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Trichotillomania in History

Compiled by Geoff Dean

Human hair is prominent in our appearance, and important in the way we think about ourselves. We cut, colour and plait our hair. We shape our eyebrows, and make a feature of our lashes. We trim our nostril hairs, groom our beards and manicure our moustaches. Hair is somehow a powerful symbol in the image we present to the world.

In some circumstances, hair pulling has been socially acceptable for as far back as we have records: at least several thousand years. There are records that early Greeks shaved, cut or tore out hair from their heads to lay upon the corpse or funeral pile of a friend or relative (Corson 1984).

Members of the Jain monastic sect in India regularly pluck out all the hair from their scalp as a rite to denote detachment from pain (Shome et al. 1993). New brides in the African Ila tribe ritually pluck all their husband's pubic and chin hair following consummation of their marriage (Gregersen 1983).

Removal of unwanted hair through plucking has been sanctioned in many cultures: and tweezers have been found in the tombs of some ordinary citizens of ancient Egypt (Corson 1984). But hair pulling is often associated with depression, frustration, anxiety or boredom; and the saying "I could pull my hair out!" is a common one.

Many people are trapped in a cycle of hairpulling over which they have apparently little or no control: alternately drawn by the addiction to the behaviour, and then crushed by the shame of the consequences. It comes as a gentle reassurance to learn that the behaviour was noted in the Bible; by the philosopher Epictetus; and even by Homer, our first great story teller.
More on Ancient Literature

There are also instances of hair pulling in art, often depicting distressed or mentally ill people. Artus Quellinus de Oude (1600s) depicted a woman tearing at her hair in his sculpture "The Women From the Mad House." In a drawing of St. Luke's Asylum in London (1809), Thomas Rowlandson and August Pugin show a patient pulling her hair out, with both hands full of locks (Gilman 1985).

Shakespeare gave numerous references to hair pulling, even by Romeo in the famous love story. It comes as comfort to note that the Bard does not judge the human condition, but contents himself with its description.
More on Shakespeare

The medical record of the condition is also not new, and there is reference to it made by Hippocrates, one of the founders of modern medicine, in the 5th century BC. Other, more formal, records date from the 18th and 19th centuries AD.
More on Medical Literature

The term "Trichotillomania" is the survivor from a host of terms offered by many physicians. The conclusion is, perhaps, that it is not possible to resolve upon an ideal name. This may reflect the great variety of associated behaviours and the difficulty in describing and classifying the condition in an unambiguous way.
More on the Choice of Name

It is very sweet to many people who suffered alone and unknowing, sometimes for decades, that the condition has a name, and is known to medicine. May history record, in time, that it went the way of Smallpox, and vanished from the planet.

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