Trichotillomania, or "Trich", the Hair Pulling Disorder

It was an ordinary day in 2006. I had just picked up my third grader from school. She was eight years old at the time, almost nine. We were back home and I was checking through her backpack to see if she had any homework. I asked her how her day had been, but she didn't seem to hear me. I looked over at her and saw that she was squinting and rubbing her eyes. Oh, great, I thought. She's going to need glasses. I asked her if she was having trouble seeing the TV. She said no, but continued to rub her eyes and look uncomfortable. I thought maybe she had a headache from straining her eyes to see the board at school. So I asked her if that was the problem. She got very agitated and told me that she could see just fine, but her eyes were bothering her and she didn't know why. At this point, it was time to take a look for myself. Thinking I would find an eyelash or a tiny piece of gravel or dust, I grabbed a flashlight and began the search.

I was shocked at what I discovered. She not only had no eyelashes trapped in her eye, but almost all of her eyelashes were gone! She had left for school that morning with a beautiful set of eyelashes, and seven hours later, here she was sitting before me with puffy red eyelids almost completely void of eyelashes. It looked bizarre, and it was obviously causing her discomfort. It was obvious she had pulled them out, but why would she do that? Why would anyone do that? I demanded to know why she had done it. I was angry that she would disfigure herself this way. She had a complete meltdown and held strong to her story that she didn't know what happened to her eyelashes.

For a while, I was angry that she kept denying doing this to herself. Then, after the shock wore off and I was able to give it some thought, I realized my mistake. I realized that she was very embarrassed and ashamed about what she had done. She was too embarrassed to admit it even to me, her own mom. I didn't want her to be afraid to talk to me, so I apologized for my angry reaction. I told her that I understood why she was embarrassed and didn't want to admit what had really happened. I explained that she wasn't in trouble and encouraged her to talk to me about it when she was ready. Letting her know that I wanted to help her, not punish her, was what she really needed to hear. The moment she realized I wanted to help her, the emotions came rushing out of her like a tidal wave! She told me that she couldn't help it, she couldn't stop herself. Sometimes, she said she didn't even know she was pulling until she found a pile of eyelashes on her desk. She also admitted that she had been doing it for a while, though she didn't know exactly how long. I felt like I must be a terrible mom. How could I not have noticed? She had been spending a lot of time in her room, but I just thought she liked being in her own space, watching her cartoons and reading her books. I never thought she was hiding something like this.

This time in her life was stressful. It was stressful for our whole family. We had recently moved to a new town. Her little sister had just turned one year old. We were all adjusting to my new status as a stay at home mom. My husband was less than a year into running his own business. She had changed schools because of the move and was having a hard time adjusting. She was actually already in counseling at this time to help her deal with all the stress from all of these changes. So at her next appointment, I asked her counselor about her eyelash pulling behavior. He said it was kind of like fingernail biting. According to him, it was no big deal. He said her eyelashes would grow back and eventually she would grow out of the behavior. We discussed some redirection techniques.

So began the "wait and watch" phase. For the next few months, whenever I would notice her pulling her eyelashes, I would ask her to sit on her hands or hold a small object in both hands while we discussed what her thoughts and feelings had been before and during the pulling. From what she was telling me, I realized that her pulling always coincided with negative thoughts and feelings about herself. Stress was a trigger. But it seemed like talking about it helped a lot. She was pulling less and less at home, but she did come home from school at times with large sections of her eyelashes just gone.

I was debating whether or not I should bring it up to her teacher. I really didn't want to put her through any more embarrassment. Then, one day I saw a preview for an upcoming episode of 20/20 about "Trich". I had never heard that word before, but the preview had peaked my interest. Was there a name for what my daughter was going through? The counselor was aware that my daughter had an ongoing problem, but he had never told us that there was a name for it. We didn't know other people had experienced these symptoms. We also didn't realize how bad it could get. Together, we watched the show. These brave women shared their stories. They revealed their "secrets", including removing wigs and hairpieces to expose vast bald patches and hair in all different stages of growth. My daughter and I were glued to our seats. The pulling, the negative thoughts, the lack of awareness, the hiding, it was all so similar to what she was experiencing. The magnitude of how bad it could get and how it could affect a person's life for years really had an impact on my daughter. I never did have to talk to her teacher, because after watching this show, she stopped pulling her eyelashes out. She has never done it again. It's been two years.

Trich is a rare disorder. It affects mostly women and girls, and usually (though not always) starts around the ages of 9-11 years. Some studies suggest that anywhere from 1% to 5% of the U.S. population are suffering from Trichotillomania. Treatments are available, such as Talk Therapy, Habit Reversal Training (HRT), and sometimes antidepressants. Many who suffer from Trich do not find relief from these treatments. Scientists are still working to pinpoint exactly what causes Trich. Some studies strongly suggest that it may be caused by a specific gene, while others are focusing on chemical imbalances in the brain. Hopefully, as science advances, more effective treatments will become available to treat this rare and mysterious disorder.

Sources: abcnews.go.com/Health/MindMoodNews/story?id=4423028&page=1, Trichotillomania a True Medical Mystery by JuJu Chang and Eleanor Yu, en.wikipedia.org/wiki/Trichotillomania, www.kidshealth.org/teen/your_mind/mental_health/trichotillomania/html, www.webmd.com/anxiety-panic/trichotillomania, http//www.trich.org