How can I help my child?

First of all, ask yourself if you believe the following statement:

It is better to be a happy and accomplished person who pulls hair than it is to be an anxious and unproductive person with hair.

Now some philosophical things which I feel strongly about:

The shame and loss of self-esteem are the worst parts of trich. It would be nice to have hair but veteran trichsters will tend to tell you that they felt more than half-cured when they dealt with the emotional issues of isolation and feeling like a freak.

It is good for anybody to have hobbies and skills. If you can direct your child to hobbies which involve hands-on activity this might have the bonus of helping direct the hands away from the hair.

The sense of accomplishment and the stress-relief from losing oneself in a hobby also have the potential of helping a trichster stop pulling.

Whether you guide your child to these activities inconspicuously or choose to do it more directly by pointing out the wisdom of the action when defending against trich impulses, don't make it sound like a punishment. Even if you are sure that certain aspects of the behavior are conscious, most of the behavior is at this time beyond your child's conscious control. Punishment increases the stress your child already feels over this and decreases the enjoyment of the activities you want your child to substitute for pulling, and thus can reinforce the urge to pull. This is not to say not to punish your child for anything. Carry on with parenting as normal, yet try to remember that part of the frustration of trich is the growing sense of failure the puller feels when they realize they don't know how to stop despite all of the incentive they have been given to stop.

I hope that you aggree that even if the pulling never stops, the gift of these substitute activities can help your child be a happy, well-rounded person with or without hair.

Also, the gift of a secure relationship with a parent is irreplaceable. If you have already shown to your child your frustration over their pulling, that is okay. You were honest. Hopefully to your own honest feelings you can add the realization that there are a lot worse things than pulling out hair. Also, hopefully you can learn to separate the hair-pulling behavior both from your feelings about anything you might have done wrong and anything you believe about your child's ultimate potential to find happiness in life.

If you can help your child also separate the hair-pulling behavior from his or her sense of self-worth, your child will be spared the worst effects of trich and will be strong enough to face the harsh realities of life without hair.

That said, I know that you still want to hear something more concrete.

First there is Mike Grant's on-line support group for parents.  (mailto:ttmparents@aol.com)

Now some advice, much taken from the posts of a parent whose child is in remission, some from those other sites around the web:

• Call around and find a doctor familiar with trichotillomania.
• If you simply can't find a doctor familiar with trich, and even if you have, you might want to go to your first appointments armed with literature, for instance print-outs from the board or materials from TLC.
• Realize that things do not get better overnight--recovery is hard work a very slow.
• Counseling might be in order for the other issues which crop up when this frustrating disorder is being dealt with.
• This counselor needs to be chosen specially too. He or she needs to be a good fit for your family. Trich is poorly understood. Flexibility and resourcefulness are both important traits for a counselor who is treating a trichster, whether that trichster is a child or an adult.
• The trichster and the trichster's parents need to be honest with the counselor about their relationship and their feelings, including their pain.
• There is no reason to think hospitalization would be required.
• There is no reason to think meds would be required unless there is a concurrent diagnosis which is typically treated with meds. Behavior modification or cognitive behavior therapy should be used before or along with meds.
• Some children just aren't ready to deal with this consciously "now" and might need to be given space while they come to terms with this.
• Some parents and counselors don't want young trichsters to know that the disorder has an official name or many other people who do the same thing. Some don't want children writing into the bulletin board. There are many pros and cons. Self-acceptance is good yet it is understandable that parents don't want to give their children an excuse to accept a behavior they might be able to overcome without too much trauma. However, if the child is suffering from feelings of isolation and shame, it might be worthwhile to let the child know they aren't the only one, that there is something more happening inside them than just a lack of willpower.
• For those parents who would like their children to be able to communicate with other trichsters but are worried that the Fairlight bulletin board is simply too adult-oriented, there is a possibility that when Fairlight updates the main bulletin board programming a separate site will be created for children or teens, as well as a special forum for parents of trichsters.
• However, without ever mentioning the word "trichotillomania" to your child (and even without seeing a doctor) you can start to implement strategies mentioned elsewhere in this FAQ. For instance, many parents have found that simply eliminating raisins, peanut butter, cola and other potential trigger foods from their child's diet seems to curb the pulling. The most recent person to mention this also added bananas to their diet because potassium has been mentioned so often on the board.
• Examples of habit reversal techniques one might implement without a doctor can be found in Lee Baer's Getting Control, as well as other resources mentioned in this FAQ and on the net.
• Most of the advice one hears from adult trichsters on the board is still going to be "give unconditional love" and "don't pressure your child." You can take that for what it is worth since it comes from people who are still pulling but it could be worth a lot since a lot of the posters on the board have very sad memories of the results of their parents' frustration. Also, more than one parent has reported that when they have relaxed and not inspected their child as often for damage, there seems to be less damage to see anyway.
• Thus, their advice is to help in subtle ways that don't focus too much attention on your child but always let your child know you are there for them.
• Try to keep your strategies from sounding like punishments.
• For instance, a good strategy is for you to recognize your child's triggers, such as watching too much TV or staying up too late. So, you should guide your child away from the television to other activities, or send your child to bed for the night. However, try to make the other activities sound reasonable or enjoyable and not punishments they earned by not being able to control their pulling.
• One mother of a ten year old with trich suggests telling your child to find you and sit with you until the urges pass. This mother pointed out that your child might not agree to do that at first but that at least you will be showing your child in as non-threatening a way as possible that you are there for them.
• Another mother said that letting your child feel that she or he is in control and you are "just" part of their support team is important.
• Without crowding your child, avoid lengthy periods of time when your child is alone. For instance, if your child is prone to shut herself (or himself) up in their bedroom, invite them to come and talk to you in the kitchen or do homework in the dining room. Invite your child to help you shop and cook and garden and such, even if they aren't really that much help!
• Structure your schedule so that you can save as many activties that you can share with your child for times when your child is out of school and most likely to pull. (We never said this would be easy! :-)
• Let your child design signs to post in danger areas (such as on mirrors or in the bathroom) which tend to be their most common places to pull. Positive reminders are better than negative ones, such as a reminder to do a certain alternative activity rather than just something that says, "Danger!" or "Don't pull!"
• A regular schedule can be important. Not rigid but it is important to have regular and sufficient sleep hours and regular and healthy meals, for instance. Again, this might do no more than help your child feel good about life, but it could also help to reduce trich symptoms.
• I could go on but the list is starting to look more like the list for adults. So, that is my cue to end this list with a reminder you that you might find a lot of good ideas elsewhere in this FAQ that you and your child might be able to adapt to fit their personal and age-related needs. Amanda's site might offer you more ideas if you just wish this list went on further!
• Remember that there are many other aspects to your child than his or her hair or the particular behavior of pulling out that hair. Don't let this one behavior take over your or your child's life. (Easier said than done, but easier to do now that you have found a site where you can vent your feelings.)