How much time have you spent thinking about your split ends? For anyone with long hair (especially someone like me who fries their bleached locks with ghds daily), they’re a sign you need a trim. But for some they’re a full-blown obsession. While occasional picking and cutting of the ends of your hair can be just a mindless time-waster, for others it’s a form of an impulse control disorder called trichotillomania. This condition is just one Body Focused Repetitive Behaviour (BFRB) – others include hair pulling and skin picking, which can easily become chronic. Research suggests about 1 in 50 people experience trichotillomania in their lifetime. Over 80% of those people are women, and it usually begins in early puberty. For many, the behaviour is a way of relieving stress or anxiety. Kate, 34, picked up the habit in her early teens. “I have no idea why I started doing it,” she says. “I definitely do it every day, and if I'm stressed or worried I do it much more. It doesn't exactly make me feel good, but it’s a way to switch off my brain. “I’m not proud of doing it – I know there are so many much better uses of my time – but that doesn’t stop me. I sometimes pick my hair in public, on the bus or at my desk at work. When I became a mum I even did it while breastfeeding, covering my child in little bits of hair. “I regularly do it for over an hour, sitting on my bed next to a lamp so I can see the ends clearly. The tiny little cut-off hairs everywhere drive my husband mad. I would like to stop doing it, but I don’t know how.”
Some published reports say it’s easier to stop smoking, which gives you an idea of how difficult it is to treat
Without treatment, trichotillomania can easily become obsessive, says Dr David Kingsley, president of the World Trichology Society, who has dedicated over 30 years to studying hair. “It’s extremely difficult for people to stop doing it,” says Dr Kingsley. “Some published reports say it’s easier to stop smoking, which gives you an idea of how difficult it is to treat. “I’ve had patients who’ve been peeling or picking their split ends for long over a decade. Most don’t even realise they are doing it, others refuse to admit to it. It’s quite deep-rooted in the psyche." The majority of women who experience this have neither had a diagnosis nor sought professional help. However, for 29-year-old Annabel, whose habit began during GCSE exam time, there was no choice but to speak up. “I clearly remember cutting individual split ends with scissors for hours when I should have been revising,” says Annabel. “Then when I went away to university I felt really unhappy and my obsession with my split ends took over my life. “It was never a vanity thing, it’s not about having no split ends. It was about taking me out of my current situation by giving me control over something. When I had a deadline I’d lock my door and do it in front of the mirror for hours, not telling anyone where I was.” By the time the Christmas holidays came around, Annabel felt desperate and told her mum, who arranged for her to see a therapist. As well as talking therapies to help treat sufferers, Dr Kingsley advises patients to think of ways to keep their hands busy at all times. To that end, non-profit London-based organisation Trichotillomania Support sells specialist jewellery (similar to charm bracelets), as well as listing support groups and offering a range of treatment courses based on cognitive behavioural therapy and habit reversal. Some of these courses last over a year. “It can take decades to train yourself to stop,” says Lucinda Ellery, a hair expert who runs an NHS-recognised studio to help those with trichotillomania. “It’s about changing perception, and having support and determination. “Different things work for different people; many clients find cognitive behavioural therapy beneficial, and others find hypnotherapy helpful.” Clinical hypnotherapist Lisa Jackson sees clients who have been picking their hair for decades, as well as others for whom it’s a new and worrying habit they want to curb.
It felt like a weird and shameful thing to be doing, but it really did hijack my life for a while
Lisa says: "I aim to remove the unhelpful habit but at the same time work together with my client to find something else that will give them a sense of comfort. That might be anything from taking regular sips of tea to playing with a stress ball to popping bubblewrap. We also agree on practical strategies such as wearing a hat or headscarf, to put a physical barrier between them and the bad habit. “Hypnotherapy aims to bring the unhelpful unconscious habit into conscious awareness. While they're hypnotised, the client isn't told they won't do these things, rather they're told that whenever they're about to do these things they will immediately stop, and then only be able to carry out that behaviour by making a conscious decision to do so. “This is a way to counteract many people's resistance to being told not to do something. The hypnosis session is then reinforced at home with the client mentally rehearsing times when they formerly would have turned to the unhelpful habit but instead see themselves performing the new, alternative strategy. It can be treated in as few as three hypnotherapy sessions, provided they don't reveal very serious emotional issues.”
Although it’s by no means easy, Lucinda is confident the behaviour can be overcome. “We can reframe the thought process and thrive despite trichotillomania. Many clients will manage to break the habit but they will be aware that it is always there and needs to be managed.” Happily, after several months of weekly therapy sessions Annabel was able to kick her split-end-picking habit. “It felt like a weird and shameful thing to be doing, but it really did hijack my life for a while,” says Annabel. “I sometimes see other girls doing it in public and want to tell them there are ways you can stop if you just ask for help.” For help and advice visit Trichotillomania Support. You can find more information about Lucinda Ellery here and Lisa Jackson here.