Trichotillomania: Treating BFRB's like Hair-Pulling Disorder and Skin-Picking Excoriation

Learn effective treatments for trichotillomania and skin-picking disorder—discover how to manage BFRBs with proven behavioral therapies and self-help strategies.
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Trichotillomania, also known as hair-pulling disorder, is a mental health disorder you have repetitive urges to pull your own hair. And it’s not just the hair on your head; people can pull hair from their eyebrows, eyelashes, and other body parts.
And this is an interesting compulsive cycle, because this condition often triggers a sense of increasing tension before pulling and a sense of relief or pleasure after pulling. Sometimes they have a ritual of touching the hair, putting it in their mouth, examining or biting the follicle, or even eating the hair. It's a compulsive cycle that can be challenging to break.
I recently interviewed Dr. Michael Twohig, an expert on trich, and in this video I’m going to summarize what I learned about what causes trichotollomania, and how it can be treated- both psychologically, with habit reversal training and breaking the cycle of giving in to urges, and with medication and nutritional treatments.
To clarify, trichotillomania isn't simply a "bad habit." The APA classifies it within the group of disorders known as "Obsessive-Compulsive and Related Disorders." These include OCD, body dysmorphic disorder, hoarding, skin-picking disorder, and other types of BFRB’s (Body focused repetitive disorders which include nail biting, lip biting, cheek chewing, and others). But for many people, these BFRB’s become so severe that people are missing large chunks of hair, or skin or they work hard to cover it up with wigs and makeup.

00:00 Intro
01:36 Free Course
03:47 Causes of Trichotillomania
06:10 Focus Vs. Habit
07:24 Treating Trichotillomania
10:08 Dealing With Urges

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Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health.
In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (the Polyvagal theory), Peter Levine (Somatic Experiencing) Francine Shapiro (EMDR), and Bessel Van Der Kolk. I also rely heavily on the work of the Arbinger institute for my overall understanding of our ability to choose our life's direction.
And deeper than all of that, the Gospel of Jesus Christ orients my personal worldview and sense of security, peace, hope, and love https://www.churchofjesuschrist.org/c...

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