Trichotillomania: Little Acts of Harm

You already know what it feels like to pull a hair out of your scalp. Everyone does; you’ve never had any real reason to do it, but at some point in your life, you’ve just gone for it and just grabbed an individual hair and tugged. It’s one of the smallest, most harmless ways we can examine our body’s capacity for pain on our own terms: no risk of damage, no chance of any pain that’s worse than scratching yourself with your own fingernail. Maybe you found a little thrill in it, in knowing that it won’t hurt terribly, but it’ll hurt just enough that you have to psych yourself up to do it. There’s the excitement of preparing yourself to do it, followed by a satisfying little pop of pain and a rush of relief that it wasn’t as bad as you thought it was going to be. Like pulling at the loose skin at the edge of a nail, it’s one of those small acts of damage to the self that people just do, and think nothing of.

What far fewer people will ever experience is the feeling of wanting to pull hair our of your scalp. It’s in the wanting that things get a little more complex. I learned the word trichotillomania less than a year ago. It was a uniquely cathartic feeling to realize that there was a name for this, for this seemingly inexplicable pattern of behaviors and this uncomfortable urge to pull at my own hair that I’d been trying to make sense of on my own for years.

It follows the same pattern every time. First comes the normal part: the running of your fingers through your hair when you’re stressed or anxious or thinking, or just when your hands don’t have anything better to do. Then your fingers get more precise in their movements. It starts to become apparent that they’re not combing randomly, but combing like you comb a beach; they’re on the lookout for something. Then they catch what they’re searching for and there’s a quiet little rush in the discovery: a hair that feels different from the rest of them, with a texture that marks it out from the rest. (I have completely straight, utterly textureless hair, but occasionally an anomaly will grow out of my scalp that’s thicker and wirier, with a slight wave to it and a coarse and uneven texture that just feels so interesting and so satisfying to run between my finger and thumb.)

And you have to pull it. You just have to pluck it out. You can’t just appreciate the Special Hair as it is, growing peacefully out of your head with the rest of them. It has to die.

Sometimes there’s collateral damage. Sometimes the Special Hair is hidden in a little clump of normal hairs, and you can’t disentangle it from the others, so rather than risk not being able to pull the chosen hair and loosing it forever, you just pull the clump of four or five.

It doesn’t feel good, exactly. It doesn’t come with the mad, addictive endorphin rush that is the cruelest trick of more serious, more dangerous acts of self harm. It feels like lint-rolling a coat feels. That pop of pain brings with it a pop of satisfaction, the feeling of a job well done. It just trips something in a weird little corner of your monkey brain that wants that feeling to be repeated and repeated and repeated.

And then of course, if you repeat and repeat for long enough, you start to see the damage.

In preparation for writing this, I tried to pinpoint exactly when I first started pulling. I found this almost impossible to do; hair pulling for me is such a thoughtless, unconscious act that it was like trying to remember biting my nails for the first time. I don’t think I was doing it as a child, or at least not regularly enough for it to have been a problem. I have a feeling that it must have started when I was in my mid-teens. It certainly escalated to a new extreme with the stress of being an undergraduate student, and stayed at that heightened level for the next several years. These things are very difficult to de-escalate: if you become used to pulling fifteen or twenty hairs a day, you can’t go back to just three or four.

So realistically, that’s about ten years of steadily, regularly, pulling my own hair out of my head. And for years it didn’t bother me, because for years it wasn’t visible. Until, all of a sudden, it was.

I was in my early twenties when I really started to notice the damage. I had a batch of wispy flyway hair that seemed at all times to be sticking straight up from my parting like I’d just rubbed a balloon on my head. This was where the hair had been pulled and was growing back at a different rate, struggling to catch up with the rest of it. There were patches of my hair, at the temples or at the crown, that had been plucked so severely over so many years that they were visibly thinning. Looking in the mirror, the bathroom light would sometimes shine straight through these thin patches, and my stomach would lurch at how easy it was to see my scalp underneath.

It’s like having moths in your wardrobe and not even realizing it until you notice the holes they’ve chewed in your favorite coat. You still wear it; it’s not like you’ve got another coat, but now you go about your day hoping the people you pass by don’t notice the holes in the cuffs and the hems that are so glaringly obvious to you. I don’t know if it was visible to others. But it was visible to me. I would try and part my hair in ways that were unnatural to it, awkwardly flip it over itself, just to hide the patches where it was thinnest or the fly-aways were most wispy, only for it to fall back to its natural part whenever the wind blew or I ran my hand through it without thinking. I hated it. I hated noticing new patches of thinness every day. I hated looking at old pictures of myself and seeing how much thicker my hair had once been. I began to have dreams where I woke up one morning to find whole clumps of my hair ripped out, leaving my bald scalp exposed. And I couldn’t get rid of it. I couldn’t think of a way to stop pulling for long enough to let my hair heal, which surely meant that it never, ever would.  

It got to the point where as long as I had hair it would bear the scars of this stupid, irritating little compulsion.

So guess what.

I shaved my head.

I think of it as hitting the reset button. I restored my hair to its factory settings, erasing the damage I did to it after all those years, and finally giving it what it most desperately needed: a chance to take its time, and grow.

Now, it would be irresponsible not to say at this point that there are a vast number of far, far less drastic ways to manage trichotillomania than a full buzz cut. A quick google search will take you to any number of helpful pages, full of genuinely wonderful advice on how to manage your impulses and identify what it is that makes you want to pull. I’ve been following this advice myself for as long as I’ve known that my condition had a name, and it really does make a difference. I just got to the point where I wanted it all gone. I wanted a clean slate.

I’m about four months post-shave at time of writing. I’m currently rocking a scruffy pixie situation that I’m very happy with. My hair is growing thickly and evenly. Sometimes I go looking for the patches that were most affected by the years of plucking and can’t find them. It’s quite a bizarre thing to adjust to, to suddenly have a normal head of hair after all those years.

I don’t know if this means I’m rid of it for good. I doubt it. It seems far too easy and practical a fix for such a uniquely illogical and impractical problem. But when the urge returns, if it returns, I’ll have an understanding of it that I didn’t have before. I know that I’ve gone four months now without any urges to pull my hair out, and that means I have it in me to go on indefinitely.

And if that doesn’t work, at least I know I can definitely pull off a buzz cut.