As I tilt my head down slightly and look in the mirror, I run the tips of my fingers across the part of my hair, which has visibly thinned. In sections, I grab at the short strands along my hairline, pulling them upward and frowning at the length of the recently-grown hair in comparison to the rest of my scalp. I uncap the dark brown hair powder and tap it along the top of my head – what follows is a sigh of relief. Later, the pulling starts again, and I repeat the same routine the following morning.
I have trichotillomania (TTM), a hair pulling disorder. For some extra, more professional context, here’s a great definition from Mental Health America: “Trichotillomania is a body-focused repetitive behavior classified as an impulse control disorder … which involves pulling out one’s hair. Hair pulling may occur in any region of the body in which hair grows but the most common sites are the scalp, eyebrows, and eyelids” (Mental Health America, 2025).
For me, I generally pull from the scalp, but at times I pull from my eyebrows as well. When pulling, I look for the “perfect” hair, meaning I try to pull the follicle along with the strand of hair; when I do, it feels rewarding. Once I’ve plucked out a hair, I tend to fidget with it, pinching it between my fingers, picking at the follicle, actions like that – the whole process feels incredibly soothing, especially if I’m stressed (though I do tend to pull when I’m bored as well). Because of the gratification and relaxation it provides, along with the access to my hair being easy, pulling has become habitual, and incredibly hard to try and quit.
And beyond being a habit, my TTM brings along embarrassment. I’ve pulled for years, and I remember especially in my Sophomore year of high school, I’d pull a lot, particularly in class. During lectures, tests, group discussions, it felt like my hand would move on its own, and would continue plucking hairs until a clump of strands were on my desk. I’d have to walk (usually to the front of the class) and grab a tissue to put the hairs in and then throw them in the trash. I remember feeling incredibly embarrassed yet simultaneously being unable to stop, which frustrated me, and continues to do so. I am frustrated with the thinned hairlines, the bald spots, and the clumps of hair. And it frustrates me further that as I’m writing this, I’m fighting urges to pull. TTM is draining, and since it’s been ingrained in my mind for years, breaking the pulling habit has become all the more difficult.
That said, I’ve recently found myself feeling ready to start treatment and actually follow through with this journey of being free from TTM. I don’t really know what provoked it, I assume it’s because after years of pulling I’ve grown so sick of it that I’m finally itching to stop. And as someone who has gone through brief TTM treatment as well as other forms of treatment, I can say, at least for myself, that treatment is a thousand times more effective when you truly want to change. I’ve tried TTM treatment in the past (not much, just some exercises with my therapist), but nothing ever stuck because, to be honest, I didn’t do that treatment because I wanted to stop, I did it because I was told to do it (that’s something I can go into more detail about another time).
Now, I feel ready, and I’m trying to be more proactive with keeping my hands occupied (fidgets, stress balls, etc.) and away from my scalp if I feel urges. I’m not perfect at it, but there has been improvement in the past few days! And like any treatment journey, this won’t be easy nor quick, and I’ll have slip ups along the way. And you know what? That’s completely fine! I have no idea what the future holds in store for my TTM, or if I’ll ever break the habit, but as I said in my previous post about body image, I know I have it in me to try and recover. And if you’re struggling with TTM or any related disorder, I know it’s not easy. In fact, freedom from these habits can seem impossible. But I’ll be here, cheering you on from the sidelines, and whenever you’re ready to start treatment, we’ll be on that journey together – you, me, and the millions of others battling this disorder – you are not alone.
I believe in you, and I am proud of you.
Trichotillomania (Hair Pulling). Mental Health America. (2025, March 6).
https://mhanational.org/conditions/trichotillomania-hair-pulling/
This was very sweet, i loved how you are always so open to write about your own experiences this is amazing
Thank you! Honestly it’s really healing for me to write about these experiences, I’m glad you find it so sweet 🙂
It’s inspiring how open and honest you are with your experiences. I wanna say i’m really proud of you and your perseverance! I really agree that the effectiveness of treatments is dependent on one’s willingness to participate and wanting to make a change.
Thank you Lily, you’re so kind! And yes, willingness to participate is key — I remember being in DBT and learning about the importance of willingness, though it hadn’t really clicked for me until long after. Regardless, I’m glad to have now understood that lesson since it definitely helps with starting treatment/recovery!