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This guest post was authored by Kimi Vesel, a biotech project manager.
My first year of college, I fell into an immediate and profound love affair with psychological research. Humans are complicated, and we understand ourselves better through making and testing predictions about one another, whether we realize it or not.
For the past few years, I’d been uncontrollably pulling out my own hair with alarming frequency, unable to understand why. When I took my first class on mental illnesses, I noticed that trichotillomania, the disorder I was just beginning to accept, was relegated to a one-sentence footnote in my textbook. The first weeks of that semester were spent in frigid upstate New York winter, and not long after my first realization, I had another: on days I kept my gloves on in class, I didn’t pull at all.
I’d be lying if I said my motive for studying trichotillomania was not deeply personal. It's true that when I entered the world of research, I saw an outstanding need for answers to seemingly basic questions, but what I was really after was insider knowledge that would enable me to essentially cure myself. I set out to learn everything I possibly could about Body-Focused Repetitive Behaviors (BFRBs) – which include hair pulling, skin picking and nail biting disorders – and found a job after college coordinating clinical trials.
Over time I became secure enough to take the plunge and see a psychologist. For a combination of reasons, I didn’t vibe with therapy. I quit after two sessions and never looked back.
Since then, I’ve invested a lot of trust in myself as my best advocate, playing the dual role of investigator and subject. I met more people with BFRBs, especially through events hosted by The TLC Foundation for Body-Focused Repetitive Behaviors, and began to fully grasp how pervasive this self-help mindset is among us. Many of us are too independent, under-resourced, or ashamed to entrust anyone else with our recovery.
I try to approach my own recovery in a scientific way. I remain open to trying new strategies that might be compatible with my lifestyle. In order for a strategy to have a fair chance of success, I try it out for a moderate period of time, in a variety of settings. Though it may be tempting, I don’t try more than one strategy at a time. Most importantly, I choose my strategies from published research. A study is not a guarantee that something will work for an individual person, but a peer-reviewed journal article is one of the only places where science doesn’t get muddied by marketing.
Through this method, I’ve found what works for me and what doesn’t. I can't do hats or supplements. My attempt at an undercut hairstyle was a disaster, and acrylic nails helped deter pulling at first but only for about a week. Fidgets are more trouble than they’re worth, for me, and concealing bald spots with colored sprays is helpful, but only temporary. I do like wearing clip-in extensions for special occasions, and calming activities like reading or meditating don’t do a thing for my hair-pulling, but I still feel better after mellowing out.
Then, there are what I call the “know better, do better” strategies: I know they work when I do them, but I have to actually, ya know, do them. This category includes wearing gloves or finger grips, setting a short timer in high-risk environments, and logging my pulling episodes (which is arguably the best thing a makeshift scientist can do). I’ve seen success with all of these strategies, they just take a lot of attention and emotional work, and I don’t have that all the time.
Finally, I have my tried-and-true strategies. I never pull when I’m working out, so I visit the gym regularly for my own sanity. I practice cognitive restructuring, where I try to accept myself as a person with trichotillomania instead of feeling ashamed of it, and I tell nearly every new person I meet about my condition. I borrow ideas from Cognitive-Behavior Therapy (CBT) guidebooks and articles. I recently bought a wig, and am looking forward to test-driving it.
Managing a BFRB is not a one-size-fits-all experience, nor is it one of complacency because the constant changes we all navigate in life sometimes necessitate a change of approach. My college strategy of wearing gloves wore off as the weather got warmer in Syracuse, and my busy hands still constantly try to find ways to pull in spite of my best-intentioned attempts at stopping. One would think after all the time I’ve spent studying BFRBs that I’d have unlocked the key to curing myself, as I once naively thought I could, but I haven’t.
That said, I see trichotillomania as the ultimate behavioral puzzle and haven’t given up yet. Stay tuned.
