Angela’s Trichotillomania (Hair-Pulling Disorder) and Anxiety

trichotillomania hair pulling

According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), trichotillomania, is defined as the compulsive urge to pull out one’s own hair. As such, it is classified as an ‘impulse control disorder’. Trichotillomania is also related to obsessive-compulsive disorder (OCD). The actress, Olivia Munn of HBO’s Newsroom, is probably the most well-known celebrity who suffers from hair-pulling disorder. From interviews, Munn specifically pulls out her eyelashes.

Angela, a woman in her mid forties, was an office secretary. She sought my help because for the past 12 years she had been struggling with anxiety and hair-pulling disorder. Angela’s usual pattern was that she would first feel some tension building up. Then she felt the urge to pull out her hair. She would try to resist the urge but then her anxiety would become unbearable. At this point she would start to pull out some hair. Immediately afterwards she would feel relief with a pleasurable sense of gratification. However, after pulling out some of her hair, she felt guilty and depressed. She realized that she had a bald patch as a result of her compulsive urge and felt ashamed of herself. For several days she would feel angry with herself and commit to try and resist the next urge.
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