This list was compiled from Instagram, from people who struggle with trich, so take their word on these suggestions when discussing the disorder.

Biggest takeaway? Listen and support over dashing out advice and solutions.

What to SAY

A discreet catch.

If they’ve given you permission, a gentle, discreet catch if you see them pulling. Maybe holding their hand in a loving way to let them know you care. If you’re not on hand-holding level, you could come up with a code word that works for both of you. Bonus if it’s something funny that’ll make them laugh (who doesn’t need more endorphins?!)

Some examples of comments could be: “Be kind to yourself.” or “I love you. You’re pulling and I know you’re trying to stop.” If that doesn’t feel genuine, ask if they’d like to go DO something. Getting up from the spot can help alleviate the urge to pull.

Send them something.

Some ideas would be a headband or fidget toy. If it’s for a big occasion a Keen bracelet would be an awesome gift for someone with trich. Even links to things about trich you’ve seen online like photos of hairstyles that would cover their bald spots, hairstylists that are trained in trichotillomania in their area, or products that cover or regrow hair. Articles about trichotillomania and latest research could also be helpful.

 Let them know you’re thinking of them and working to support and understand them.

 Or, if someone comes to you about it, simply saying “yes, I’ve heard about that” can be deeply relieving.

Compliment them.

 “You look fierce with a shaved head.” Or find some other feature besides their hair that you admire. “Your eye color is stunning.” Or better yet, a personality trait. “I love how genuine you are.” It doesn’t take a lot of effort on your part and who doesn’t like getting compliments?

 Ask, “Can you explain what it’s like for you?”  

This should be in “How to be a great listener!” handbook, Chapter One. Someone with trich may find this therapeutic and if you met them with understanding and sympathy, it normalizes the disorder, which in turn, diminishes the shame. A win-win.

Recently, I told someone about my trich and she said, “I don’t have that, but I can totally see how it could be something addictive/pleasurable” and I was surprised. She’d never heard of it before but she got it!  

What NOT to Say

“Just stop pulling!”

Okay. This one got a lot of mentions. Understandably this would seem like a sensible solution. But, if you were with someone with asthma, would you tell them “just breathe better.”?

It’s not a decision, it’s a disorder.

And without going into specifics of how OCD behaves, pulling is usually the brain’s way of telling the person “this will make me feel better”. So, although people can try to stop pulling, it’s not as easy as it seems.

“Why would you do that to your beautiful self?”

Oof. This is seemingly complimentary but the implications that one was once beautiful, and now isn’t, can have a life-long effect on self-esteem. Most of the time, people who are left with bald patches already don’t feel “beautiful” so they don’t need any other reinforcement of that.

“What is wrong with you?” or any version of “Why would you do this?”

Again: Trich is an Obsessive Compulsive Disorder, usually brought on by stress and anxiety. The person does not know WHY he or she does it, they just know it feels good and soothing. The compulsive part of it makes them keep pulling until the action is completed. Some people are unaware (subconscious pullers), only to snap out of it with a patch of missing hair, or no hair at all. Some people pull while sleeping, so it’s not something one CHOOSES to do. Asking “why” is irrelevant and unhelpful.

Diminish it or compare it to “bigger problems”

If someone with trichotillomania has come to you about it, that took a lot of courage. Most of the time, shame and embarrassment follow people with trich, so to imply it’s nothing to stress over is a massively unsympathetic point of view.

Don’t compare problems. Period. “Well, it could be worse”. Nope. No. No. Again, unhelpful.

Everyone’s got bigger problems than you, and the person next to you, but comparing them doesn’t minimize what’s going on for each of us inside. If a problem is big to someone, and you love them, then you should make it a big priority to listen.

Don’t inspect someone’s hair or ask “what happened?”.

Would you lift up someone’s shirt and ask “what happened?” if someone had put on weight? There’s no excuse to ask about someone’s physical appearance. Period.

Things like, “Why don’t you love yourself?”

There is no correlation here. People can love themselves deeply and still have OCD. Try rephrasing this to something like, “Know that I love you no matter how much hair you have.”

Don’t give tips or advice unless asked.

People with trich have usually tried EVERYTHING. From sitting on their hands, fidgeting with toys, putting bandages on their fingertips, wearing caps to bed, standing on their heads and counting backwards from 100. We don’t need advice; we need a supportive listener.

**I hope this guide was helpful. Please note that everyone differs in their responses and what they find helpful and unhelpful. It’s always best to ask the person struggling what would be helpful before diving into what you think is best. Would love to know your thoughts below in the comments.