Trichotillomania Treatment Woodland Hills

Do You Struggle With Compulsive Hair-Pulling, Skin-Picking Or Nail-Biting?

Are you confused and distressed by your uncontrollable urge, whether it’s pulling your hair (Trichotillomania), picking at your skin (Dermatillomania or Excoriation Disorder), or biting and picking at your nails (Onychophagia)? Does your compulsion shame and embarrass you? Even though you want to stop, are you unable to overcome the urges?

Perhaps your compulsive habit started when you were a child. It might be hard to explain why you do it—maybe to soothe yourself whenever you feel anxious or restless. Or conversely, you might pull your hair, pick your skin, or bite your nails at times when you are mentally checked out, like watching TV. In either scenario, whatever relief it provides is temporary, and you’re left with physical reminders of your behavior.

You Might Struggle With Shame And Embarrassment

If your hair-pulling has led to noticeable bald spots, you may use hats, scarves, or wigs to cover up the evidence. As the shame of being unable to control your compulsion becomes overwhelming, you might experience ongoing anxiety, depression, and body dysmorphia. Sadly, you may choose to isolate yourself from others and refrain from activities you enjoy rather than be found out. 

Similarly, your skin-picking or nail-biting may start as a way correct an imperfection but—in an attempt to scratch off a bump—you end up with noticeable bleeding and swelling. Using makeup and hiding your cuticles can only do so much to conceal the scars. If only you could get the overwhelming urge to pick or pull under control.

The good news is with treatment, the urges that cause body-focused repetitive behaviors (BFRBs), such as Trichotillomania and Dermatillomania, can be reduced. Utilizing the Comprehensive Model for Behavioral Treatment (ComB) model, hair pulling, and skin picking disorders it’s possible to manage your BFRB.

Body-focused Repetitive Behaviors (BFRBs) Can Be Mysterious And Vexing

Although “Research suggests at least one out of 20 people has a BFRB, with trichotillomania alone believed to affect about 10 million people in the United States,” its precise cause remains unclear. [1] However, the most recent Diagnostic and Statistical Manual (DSM-5) classifies BFRBs under “Obsessive-Compulsive Spectrum Disorders.” Some genetic and environmental components associated with BFRBs include:

  • Having one or more family members who pull their hair, pick their skin, or bite their nails;
  • Suffering from other mental health disorders, such as Obsessive-Compulsive Disorder (OCD), Attention-Deficit Disorder (ADHD), or a co-existing anxiety disorder; 
  • Responding to stress, anxiety, panic, or boredom.

The Shame Associated With BFRBs Often Prevents People From Getting Help

Because those who struggle with BFRBs often feel shameful and embarrassed about it, they live with their problem in secret. Most people who suffer from Trichotillomania will do everything they can to hide their bald spots from others, even family members, for fear of being judged or considered “crazy.” Sadly, they may not realize they aren’t the only ones dealing with this issue. As a result, many put off seeking therapy for their BFRB—whether it’s Trichotillomania,  Dermatillomania, or Onychophagia.

Although you might have previously thought you could stop hair pulling, skin picking, or nail biting on your own, it’s difficult to do without therapy. However, with the correct treatment, you can receive the support you need to overcome Trichotillomania and other BFRBs.

Trichotillomania Treatment Can Help You Curb The Impulse To Pull

If you’ve made it to adulthood without getting your hair-pulling, nail-biting, or skin-picking habit under control, it probably feels like the right time to find solutions. Understandably, you may be frustrated if you tried therapy before to no avail. However, unless you worked with a therapist with expertise in treating BFRBs, chances are you didn’t have a successful outcome.

What To Expect In Sessions

As therapists specializing in BFRBs, we assure you that you’re not alone. In therapy, we will help you normalize and validate your experience so you can let go of the shame you may associate with your BFRB. By providing you with psychoeducation about your condition, you will better understand its complicated nature so you can move away from a “just stop” mindset. 

It’s also important to have a community, so we encourage you to seek out online or in-person support groups. By taking the tangible steps laid out in Trichotillomania and Dermatillomania treatment, you can regain a sense of hope and confidence so you can explore your passions without your BFRB impacting your life.

Our Approach Trichotillomania Treatment And Other BFRBs

Utilizing the Comprehensive Model for Behavioral Treatment (ComB) model, therapy will focus on identifying the five areas linked to compulsive behavior: Sensory, Cognitive, Affect, Motor, and Place. The ComB model recognizes that BFRBs meet a need, either by soothing us when we feel anxious, stimulating us when we are bored, or correcting perceived imperfections. By identifying the specific factors that cause you to pull or pick, we will assess each area:

  • Sensory – we will determine if your BFRB is triggered by a sensation that the pulling or picking behavior attempts to relieve; for example, do you pull your hair whenever your scalp feels itchy or tight? 
  • Cognitive – what thoughts or beliefs are associated with picking, pulling, or biting?
  • Affect – what mood are you in—perhaps anxious, bored, or self-scrutinizing—when you pull your hair or find an imperfection on your skin?
  • Motor – what physical positions, postures, or activities make you prone to pull your hair or pick your skin, lips, or nails?
  • Place – where and when is your habit most likely to occur?

After evaluating each factor and determining the specific nature of your BFRB, we will customize treatment accordingly. We may incorporate:

  • Challenging and reframing the distorted thoughts associated with compulsive behavior—for example, thinking “just one more time and then I’ll stop;”
  • Teaching emotion management skills so you can identify and notice when there is a shift in how you feel that puts you at risk of pulling hair or picking skin;
  • Creating behavior plans to better cope with places or events that trigger BRFBs—such as getting in and out of the shower without pulling hair;
  • Implementing mindfulness skills and relaxation techniques into your daily life—both are incredibly helpful tools to increase awareness of your behaviors if you pick or pull habitually or unconsciously; 
  • Fostering self-acceptance and compassion for yourself. You may be conditioned to self-criticism and punishing yourself due to Trichotillomania or another BFRB, which we will address in treatment.

If your BFRB co-occurs with another mental health disorder, such as OCD, ADHD, social anxiety, or depression, we will ensure the treatment we provide is comprehensive and will address all of your symptoms.

Our aim is that you feel comfortable in your own skin, no longer hijacked by the shame and stigma of your BFRB. With treatment for Trichotillomania, Dermatillomania, and Onychophagia, you can get your life back.

But You May Have More Questions About Trichotillomania and BFRB Treatment…

Are Trichotillomania and Dermatillomania considered self-harm?

While some BRFBs can cause skin irritations and lasting scars, it is a misconception that they are a form of self-harm or suicidal behavior. [2] Receiving effective treatment for Trichotillomania and Dermatillomania can be challenging because picking or pulling may produce a sense of physical relief, like scratching an itch. Using the ComB model, your therapist can help determine the factors that contribute to your BFRB and, from there, offer skills and techniques that will suppress your urges.

Why seek therapy for my BFRB? Shouldn’t I be able to stop on my own?

Treating BFRBs is not simply a matter of willpower to reduce compulsive behavior. By utilizing ComB therapy, we will collaboratively assess the pattern of your BFRB in-depth, identifying every aspect of how it gets reinforced. For example, what was your emotional state right before you pulled your hair? What were you thinking about? By tackling these triggers, among others, we can affect lasting change.

With Treatment, You Can Get Trichotillomania Under Control

We have specialists on staff ready to help you. To schedule an appointment to begin Trichotillomania treatment at our Woodland Hills therapy practice or online, please fill out the contact form to schedule a free phone consultation. 


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