Editor's Notes on Trichotillomania

Thursday, April 11, 2002

Judy mentioned that she was able to educate herself about this condition by doing research on the Internet so I set about building a set of references for her story and was definitely affected by what I found.

As an educational psychologist and counsellor I have seen a lot of problems in my life and career and some of them have a good deal more mystery to them then others. For centuries the impulsive cursing and twitching that we now know as "tourette syndrome" were dismissed as some sort of crazy people or that they were "a little funny". The condition was rare enough that most people never met anyone with the problem. However, the compulsive behaviour associated with the condition was pretty hard to ignore with a seriously affected individual and during the later part of the twentieth century the condition was sorted out someone and various treatments developed but clearly this was a problem.

The compulsion to pull out one's own hair was and as Judy points out pretty much a subject few realised was a recognisable disorder. Though I had heard of it I had to go back to my childhood memories and sure enough I remember not one but more than one case of this condition among people in our little community and others I saw in neighbouring villages. I remember it was thought of at the time as "a nervous problem". Clearly that simple description was pretty accurate but from the web sites I looked at the problem is much more common than I had ever thought. In nearly thirty years in classrooms I could not recall a case and certainly did not have any counselling client with the problem.

With a problem like this one that is relatively rare the isolation and feelings of self esteem for the person with the condition must be very tough to deal with and certainly compound the possible causative factors in developing the condition. As Judy mentioned it seems to appear in most people in adolescence and as she described it seems to be progressive. In several of the articles and sites I looked at there seemed to be some suggestion that early treatment could lessen the severity of the problem and this really becomes important to us all.

Without awareness of the condition we as parents might miss the symptoms and fail to seek immediate assistance with helping the young person deal with the problem.

Dr. Frederick Penzel, a psychiatrist, really does a fine job of walking a counsellor through the treatment that involves behaviour modification to assist a person to reduce the problem but most telling was his warning that without dealing with the underlying stress the individual is experiencing the behaviour treatment may be even more stressful then the condition.

As adults the trauma of moving through adolescence dims a bit but we all have to meet the toughest times in our lives as people little more than children and the vulnerability of us all at that time is really extreme. Besides dealing with physical, emotion and sexual development our bodies were almost at war with themselves as chemical imbalance is a part of growing up. Dr. Penzel noted this in another of his articles dealing with the use of medication to alleviate some of the symptoms but once again he points out that alone this treatment doesn't work with everyone and is only part of a complete treatment plan.

It is interesting that even some well known stress relief medication can be beneficial. But it is absolutely crystal clear from the material available on the web that this conditions needs to be addressed by a trained professional and the most important aspect is for a parent to recognise that this is a matter to be dealt with.

Judy Howe has done us a favour by bringing it to our attention and it is up to us to keep our eyes open and be aware of the nature of the condition.

Once firmly established as a compulsive behavioural problem the individual will become powerless to deal with stress in any other way.

Timothy W. Shire