News ID: 230792
Published: 0708 GMT September 04, 2018

Why some people are addicted to pulling their hair out

Why some people are addicted to pulling their hair out

Christina Pearson was 14 years old when she started pulling out her hair, creating bald patches on her head. She was taken to a psychiatrist, but in 1970 there was no name for her disorder, and certainly no treatment.

The doctor issued a psychiatric discharge that removed Pearson from high school. In that moment, she felt relief, wrote.

 Going to high school meant that somebody might pull off her hat and reveal that her head was mostly bare — a possibility she found “so frightening that anything was better than that”.

In the ensuing months, Pearson holed up at home, pulling out her hair and feeling, she said, like a monster. Scared and searching for relief, she eventually decided to leave.

“I hitchhiked across Mexico at 14 and was doing peyote out in the desert, all kinds of things,” she said. “I really lived a very fringe life.” At 15, she started picking her skin, her body frequently covered with open sores. By 20, she was addicted to drugs and alcohol.

At the age of 30, Pearson ‘finally got sober’. She had started a small telecommunications business with a friend in Santa Cruz, California. In 1989, she received a phone call from her mother, who had just listened to a story on the radio about a study published in the New England Journal of Medicine. “There’s a name for what you used to do,” Pearson’s mother told her, not knowing that Pearson still pulled her hair. The news that there was a name – trichotillomania – “rocked my world,” she said.

After decades of feeling shame and isolation, she began to feel hope: There were others out there living with the same condition. Pearson started a support group. A Seattle news network invited Pearson to appear on air, where she spoke about her life and provided a number for a trichotillomania hotline that she planned to operate herself.

She returned home to over 600 messages. “People were crying and sobbing and begging for help,” said Pearson, who spent a week calling each person back. “It was the best therapy I ever had, because I heard my life coming out of other people’s mouths.”

One night in bed she had what she calls a peak experience, or spiritual vision. Pearson decided to walk away from her business and devote her life to improving public awareness of trichotillomania. “I was scared shitless. Me: I’m a drug addict, I’m a small-business person, I’m in sobriety, I have an eighth grade education, and I’m going to get out there and change the world and some weird pathological disorder?” said Pearson. “I just was terrified.”

But then she adds: “When we receive that kind of inspiration, what I’ll say is this: We are called all the time. Rarely do we choose to respond.”

Step into any classroom or coffee shop and, the odds are, at least one person in the room has a body-focused repetitive behavior (BFRB), such as trichotillomania or skin picking disorder.

People with BFRBs perform repetitive self-grooming activities such as picking, pulling or biting. These can cause emotional distress and damage to the body, but the people performing the behaviors can’t stop. At their most extreme, these conditions are life threatening.

A significant minority of people with trichotillomania (commonly called ‘trich’) ingest their pulled hairs.

Over time, the hair can block the intestine and require surgical removal. Skin picking can lead to infections that require intravenous antibiotics and skin grafting.

More commonly, BFRBs take an emotional and social toll. They often begin in late childhood or early adolescence, making kids vulnerable to bullies. Echoing the experiences of many, a man in his late twenties described middle school as ‘absolute hell’ because kids perceived him as ‘the weird kid with missing eyelashes’.

Another woman, now 30, recalled watching her classmates play keep-away with the wig they had snatched off her head. Furthermore, BFRBs are often a source of conflict between child and parent, which can heighten a child’s feelings of shame and isolation. Meanwhile, in adults the condition can lead to fear of intimacy, missed job interviews, and hours lost each day to picking and pulling.  

Individuals living with BFRBs often keep their condition a secret, hiding the physical effects with makeup, wigs and layers of clothing.

As a result, many are surprised to learn just how common these disorders are. Some experts estimate that between two and five percent of people have trich and roughly five percent of people have skin picking disorder, also referred to as ‘dermatillomania’ or ‘excoriation disorder’.

Precise numbers are not available, however, because there has been no large-scale global study of BFRBs.

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