Tuesday, May 6, 2014

HRT and Stimulus Control for Trichotillomania

HRT- what is it and how can it help with your trichotillomania

HRT, also known as Habit Reversal Training is a therapeutic technique that has helped me personally with my trichotillomania.  The jist of HRT is to reverse the automatic behaviors and learn to be more mindful.   Here's the Wikipedia definition

Everyone pulls for different reasons.  Maybe you're tired, maybe stressed.. Or maybe you're just watching TV and you hadn't realized you were doing it in the first place.  Here's where HRT can help. 

One of the biggest pieces to this puzzle for me- stimulus control techniques, or habit blockers. I know this doesn't work for everyone, but again I'm just speaking about things that have worked for me.  I would also like to add that I don't hide my trichotillomania with my habit blockers.  Some choose to but that can easily become a crutch and you may find yourself pulling more because you feel like it doesn't matter, because no one can see.   The idea behind these blockers is not that they will not STOP you, but that they will help you become more aware of your actions and give you the chance to use a competing response instead of giving in to the impulse to pull. 

This can work for all types of pullers (and even skin pickers too!)  Just put bandaids on the fingers you pull with.. I know, I know- what if you pull with multiple fingers on each hand?! Wrap those babies up.  Reducing the sensation to your fingertips can help tremendously.  I've found that the blister bandaids work best for me,  because they stay on for days at a time (even through showers!) and aren't that noticeable.  I know some people have had more success with the fabric type fingertip bandaids too.  

Hats, scarves, headbands
Specifically work for scalp pullers, obviously.   Not much to say about these.  I have limited success with these kinds of things, mostly because I make the choice not to even put them on.

Acrylic or gel nails 
Works for some women.  I found it especially helpful with skin picking.  Before you have them put on, you have to ask yourself if it's in your budget (they need to be maintained every couple of weeks or even every week) and what part of your fingers you pull with.  I tend to pull with the very ends of my fingers, so the longer my acrylics are, the harder it is for me to grasp a hair, and the longer I have to come up with a competing response, like "I don't want to do this, I'm not going to do this."   For some people shorter nails work better as a habit blocker.  I've heard good things about the pointed nails.  

Oils, gels, Vaseline, hair masques
These are great for scalp pullers and eyebrow pullers.  Coconut oil is natural and actually pretty great for your hair and skin.  If I know I'm going to be home a while, I'll put some oil on and let it soak in.  The hair is slippery enough that it's harder to pull, which may make you more aware.  Or maybe just more frustrated but that's part of the process!  Vaseline is great on eyebrows I've heard.  I don't have any personal experience with that.  For me, these kinds of things only work to a certain extent.  Having "dirty" hair seems to be triggering for me.  

This is one thing I just can't do.  Gloves drive me nuts.  BUT for some people it's a great subtle thing to use outside of the house.  Great for people that pull while driving or watching tv! 

I know, sounds silly.  I know some people swear by their Tangle toys.  Sometimes just sitting with some silly putty or a rubix cube type toy can keep your hands busy.  It's making the choice to pick one of these up before you start to pull that can be difficult. 

This is just a drop in the bucket.  There are many things that work for people, and what works for one may not work for another.  Again- these aren't going to "cure" anything, but it may help you become more mindful and challenge yourself to say "I could pull this hair or pick this spot, but I really don't want to."  Now do I still want to pull? Heck yes! But I don't want to deal with the consequences.  In the moment, giving myself the chance to choose what's more important to me is huge.  It can mean the difference between a really terrible day or a great one.  

Obviously using and implementing this doesn't always work for me.  Right now I'm in a low spot.  I did wear my bandana all week, and then some, but I wouldn't say I was pull free.  I just greatly reduced my pulling.  Hey, it's something!  

What blockers do you use? What situations does it help you cope with? 

1 comment:

  1. I have a friend with a similar problem. Crocheting works for her. Keeps her mind and hands busy, yet doesn't require a lot of concentration. She only makes scarves. I used to make blankets with roses on them, etc. Or knitting. A person who loves to do one, may hate to do the other. I can do both, but choose to waste all my time on the computer, these days! :D