Ever since I first started read about Trichotillomania, it was always linked back to self harm. It was always explained as ‘more then a bad habit, it’s a form of self harm like cutting’. (Taken from ‘Love saved me from self harm’, Company Magazine, 2003) It is true that pulling your own hair out is an act of harming oneself, but is it really self harm or is it a disorder itself?
Self Harm classifications:
In 1986, Favazza (author of Bodies Under Siege: Self-mutilation and Body Modification in Culture and Psychiatry) distinguised self harm into three catorgaries; Major self harm (eg castration, which is rare and seen in psychotic patients mainly), Sterotypical Self Harm (eg head banging seen in autistic children) and Superficial or moderate self harm. This last category includes cutting, burning, skin picking, bone breaking, hitting, small overdoses and pulling your own hair out.
Then in 10 years later in 1996, Favazza breaks down the superficial/moderate self harm into compulsive, eposodic and impulsive self harm. Trichotillomania comes under compulsive. Favazza also states that this type of self harm has different roots (no pun intended there!) to impulisive self injury.
Impulsive self harm is when someone engages in harming themselves, for example cutting, and has difficulty controlling the impulse to cut. They identify themselves as a self harmer whereas eposodic self harmers will self harm now and then and not feel so ‘addicted’.
I am glad there is a distinction between self harm like cutting and the compulsive self harm of hair pulling.
But why am I glad?
Well I have been an impulsive self harmer for many years. Mainly engaging in cutting. Although I hate that word! From my personal experiences, pulling out my hair is totally different to cutting myself.
When I have cut in the past, I feel a build up inside that cannot be relieved in anyway, I need to cut. It is almost a seperate emotion itself. But with hair pulling, yes I get a sort of build up of emotion but the hair pulling is done subconsciously. Cutting is done consciously. When I have cut, it means I have to find my blade, plasters and find a safe place to do it. Hair pulling can happen anywhere at any time and can be infront of people. Because of this, cutting is about 85% behind me whereas hair pulling is very much at the forefront of my mind and causes far more frustration!!!!!!
A tip for self injurers
This is something I learnt to help me at times I want to cut. I imagine a wave. Waves come in and go out, they crash, they fall but nothing is permenant. This is the same as emotion, however bad things are, the wave does go out eventually. This has worked for me.
Stay Safe x