So much of trichotillomania has to do with our sensory needs. The urge to touch, rub or look at the hair or it’s follicle. The soothing feel of a soft hair in between your hands. Can you relate? I rub the hair between my fingers, loving the scratchy sensation it makes on the lines of my fingerprint. Some hair pullers want to rub the hair on their lips, or eat the hair after pulling, some like to examine it closely.

No matter what your ritual is, all sensory related (think touch, sight, etc). Either you’re not getting enough stimulation (think: bored), or you’re getting too much sensory stimulation (think: crowded, loud party) and it forces you to need a soothing behavior like pulling your hair.

One reason trich is so hard to treat is because everyone has different sensory needs— it’s a complex disorder. There is not a one size fit approach to manage hair pulling disorder. For some people, a vibrating bracelet alerting them that they are pulling helps tremendously, while for others the need to wash their face, go for a walk or snap a rubber band against their wrist.

It’s why your friend can “stop trich” with one method while that same approach for you can be unsuccessful.

There are people who are under-stimulated and over-stimulated, and others that fall somewhere in between. Finding out where you lie is a great start to understanding what you need to control your hair pulling disorder. Here’s a breakdown of the two categories.

Sensory Over-Responsivity

“People with sensory over-responsivity are more sensitive to stimulation than most. Their bodies feel sensation too easily or too intensely. They might feel as if they are being constantly bombarded with information. These people often have a “fight or flight” response to sensation, e.g. being touched unexpectedly or loud noise. They may try to avoid or minimize sensations, e.g. withdraw from being touched or cover their ears to avoid loud sounds.”

Sensory Under-Responsivity

People who are under-responsive to sensory stimuli are often quiet and passive, disregarding or not responding to stimuli of the usual intensity in their environment. Their under-responsivity to tactile input may lead to poor body awareness, clumsiness or movements that are not graded appropriately.

Information from STAR Institute on Sub-types of Sensory Processing Disorder

Do you fall into one of these two groups or are you somewhere in between? When I heard that putting your hands in ice water may curb the urge to pull my hair, I thought, “Yes, I’ll try that.” Whereas someone who has over-responsivity to stimulus may be like, “No way, that sound awful!”. When you’re finding ideas and methods to stop trichotillomania, make sure they line up with your responsiveness level to stimuli.

If you are far leaning one way or far leaning another, it does not mean there’s anything wrong with you. You just have to line up your methods of treatments with what works for your type of response. For instance, people who are overstimulated do great by going out into nature.

Dont avoid the feeling avoid the trigger.png

You have to know your triggers to know which methods to try and which methods to avoid. Don’t avoid the feeling, avoid the trigger. If you’re having anxiety or are in the middle of a hair pulling episode, have available in your mind a list of things you can do that fall within your sensory needs.

You can go out into nature and think about what’s causing you anxiety, but if you’re already overstimulated or easily overstimulated, don’t go into a loud, crowded place and try and sort out what you’re feeling. Make sense? It’s not the anxiety that needs to be avoided, it’s the triggering stimuli.

5 senses trichotillomania grounding technique.png

So what do I do?

One way many therapists say to best deal with an episode of anxiety (or hair pulling) is to do a grounding technique.

During anxiety, there are a lot of ‘what ifs’. A grounding technique is to bring you into THE NOW. No what if.

Use your five senses to ground yourself into the atmosphere and experience of NOW. Where am I? What do I see? What do I hear? Do I smell anything? You get the gist.

How to put this into practice:

You’re feeling anxious and you want to pull your hair. Reach for something you think feels nice. For me, that would be putty and with my five senses, I begin to list in my head what it’s like. It’s smooth and malleable (touch), it smells like strawberry (smell), it’s making a popping noise (sound), I’m not tasting anything (unless eating putty’s your thing, of course 😉) (taste), and it looks red (sight). Once you have completed the grounding technique, you may notice the anxiety level has decreased because your brain is focused on the now instead of the what-if’s of the future.

Grounding is simply what is now. You don’t need to find putty or (god forbid, a parent’s worse nightmare—slime). Even if you’re in a car, you can rub the leather seat and do this same exercise. Actually touch it, feel the seams, look at the color and shades, notice the new car smell or even the awful car freshener 😉 dangling from the rear view. You may need to do this more than one time around until the anxiety starts to diminish. There’s no right or wrong order, just make sure you do all five senses.

Can i do this anywhere?

One thing you can have available at home or in your office is an empty tissue box filled with items that someone else fills for you. Inside can be things like a marble, a piece of a sponge, a golf ball, a spiky fidget ring, a LEGO. Things that are different in size and texture. Describe the object with your five senses while your hand is in the box and before you get to sight, try and guess what it is. Were you correct?

Using your senses keeps you in the now instead of inside the anxious projections your mind tends to wander towards.

How do you know this works?

Dr. Charles Mansueto, an expert clinical psychologist and noted TTM theorist explains ‘… people pull when they are either overstimulated (due to stress or either positive or negative excitement) or under-stimulated (bored or physically inactive). Hair pulling might be an external attempt on the part of a genetically prone individual to regulate an internal state of sensory imbalance. It is truly ironic that something like TTM could satisfy a biological need and yet be so destructive at the same time.’

So what does this all mean?

Your body needs the correct balance of just the right amount of stimulation to remain balanced. How will you do this? Learn what under-stimulates you. Do you need more touch? Learn what over-stimulates you? Is a place too loud or too crowded? With this new information, you can avoid triggers and add or take away things that may be sensory overloads. Once you find your balance, you may also find the need to pull your hair decreases or stops.

I’d love to know…

What are things that seem to trigger you? Do you lean towards being easy over-stimulated or easily under-stimulated? I’d love to know in the comments!