Monday, January 2, 2012

Let 2012 Be the Year You Commit to Recovery

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.

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 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 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.