Some advice I lifted from Amanda's site:
Not all TTM sufferers are the same. People pull for different reasons, in different places, and at different times. Some people pull a lot and some a little. And everyone has their own ideas of help.
First thing to do is ask your loved one (the TTM sufferer), "What should I do when I see you pulling?" Second is to listen closely to their answer. Communication is the key. They may have been afraid in the past to come out and say what they have wanted and your asking might help to open up those lines of communication. Many TTM sufferers really are not't sure what they want or what will work. So both of you may need to try out a few ideas before you find one that works.
Remember that communication is a 2 way street. They may be embarrassed and respond by being angry and defensive. They may shut you out and refuse to talk about it. If they will not discuss the issue, then its probably best to respect the silence. What you can do is be there when they are willing to talk.
I have asked some TTM sufferers what they would want they're loved ones to do when they see them pulling. This is a sampling of the responses I got.
"I think it would be of great help if my husband could rub my head or brush my hair or something that would satisfy that sensation that makes me want to pull. Also, if we spent more time in the same room together it would help. But we don't and I won't ask him to rub my head or brush my hair, because I hate admitting that I have a problem."
"If the love one could gently draw attention to the pulling(if your alone). Some people pull unconsciously and need someone to help clue them in. Don't do this if other people are in the room!! Or form a secret signal that won't be obvious. Hug the person. Or a shoulder and neck massage would be good. My muscles are always tense when I pull. If I can relax the muscles, it gets rid of the urge at least temporarily. Remind them to take a few deep, long breaths."
"Hold the hand that is doing the pulling and tell this person that you love them."
"I think that I would like someone to gently rub the pulling area that is bothering me. Or maybe just a general massage. The reason I don't know is that my husband won't humour me, he's too lazy. The reason I think this would help is that it may calm me. Also, perhaps we over groom ourselves because we need socialising that we are not't getting?"
"What I would suggest to seeing him or her pull would be to* ..
II. Distract him or her with something else to keep his mind busy. But do it without saying ANYTHING about his or her pulling.
III. Gently hold his or her hands and tell them that you love them.
IV. Ignore the behaviour, but stay in the same room (they will either stop or retreat to another room). If they retreat, let them. The need is so strong sometimes that only pulling will ease their minds."
"I may not be typical but the best thing someone can so for me is to not mention it at all. Except to say that I look okay if I ask if my eyebrows are on straight(if they ARE straight). It hurts me for someone to say, "Ah, ah, ah, you're doing it!" Also making an effort to be educated a little helps. It validates my feelings and actions. When I got married my best friend helped me with my make-up. That showed me more than she could say. Nothing that anyone said has ever stopped me from pulling. But love helps us to feel better."
"For myself, I do not wish to be treated like a child and told what to do. That pressed my buttons. I started pulling as a response to abuse that included encroachment on my boundaries, and I get furious if someone embarrasses me by saying anything. I think that I would prefer a friend not say anything at all if they saw me pulling, but no one has ever seen me pull. I think if you see someone pull, you should perhaps mention it and offer assistance, then establish between the two of you an acceptable response. NEVER, EVER say, "Why don't you just stop?", or "Doesn't it hurt?" or anything like that."
"Don't say, "Why can't you just stop?" , "Why are you doing this to yourself?", or "Why can't you do something else with your hands?" And certainly don't yank the person's hand away from his/her head, eyelashes, eyebrows, etc. Maybe the best thing to do is be supportive, talk to the loved one with TTM. Only when he or she wants to talk about the pulling. Don't force the issue."
"I would want that person to first remind me I'm pulling, in case I'm doing it unconsciously. Ask me if I want my hat or silly putty, in case I can't get out of the trance. Talk to me about the "issue" if there is one, and that's why I'm pulling. Change activities with me so I won't pull. For instance, shut the TV off (only if I agree) and go outside with me. Play cards instead of reading. If we can go out to dinner or a movie, then go. Visit friends. Never say "Stop that!"
V. WHAT ELSE CAN I DO TO HELP?
These five responses that one person sent me, sum up what everyone has been telling me they want.
VI. Be as non-judgemental as possible.
VII. Learn about the problem and possible answers to it.
VIII.Be there as emotional support.
IX. Keep the lines of communication clear, including joint counselling if it would be helpful.
X. Unconditional love.
The helper needs to be told about why the helpee might become defensive, about how this is wrapped up in their identity and sense of (generally low) self esteem. All parties need to know this. But all parties need to know not to take advantage of this to try to shock or manipulate anyone. Trichsters need protection against this sort of instinctive understanding which some people do try to control them with. And they need to be able to communicate their needs to those who really have a chance of helping a little.
Back to Steph stuff now ... my advice to those who feel shut out by us sometimes:
Please, please don't take it personally. We trust you. We love you. We do.
Our shyness at telling you and our flinching when you touch our hair or look at our lashless or browless face is not about you. It is about our shame and conditioning and how we can't bear to look at ourselves and don't want anyone else to see us this way.
A few random thoughts I'm not sure where to put: (Maybe it is redundant, but I'm too tired to see if Amanda already said it. :-)
Last words: "This could be worse."
We don't want you to minimize this but we also don't want to make a mountain out of a molehill. It is very hard to have trich. It is a paradoxical disorder. In some ways we are very delicate. Yet we are also very strong. We need to be handled with care because there is a lot of pain associated with the conscious self-destruction. Yet we aren't going to snap ... most of us hurt ourselves and hold ourselves back from fulfilling our full potential but we are not suicidal and we get our jobs done and we're nice to other people. We learn very interesting lessons while enduring, acknowledging and overcoming this. We are at a crossroads. At any moment with little effort these weaknesses of ours could be made into strengths. Even before we overcome this we have very interesting insights into important aspects of life that many others never deal with though it would profit them to think of it. Many people who don't have as conspicuous indicators of stress or other problems as we do are silently giving themselves ulcers. As we work through our problems we might actually be helping your world be safer and saner.