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 involves the repetitive pulling out of one's own hair. It is conceptualized to belong to a collection of behaviors known as Body Focused Repetitive Behaviors (BFRBs), behaviors in which individuals pull, pick, scrape, or bite their own hair, skin, or nails, resulting in damage to the body.
What are the signs/ symptoms of Trichotillomania?Diagnostic characteristics include:
- recurrent hair pulling
- hair loss
- repeated attempts to decrease or stop the behavior
- distress or impairment in an area of daily functioning
Is Trichotillomania a form of Obsessive-Compulsive Disorder?
Trichotillomania is currently classified in the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition (DSM5) as an Obsessive Compulsive and Related Disorder. It is conceptualized to belong to a unique family of Body-Focused Repetitive Behaviors (BFRBs) with Excoriation (Skin Picking) Disorder, nail biting (onychophagia), and cheek/lip biting. Trichotillomania does share commonalities with Obsessive-Compulsive disorder as well as Tic Disorders, however there are also significant differences that distinguish them.
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?
Evidence-based treatment for Trichotillomania includes a specific Cognitive-Behavioral Therapy (CBT) - Habit Reversal Training (HRT). Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT) have been demonstrated to be effective supplemental strategies in addition to HRT. Some individuals have benefitted from medication as well; however, there is no current FDA-approved medication indicated for BFRBs. 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, including HRT, ComB, ACT, and DBT skills training to alleviate symptoms and improve self-esteem. The Center also sponsors a Trichotillomania and BFRBs support group.