Excessive Hair Pulling Behavior

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Excessive Pulling Behavior in which people pull out hair from various parts of their body (e.g., their scalp, face, arms, legs), or sometimes from their pets. In many instances the hair pulling results in bald patches. The strength of the urge varies. For some, the urge is incredibly strong. In addition, some people dissociate or “zone out” while they are pulling and lose track of time.

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Hair pulling is usually preceded by an emotional feeling of tension or anxiety. During episodes of pulling, feelings of relief, relaxation, or even dissociation usually occur. After episodes of hair pulling, feelings of guilt, shame, and deep sadness are common. Hair pulling  frequently results in disruptions to one’s life such as lateness or avoidance of social interactions. There are many different triggers of hair pulling and the specific triggers vary from person to person. Common triggers include:

• being in a location in which pulling hair commonly occur (e.g., the bathroom, bedroom, or car)

• being around utensils used to pull (e.g., tweezers, mirrors)

• noticing an imperfection in the appearance of one’s hair (e.g., the shape of the hairline is not perfect)

• feeling an imperfection in one’s hair (e.g., the hair does not feel smooth)

• feeling anxious, very sad, angry, excited, or bored

• desiring to fidget with one’s hair 

• desiring to feel a certain physical feeling from hair pulling  (e.g., a tingling feeling when the hair is being pulled from the scalp)

• finding oneself hair pulling after a significant amount of time (minutes to hours) during which the person was not aware of the pulling.

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Excessive Hair pulling Behavior is defined as impulse control habit. It functions very much like uncontrollable habits: The urge to pull increases as the frequency of pulling increases; Hair pulling  feel pleasurable despite the fact that the behavior later causes deep sadness, shame, guilt, scarring, bald patches, and other negative consequences.

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what may be the feelings of hair pulling?

Hair pulling may happen when a person is awake and aware of what they're doing, frequently resulting in highly focused pulling sessions that can last several hours. Hair pulling also occurs when a person is unaware, or focused on something else; for example, when watching TV, reading, using a computer or phone. It can also happen when people are asleep. Often the experience of hair pulling is pleasurable or satisfying as a person does it, making it more challenging to change the behavior.

 

Hair pulling follows the classic negative cycle: generally, an urge to pull arises, caused by a trigger (obvious/not, internal/external). The trigger can be active (eg grooming behavior such as scanning for imperfection/difference) or just a sensation (tingling, itching) that occurs on the scalp or in the hands. Attempts at resistance are made, followed by giving in and pulling until reaching a point of satiation, which may take minutes or hours.

Afterwards, immediate feelings of satisfaction and relief start to give way to a strong awareness of the damage done, along with feelings of failure, shame, self-criticism, anxiety and being out of control, and resolution to not pull again. These negative reactions lead to uncomfortable feelings, which often triggers more hair pulling.

There is currently no established cause, but contributing factors include stress, anxiety, genetic predisposition and difficulties with impulse control (eg impatience, frustration, perfectionism).The result can be bald patches, skin/follicle infections, and sometimes permanent hair loss. The physical effects are often made significantly worse by the psychological impact of reduced confidence and self-esteem (including envy and jealousy), shame, isolation, anxiety, depression and frustration.

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How hypnosis can help hair pulling 

When pulling their hair, individuals often show many of the characteristics of being in trance. Their attention is narrowly focused, they are powerfully engaged with the activity using all senses and time may seem to disappear. And all this is often triggered by a powerful suggestion/cue that has been built and reinforced over time when in this trance-like state. So, in many ways, people who pull their hair already have a lot of experience of going into trance and using it to reinforce behavior and its benefits - they just need a bit of help to turn that power in a positive direction.

 

Hypnosis may be a very effective for hair pulling, as it can help you regain control, increase your awareness and ability to choose more beneficial responses. The hypnotic trance is also good for deep relaxation, so your stress and anxiety levels are reduced, which in turn makes it less likely that you'll want to pull your hair.

In the deeply relaxed state of hypnosis, your subconscious is more receptive to revising thoughts and actions, so you can:

• increase your awareness of how your hair pulling operates, especially increasing awareness of your hands

• regain control of your focus, so you can tolerate thoughts and urges more readily and consistently

• create and rehearse a new, personalised response that is incompatible with hair pulling

• identify trigger situations and people, and rehearse using your new response in these situations

• increase your calm, confidence and relaxation, so the need for hair pulling is reduced

• develop a "stop at one" response in case you do start to pull

• build a robust, personalised plan for dealing with any relapses quickly and constructively

• learn how to use self-hypnosis as a direct substitute for hair pulling, as appropriate

• safely and easily identify and work with any past events that may be contributing to your hair pulling

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And when your hair starts to grow back, hypnosis can also help you deepen the determination, confidence and patience to meet the challenges that are features of this part of the healing process, such as letting new hair growth be and being at ease with how your hair looks (eg if regrowth is uneven, if you decided to wear a wig or shave your head).

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Hypnosis can also help you reduce any tendency to compare yourself unfavorably with others, keeping going even if you do pull again, and begin to feel more comfortable with letting your hair get on with doing its job. In addition, if there is a past experience that is contributing to your hair pulling, the hypnotic state allows you to safely and easily work with that experience, so it no longer fuels the urge to pull your hair.