging the very real condition of having trich. When you can say, OK, this is really hard, but maybe I can stop now, instead of continuing. I'm not going to tell myself that it "doesn't matter" if I stop now, because of all the "damage" I've already done, because that's not true. It ALWAYS matters if I can take a step, however seemingly small. You may want to take a look at the book Too Good For Her Own Good by Claudia Bepko (It's on Amazon for one cent plus 3.99 shipping used; or Letting Go of Shame by Ronald and Patricia Potter-Efron. :)
Delete