Trichotillomania (TTM) and Related Body-Focused Repetitive Behaviors (BFRBs)

What is Trichotillomania?

Trichotillomania (trick-o-till-o-MAY-nee-ah; also known as TTM or “trich”) is a disorder which causes individuals to pull out hair from the scalp, eyebrows, eyelashes, or other part of the body, resulting in noticeable hair loss.

What are the signs/symptom of Trichotillomania?

The most common characteristics include:

•the inability to resist urges to pull one’s hair
•a mounting sense of tension prior to pulling one’s hair (for some)
•a sense of gratification or relief after pulling one’s hair
•noticeable hair loss
•significant impact on one’s daily functioning

Is Trichotillomania a form of Obsessive-Compulsive Disorder?

Trichotillomania is currently classified in the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) as an Impulse-Control Disorder; however, Trichotillomania has most recently been conceptualized to belong to a unique family of Body-Focused Repetitive Behaviors (BFRBs) with skin-picking, nail biting, and cheek biting. Trichotillomania does share commonalities with Obsessive-Compulsive disorder as well as Tic Disorders, however there are also significant differences that distinguish them.

Is Trichotillomania self-mutilating and/or painful?

For most individuals who pull their hair, the behavior is not intentionally self-destructive. In fact, most individuals with Trichotillomania are upset by and self-conscious about the damage caused and put forth great effort to cease the behavior. Generally individuals with Trichotillomania do not experience the hair pulling as painful.

How are Trichotillomania and BFRBs treated?

The most consistently empirically-supported treatment for Trichotillomania is Cognitive-Behavioral Therapy (CBT). This form of therapy should be provided by a psychologist with expertise in treating Trichotillomania and involves identifying “triggers” to pulling behavior as well as ways in which to interrupt the pattern of behavior and redirect the response to pulling “triggers.” Some individuals have benefitted from medication as well. Many individuals find participating in a support group and having contact with others who have Trichotillomania and other BFRBs very helpful.

How can The Center for Emotional Health help me?

The Trichotillomania and Related Body-Focused Repetitive Behaviors Treatment Program at The Center utilizes state of the art cognitive-behavioral therapy, family involvement, and emotion focused approaches to alleviate symptoms and improve self-esteem. The Center also sponsors a Trichotillomania and BFRBs support group.

How is The Center for Emotional Health uniquely experienced with Trichotillomania and RBFDs?

Dr. Deibler trained for a full year, 1999, in the treatment of Obsessive-Compulsive Spectrum Disorders, including Trichotillomania and BFRBs, as an apprentice of Dr. Charles Mansueto of the Behavior Therapy Center of Greater Washington, LLC, author of “A Comprehensive Model for Behavioral Treatment of Trichotillomania,” and a leading expert in the treatment of Trichotillomania.

Following her apprenticeship, Dr. Deibler was awarded a three-year fellowship to research Trichotillomania and Obsessive-Compulsive Disorder at the National Institute of Mental Health, where she spent three years interviewing, evaluating, and studying over two hundred individuals with these disorders and their families. Dr. Deibler produced a 160-page doctoral dissertation as a result of her efforts, “The Five-Factor Model of Personality in Trichotillomania and Obsessive-Compulsive Disorder: Implications for Diagnostic Classification” and was awarded a certificate for “Outstanding Graduate Research” by the National Institutes of Health.

Dr. Deibler has presented her works at regional, national, and international meetings and has published her work in peer-reviewed scientific journals. Dr. Deibler is an active member of the Trichotillomania Learning Center and has been involved in working with the Trichotillomania community since 1999. She has also appeared on A&E’s

, CBS evening news, It’s Your Call with Lynn Doyle (Comcast Network, Retirement Living TV), and will be appearing on CBS’s Swift Justice with Nancy Grace in the fall of 2010.