This story is written by a Ryerson University Student, Joseph Castaldo - after final editing it will be submitted to some major magazines. I worked along side Joe as did a few other Trichsters to bring this story together to be told... I feel Joe did a great job, it is compassionately spoken, giving a glimpse of what a simple act like going to the hairdressers can be like for some one suffering from Trichotillomania.
-Nancy
Nancy peers through the window of the salon, pretending to read the deals advertised inside. She’s been looking for over five minutes. “Just get off your ass and do it,” she tells herself. Nancy has already told herself twice this morning: once upon leaving her house, and again after she drove right past the salon, forcing herself to turn around.
Nancy’s blond hair is pulled into a ponytail to help conceal the thinness on top. She has trichotillomania, a disorder that causes her to pull out her hair. Nobody except her husband knows. A bald spot used to stretch like a wide scar from her crown to her hairline, but now her hair is growing back. Nancy hasn’t been to a hairdresser in over three years, and says her head needs spring-cleaning.
After five minutes, the salon is empty and she opens the door. She flinches as the bell attached to it jingles, and she steps onto the shiny marble floor, swept clean of yesterday’s hair. A woman appears from a backroom. “Do you have time to cut my hair?” Nancy stutters. After a quick shampoo, she’s whisked to a barber’s chair, and draped in a smock. Pictures of models running their fingers through thick, shiny hair smile at her in the mirror’s reflection. The hairdresser picks up a handful of Nancy’s hair, examines it, her brow furrowing, and lets it drop. Again and again she does this.
Nancy waits for it, waits for the hairdresser to exclaim, “What the hell have you done to your hair?” Underneath the smock, Nancy clutches the bracelet on her left arm - seven gold hearts with a little diamond in each one. Her husband bought it for her one Christmas as a reminder not to pull her hair.
But the hairdresser says nothing about it. She asks about Christmas shopping. “Oh, I haven’t even started yet,” Nancy says. The idle chatter goes on, and she lets go of her bracelet.
Up to a million people in Canada are doing the same as Nancy, clutching bracelets, clenching their fists, doing whatever they can to fight off the urge to pull out their hair. Studies published in the American Journal of Psychiatry estimate one to three per cent of the population has trichotillomania, but an accurate number is hard to get since many people with trich hide their problem, covering their heads under hats or scarves, too ashamed to seek help. Even if they do, help is not guaranteed - there is no cure for trich, and its cause is unknown. Doctors who study trich say it’s under-researched, especially for a disorder so prevalent. Drug treatment and therapy are available, but success is rare. Like Nancy, people with trich are left to find their own ways of dealing with the disorder.
And there’s a lot to deal with. Trich is a lifelong struggle for most, usually beginning in adolescence. But for Nancy, it arrived later in life at age 30. Soon after a sexual assault in 2000, Nancy’s hand was constantly on her head, playing with her hair. She realized it had become a serious problem one day while vacuuming her living room. Something unusual on the floor next to her favorite armchair caught her attention. She inched closer, puzzled. The vacuum handle slipped from her hand when she saw what lay at her feet. A pile of her own hair was spread across the floor, hundreds of long, golden strands that had once reached down to her waist. She had pulled it out the night before, a few strands at a time. Nancy could be watching TV or reading a book, her mind will wander and her hand will end up on her head. “Sometimes I go into a bit of a trance,” she says, “and the next thing I know, there’s a bunch of hair in my hand…Three minutes could go by, and I’ve got a bald spot.” Stress exacerbates the problem, and pulling becomes a form of relief. Anytime Nancy feels anxious, she wants to reach up and pull out a hair. “My scalp will feel a bit warm, a bit tingly. It’s almost as if the hairs call out and say, ‘Pull me.’”
Louise Lewis, 26, knows what that feeling is like. Every New Years since she was a teenager, her resolution has been to stop pulling for good; she’s broken that resolution every time. Louise has pulled from her eyebrows and eyelashes so many times that she no longer has any. She draws in her eyebrows every morning, and while many women do this, it’s not a choice for Louise. The need to pull and the brief sensation of relief afterwards is overpowering. “Every hair that I pluck feels great,” she says. “I keep plucking until I find the one that feels really good. If I don’t find it, then I’ll have no eyebrows.” Louise doesn’t tell many people she has trich. If pressed, she’ll say her eyebrows were burned off in a grease fire, and never grew back. But the friends she has told have wondered why she simply doesn’t stop pulling. Louise stresses it’s not that easy. “It’s like being addicted to a drug that’s available at all times.” An ex-boyfriend once offered her $100 a week to stop pulling. Louise took his offer, but she didn’t make it to a week. “I couldn’t make that deal. Not even for $200.”
Louise and Nancy don’t know what causes them to pull their hair. Neither do doctors. The mystery of trich’s cause has to do with the similarities it shares with other behavior disorders; trich is closely related to obsessive-compulsive disorders, anxiety disorders, and Tourette’s syndrome. Doctors aren’t even sure how to classify trich, although it’s categorized as an impulse control disorder for now. These kinds of disorders are characterized by a repetitive action done in order to achieve a sense of satisfaction or rightness, such as compulsive gambling. Most recently, brain scans on trich patients have shown that trich has more in common with Tourette’s syndrome than OCD, leading researchers to believe the arm movement involved in pulling hair may be a form of tic. Researchers at McMaster University are currently conducting a test involving Olanzapine, a drug shown to have success treating Tourette’s. The study won’t be completed until the end of the year. Other drugs used to treat trich are also used for depression, like Paxil, but success varies, and usually only lasts for a short time.
Slightly more effective than drug treatment is cognitive behaviour therapy, which teaches trich patients to be aware of when they pull. Logs are kept so patients can learn of the situations that induce pulling. Another key element learned in therapy is habit reversal training. Patients are told to do whatever they can to avoid pulling when they feel the urge, such as squeezing stress balls, or clenching their fists. Both Lewis and Roy found therapy helped them become more aware, but did little to curb their pulling habits.
Tanya Osypowich, 17, has tried both drug treatment and therapy, and while they were beneficial, it isn’t treatment that has kept her from pulling hair from her scalp for over half a year. During a stressful period last May, Tanya nearly made herself bald over a period of only two weeks. She refused to go back to school without a wig, and the sight of her head, stripped of all but a few scattered patches of blond hair was enough for her to resolve never to let herself pull again. Covering herself with a wig was also something she never wanted to repeat. “I felt really self-conscious,” she says. “I hated having to hide under it for so long.” Four months later, enough hair had grown back for her to toss the wig aside.
It now sits atop a Styrofoam head on the dresser at the foot of her bed. “I just remind myself that I never want to look like that again,” Tanya says, brushing the wig with her fingers. Tanya has also kept a lock of hair that she once pulled out, a technique she learned in therapy. She keeps it in her nightstand, a junk drawer cluttered with objects; when she pulls it out, she has to throw away a candy wrapper that lay on top of it. As much progress as Tanya has made, she’s not entirely pull-free. She still gets urges to pull, and compensates by pulling her eyebrows. “I’m not accepting the scalp pulling anymore. The eyebrows don’t bother me. I’ve got light hair anyway, so you can’t really notice.”
Nancy has also chosen not to accept pulling anymore; she hasn’t pulled for three months, not since she went to the hairdresser. The warm, tingling urge to pull still grips her, and sometimes when she’s talking on the phone her hand will flutter up to her head. But as soon as that happens, she’ll see her bracelet and remind herself not to give in. “I was so happy with my hair when I left the salon,” she says. “I went and bought a lot of expensive hair products to pamper my hair. I don’t want to lose that again.”
Nancy's Website:
http://www.trichsupport.com
Nancy's Group Link:
http://groups.msn.com/Trichotillomania