Trichotillomania, which is closely associated with Obsessive Compulsive Disorder (OCD), is characterized by inappropriate or excessive pulling of one's own hair. In many individuals, this disorder may develop gradually and usually takes years before intervention is considered.
Although trichotillomania is behavioral in nature, a number of serious cases may be intervened with the prescription of medications such as tricyclic antidepressants or serotonin uptake inhibitors, which are the most common types of drug administered in many cases of trichotillomania.
When it comes to long-term therapy, cognitive behavioral therapy (CBT) has championed the treatment and been successful in reversing many cases of trichotillomania. In many cases, however, CBT is implemented together with the administration of medication to ensure complete reversal of the impulsive behavior.
The approach of CBT is fair and simple: rewarding desired behaviors and punishing unwanted behaviors. During the course of the treatment, CBT involves steps that are more complex and may also be applied in conjunction with additional cognitive therapy.
During the course of therapy, the therapist guides the patient to become fully aware of their actions. In the case of trichotillomania, the therapist encourages the patient to bring into consciousness the destructive behaviors (excessive hair pulling) and its possible effects on each aspect of the patient's everyday routine.
Cognitive Behavioral Therapy (CBT) on Trichotillomania
The combination of cognitive therapy and behavior therapy is perhaps the most effective form of treatment in dealing with trichotillomania. At the beginning of the therapy, the patient is encouraged to list all of the emotions and thoughts they may have experienced before the onset of the impulsive hair-pulling actions to the time the action has already stopped.
To measure and evaluate the course of the therapy, the patient's progress is accurately and regularly recorded. Thus, in the process, the therapist may recommend some changes to ensure that the effects of the therapy become optimal.
Often, the therapist intermittently exposes the patient to certain conditions that would trigger impulsive behavior to manifest in the patient's actions, after which the therapist immediately associates the unwanted behavior to feelings of anxiety or stress. Such association of negative emotions to the unwanted behavior will eventually prevent the individual from feeling the urge to manifest the behavior again.
During the therapy, the patient's commitment to the established procedures and schedules is very important to ensure complete reversal of trichotillomania. This means the patient should also be surrounded by his or her support group. Close friends and family members need to encourage the individual to complete the entire duration of the therapy.