For the last twenty years, Christina Pearson has devoted herself to improving the lives of people suffering with trichotillomania, skin picking, and related disorders. In this age of the internet, it may be hard to fathom just how little help or information was available just two decades ago. Before Christina founded the Trichotillomania Learning Center (TLC) in 1991, there was noplace for people to get reliable information about these disorders, no way for sufferers to meet each other, and no one bringing together clinicians and researchers to improve understanding and treatment.
With few exceptions, Christina and TLC have played a vital role in all the advances that have taken place in this field since that time. The tenacity and creativity she has shown in her own successful struggle with hair pulling and skin picking only makes her more of an inspiration. There is much work left to be done: the ignorance and suffering that surround these disorders is still profound. But the progress we have made is great. Christina has personally been responsible for transforming the lives of many thousands of people around the world, and she has laid the groundwork for the change still to come. She is truly my hero. Here she shares her very personal story.
- Jennifer Raikes, Executive Director, TLC
Living with Trichotillomania
At thirty years old, I was the owner of a successful telecommunications company, and I was newly sober after having received treatment in a hospital setting for severe alcohol abuse and chemical dependency. I walked into a psychologist's office at three months post-treatment, declaring, "I pull out my hair and I don't want to drink over it," and burst into tears.
I felt like I was emerging from a war zone, still in shock, excruciatingly sensitized, fumbling, with no language to bridge the chasms between my insides and the world. All I really knew was that if I followed Truth, whatever that was, there might be a way out of the vortex. And I knew above all else that I did not want to return to the hell of being controlled by the demons of active alcoholism. Thus, my trip to the doctor, and my admission of hair pulling. To others, this may not seem like a big deal, but for me it had been the most closely guarded secret of my life.
Only the fear of dying a miserable, cold and lonely death (which was all too clearly available to me), was enough to push me into this admission. For whatever reason, the shame I felt around the compulsive pulling of the hair on my scalp was profound, and nothing less than desperate fear was capable of motivating me to ask for help.
How odd, I know. My childhood was chaotic and unstable. But many children experience a chaotic and unstable life, and yet do not develop chronic hair pulling. (I have my own theories about this, but that's another article!) To paint the picture, let me go back to when I was a young teenager and move forward to the present. My first actual memory of pulling my hair goes like this:
I am lying on the couch in the living room reading a book. We are living in a basement apartment in Evanston, Illinois, a block from the Chicago border. It is the summer before ninth grade, which will be at the huge Evanston High School.
I am thirteen, and feel much too old for my body, which is developing without my participation. I have a hidden life, an internal loneliness for which there is no expression. I escape, as I always have, into the pages of a book. Learning to become an avid reader at a very young age had given me access to a world of great comfort and delight, and reading for me was the very safest place in the world other than sleeping. I share this because over the years to come, reading became a prison with bars forged of compulsion.
Back to the couch: I am reading. The words stream across the page, interspersed with multiple micro-breaks of attention as I glance at the end of a hair root before biting off the end and letting the hair fall lifelessly on the carpet next to me. I am totally engrossed in the story, wanting to be a character in this fantasy world so elegantly drawn for me (I was reading The Lord of the Rings trilogy at the time), and yet my fingers have a life of their own as they flit from hair to hair, seeking, stroking, hastening, tugging, all the while searching for a certain texture or sensation. The tips of my fingers tingle with electrical recognition when a proper hair is found. It is like I have struck gold when I find the "right" kind of hair. Then, it MUST be removed. This does not come as a "thought," it comes rather as a sense of rightness, a sense of "knowingness," doing necessary "busy work" in my nervous system. All the while, I am reading. When I finally put down the book, with a sense of total separateness I view the pile of long blonde hair that lies on the floor. It is like a dream. Is that really MY hair? Have I REALLY pulled it out? Did I really EAT the ends? There is no comprehension. It must not have really happened, I tell myself.
Thus began my decades-long battle with trichotillomania, or compulsive hair pulling. My life was to become a paradox, a perceptual dichotomy. On the one hand, I knew I was highly intelligent and functional, externally "looking good." On the other hand, I had no control over the inner battle with my compulsions, so I knew I was weak and must be a defective human being. The psychic conflict that this engendered tore at the fabric of my existence.
After 17 days of high school, I got a psychiatric discharge. My mother had taken me to a doctor who knew nothing about what I was doing, but he felt I should be taken out of school. I never went back. At the time, I was vastly relieved. Looking back, it only brings up a deep sorrow, as my life became so constricted by this decision. In so many ways, my compulsive hair pulling controlled and distorted my life.
My hair pulling terrified me. The results were devastating, and yet, when I entered a pulling trance, which would often last for hours, it was as if I was doing EXACTLY what was necessary. Reading was the most dangerous time, although any time I was alone, my hand might start to drift. I pulled while driving, talking on the telephone, watching TV, and during countless other times, but NEVER with another person present. A quick note here: at fifteen, I also began to pick the skin on my face, shoulders and legs.
Even though I did not complete high school, I was bright and self-motivated. During my twenties, I ran a small communications business, was somewhat active in the community, and carried on as normally as I could. Yet at night, I was terrified of being alone in my room. I cannot tell you how many times I tried to restrain my compulsions. I would tape my mouth with wide silver duct tape, pull a ski mask over my head, tie my hands together, sometimes wrapping a rope around my jaw, always internally negotiating, making deals, contracts, threats, constantly fighting, fighting, fighting, to no avail. It was as if I was a drowning woman, struggling for air. The ONLY relief came when I engaged in extricating hairs from anywhere on my body. I would cry, watching my hand rise of its own accord to my head or elsewhere. As I look back, I now explain the feeling as "neurological busy-work" that just HAD to be done.
Often, I would try to drink myself into oblivion before bed, because then I might possibly avoid a pulling frenzy. This was to lead me in later years to a severe alcohol dependency, which ultimately forced me to deal with the reality of my compulsion.
The effect of these behaviors on my life was insidious and all-consuming. I became afraid to go out in the wind and the rain, for fear of exposing bald areas. I was too scared to go swimming, be in bright lights, get a haircut, or embrace another human being. I covered my face with foundation makeup. My fear of exposure narrowed the arena in which I allowed myself to live. I felt inherently less-than, just defective. Always, always, twenty-four hours a day, was the deep gnawing awareness of my hair pulling and skin picking. Even while I was asleep, my vigilance continued.
Three years after I first walked into her office, I was still seeing the psychologist, who had no idea what my hair pulling behavior was about. Nor did she realize it was a diagnosable and somewhat treatable disorder. She never even tried to find out what it was. After being in talk therapy for many months, I found my pulling to be worse than ever-as I was no longer using alcohol or drugs to buffer myself against the waves of compulsion. I was missing about forty percent of my scalp hair, and I was in constant dread that someone would find out. I spent hours trying to hide the bald areas with scarves, clips and hats. I had no idea that one could buy a wig through a catalogue, so my fear of going to a wig shop and perhaps being exposed kept me from buying a wig or hairpiece.
At this time, my mom called from Los Angeles about a radio program she had heard the night before. The topic was Obsessive Compulsive Disorder, and they also spoke about hair pulling as a related disorder, calling it trichotillomania. In that simple phone call, my life changed. I discovered that I was not alone, that there was an actual name for my behavior. Not only was I not alone, but I found that there were literally millions of people suffering in silence, struggling from the same compulsion!
My whole world view shifted as I began the process of reaching out, making contact, telling the truth about my experience. The sense of deformity diminished, and my commitment to change grew by leaps and bounds. I entered treatment with the Director of the OCD clinic at Stanford Medical Center, Dr. Koran, who was conducting a pilot study on the use of Prozac for trichotillomania at the time. I was treated with high doses of Prozac, which had been found to be useful as an anti-obsessional medication. For me, it was useful, although many other pullers did not benefit as I did. I also learned self-monitoring techniques, along with behavior modification.
At four months into treatment, I stopped pulling my hair. The feeling of freedom was incredible. I would lie in bed, with a feeling of awe as I slipped off to sleep without pulling. My hair grew in, and I began to try and find others who suffered also. On my own, outside of the treatment prescribed at Stanford, I also engaged in biofeedback training, shame reduction counseling, and started a peer support group in my area. I also prayed and tried to meditate as often as possible. Together, all these activities transformed my life. I felt whole for the first time. I embraced parts of myself that had frightened me, that I had run from for years.
Still, I could feel how close the edge was, how just one little misstep would put me back in the vortex. After a year of no pulling whatsoever, the compulsion crept back into my life. I could feel it coming, and yet had no tools to head it off. I was stunned. Depression flooded me and I felt like a failure. Bald areas appeared again. Slowly I came to realize that this would probably be a lifelong effort, that I was not "cured," that I needed to develop living skills to cope with the potential eruptions of compulsion in my life. Again, my pulling receded as I adapted and made changes.
It has been eighteen years now, and I have had a series of pulling episodes. Each has taught me about myself, always leaving me with new tools. The last few episodes have lasted only a short while, and the subsequent depression was much easier to move beyond as I realized that real change was happening, not always fast enough for me, but definitely occurring. In fact, there has been no depression the last couple of times the behavior emerged, as it was put to rest almost immediately.
I still take a moderate dose of Prozac, as it helps both my tendency for depression and my compulsivity. I practice the techniques I have developed to cope with impulses to pull automatically now, without needing to focus on them. I take time to meditate and pray, and attempt to embrace the wild puller within as I continue to expand my abilities to communicate my emotional states of being to myself and those around me. I have found a direct connection between my ability to process emotional intensity and my impulses to pull. I have accepted now that this is part of my spiritual homework, and I need to study and practice so I can go on to the next lesson.
What this process has shown me is that who I am within is fine, my intrinsic value is not defined by an external behavior, true change IS possible, and that I do not have to be forever in bondage to a behavior that I once thought of killing myself over.
Amazingly, through my work at TLC, I have met the man who is King of my heart, and is now my beloved husband. He understands me from the inside out, and accepts me as I am. I still struggle with intimacy and self-esteem problems, and may for my whole life. I don't know. What I do know is that I am bigger than these problems, that they are only a little piece of the mystery that is me, and I get to work on them in a state of Grace, not in a state of punishment as I once thought.
Over the past eighteen years, I have spoken at length and worked with thousands of people who pull their hair and pick their skin. I have worked closely with leading clinicians, researchers and therapeutic professionals to develop effective treatment. I have networked with professionals and sufferers worldwide. The Trichotillomania Learning Center that I founded in 1991 has provided information and solace to over one million individuals with TTM, and has assisted various media presentations that have reached countless others. It is not an easy path to work in an area where so little is known, shame still prevails, and the need is so great. In many ways it's been like swimming upstream in a strong current. There are still lots of misconceptions, and many, if not most, professionals are either unaware of the disorder, or undertrained to treat it. The good news is - this is changing, with the support of the TLC membership as a driving force.
Today, with the advice and hard work of a tremendous Scientific Advisory Board, a strong supporting TLC Membership, and a committed Board and great Staff, I expect to see things move ever more quickly toward meeting the needs of the community.
As a result of my own experience, I have tremendous drive to change how the world both perceives and deals with trichotillomania and related problems such as skin picking, and it is your love and support that keeps me going as I pursue this goal. No one need suffer alone, and there is a way of living that can really offer freedom. The difference for me today is that I am not alone, I am continuously growing, and I have tremendous hope for myself and others. (And I do have a full head of hair and clear skin.) I look forward to walking this path with all of you. It is an honor and a gift. So join with TLC, become a member of this loving community, if you are not already, and let's work together to alleviate suffering and improve life!
In Love and Service,