Trichotillomania, more commonly known as hair pulling, is classified as an impulse control disturbance. The condition generally begins in childhood and is found more commonly in females (3% of total female population) than men (1%). The most common area for hair pulling is the front temporal section of the scalp. Plucking from other areas is also quite common including areas from the eyelashes, eyebrows, and axillary. Most people with the condition will report heightened frequency during periods of heightened stress. The condition can lead to other forms of anxiety derived from negative social experiences arising from enquiries concerning the lack of hair in some parts of the person. Medication is one of the most common forms of treatment with the following medication being most commonly prescribed with varying degrees of success, chlorpromazine, isocarboxazine, amitriptyline, imipramine, clomipramine, and desipramine. Other common forms of treatment include psychotherapy, psychoanalysis and behavioral modification therapy. In the following study, researchers from Tel Aviv University looked at hypnotherapy as a form of treatment for trichotillomania.
Three children (2 females, 1 male) with the trichotillomania condition underwent 8 weeks of hypnotherapy treatment. The mean age for the onset of the condition was 8 years old and the mean duration for noted symptoms was 19 months. All of the children showed significant hair loss in moderate to significant degrees prior to treatment.
In the first session the children and parents were asked to outline the case history, the demonstrated symptoms and other important relevant information. Parents were asked to monitor the condition, to measure the frequency and intensity of the condition and how it played out during the course of treatment. A scale rating of 1 to 10 was introduced which allowed parents to rate the severity of the condition on the differing days, with 10 being the highest. Over the course of the sessions post hypnotic suggestions were given as well as self hypnosis exercises, progressive muscle relaxation training. An audio tape was given to help the children practice self hypnosis at home as well as to reinforce the treatment given during the sessions. All of the patients in this study were monitored in person on a weekly basis for 5 to 8 weeks. Following treatment, patients were followed up in the clinic for a period of 2 to 3 months for a mean total of 16 months.
In the study the first of the children showed a significant improvement after 3 weeks of treatment and showing a complete disappearance of symptoms after 7 weeks of treatment. The second patient showed significant improvement after 2 weeks and had complete resolution of the condition after 8 weeks of treatment. The third child showed a marked improvement after 4 weeks of treatment and complete disappearance of symptoms after 16 weeks. However the child did relapse during a period of heightened stress at school 20 weeks after the first initial session. The child restarted the exercises learnt and symptoms began to lesson and after 3 weeks, the child was symptom free once again.
As with hypnosis for alopecia, hypnotherapy for trichotillomania was shown to be highly beneficial for all three participants involved in the study. However future research needs to encompass more participant numbers to replicate the findings of this study.
Cohen, H., Barzilai, A., & Lahat, E. (1999). Hypnotherapy: an effective treatment modality for trichotillomania. Acta Paediatrica (Oslo, Norway: 1992), 88(4), 407-410. Retrieved from EBSCOhost.