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Trichotillomania is an impulse-control disorder or habit disorder in which individuals feel compelled to pull out their own hair. Some researchers point out that patients have an uncontrollable urge to remove hair on their body and, when they do, they feel a sense of relief. However, first, this relief is transitory and the individual will normally continue the hair pulling throughout the day and evening; and, secondly, their sense of anxiety is normally associated with other people’s reactions to the behaviour itself or the embarrassment of the fact that they have affected their appearance. When individuals pull out hair from the crown of their heads, this can cause people to stare and make unwanted comments. This problem is fairly common; however, there are many other variations including: pulling nose hair, facial hair or hair anywhere on the body. Often sufferers will try to hide the fact that they are suffering from this problem. Some men and women wear hats inside so that others don’t notice that they have large bald patches on their heads. Wearing a hat inside also helps individuals temporarily to stop this maladaptive behaviour: every time they touch their head, a movement which is in most cases unconscious, they are quickly reminded that they are in company and should not continue. Nevertheless, trichotillomania causes all sorts of anxiety problems—for example, lack of self esteem and social anxiety, and this may also lead to feelings of shame and embarrassment.


As this is a habit disorder, akin to OCD, this problem is best dealt with using a combination of pattern breaking techniques (Gafner & Benson, 2003; Williamson, 2008) and hypnotherapy. This is done by recognising the maladaptive pattern of behaviour and then interrupting it. There is evidence to support the view that using logico-rational strategies, under the remit of CBT, is helpful in the treatment of obsessional behaviour (Hayes, 2004); however, these specific cognitive interventions tend to cause early improvement which is not long-lasting (Longmore & Worrell, 2007). It is for this reason that hypnotherapy is helpful in that it helps clients to focus on, and modify, both conscious and unconscious mechanisms while effecting long-lasting change.

David Kraft PhD
UKCP Registered Psychotherapist
Fellow of the Royal Society of Medicine
Member of Council for BSCAH
Honorary Secretary for BSCAH (Mets and South)
Member of Council for the Section of Hypnosis and Psychosomatic Medicine, RSM
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