Thursday, 28 August 2014

Hair Pulling (Trichotillomania)

People frequently use the term 'pulling my hair out' to refer to frustration and stress. It's a common enough expression but for some people it’s a reality too. Hair pulling disorder is a sign of something deeper.

It is estimated that as much as three percent of the population suffers from the anxiety-related disorder known as hair pulling disorder (trichotillomania, trich, or TTM). True estimates of the problem are difficult to establish because the condition is relatively easy to hide and can vary in severity from person to person.

The most common time for hair pulling disorder to start is during adolescence. The person feels an irresistible desire to pick hair from their face or head and sometimes from other parts of their body. The most common area is the scalp and in severe cases a bald patch can appear. Once hair has been removed it is often chewed and stroked across the lips and face. Hair pulling is often seen as a response to some stressful incident or as a result of depression.

Because of its association with stress and depression the cause of hair pulling is generally thought to be psychological. Alternative suggestions include environmental toxins, an imbalance in serotonin levels, nutritional deficiencies and heredity. However, hair pulling is invariably a response to stress. Those who hair-pull will often describe the soothing effect of stroking hair across their face. Hair pulling becomes a form of welcome distraction that takes their mind off their problems and focuses it somewhere else. Not surprisingly, times of boredom or relaxation are the times when hair pulling most frequently occurs.

If someone is diagnosed with the condition of trichotillomania it points to a need for some form of psychological intervention. The various treatment approaches include talking therapies (with or without antidepressant medication) the most effective of which appears to be Cognitive Behavioral Therapy (CBT). Some success has also been reported with the use of biofeedback and hypnosis.

Frequent hair pulling and hair removal is a sign of a troubled person. On the surface it may simply appear as a bad habit and something the person will grow out of. Adolescence is a time of great emotional upheaval and when tested, those who hair pull, show elevated levels of anxiety and little in the way of self-esteem. The important thing is to support the individual, encourage treatment, and then to help them stick with the treatment process.

Tuesday, 26 August 2014

The Effects of Negative Thinking

Everyone is vulnerable to negative thinking which, if not checked, may deepen and develop into clinical depression. Negative ruminations tend to be rooted in our past and develop from certain core beliefs we still retain. In order to avoid the potential consequences of depression, it’s first necessary to acknowledge that these thought processes are negative. Only when this is done is it possible to move to a stage where negative thoughts are replaced with more adaptive forms of thinking that will ultimately feel more empowering.

Negative thinking is a key ingredient of depression. People with depression often view the world in very black and white terms. Invariably the negative thoughts relate to them, their perceived worth and abilities and their perceived lack of value. The world of rewards, fun, love and enriching experiences belongs to other people. To the person with depression their future is too chilly and bleak to even consider. They feel trapped and inert, convinced that any attempt to get them feeling better is both futile and doomed.

Everyone interprets situations in different ways. The person predisposed to negative thinking views situations in a typically pessimistic manner. So the goal of therapy is to move these pessimistic thoughts to one side and replace them with more balanced and more optimistic perspectives.

Cognitive behavior therapists place a great deal of emphasis on challenging negative thinking. The patient and their therapist work together to identify situations where negative thinking tends to occur. The therapist then sets about trying to recast these situations in such a way as to place an alternative and more positive interpretation on them. For the patient this can be a very challenging and frustrating experience. Anything that taps into core beliefs is often hard to accept. It requires of the patient a high degree of concentration and a willingness to accept that there a different ways any given situation might be interpreted.

Therapy starts with the person being asked to keep some kind of personal written account of situations where negative thinking is a common feature. They work with the person to disentangle the exact nature and content of these thoughts and the person then begins to sift what is really known from what is surmised. Once the process is complete the therapist will help to suggest alternative and more balanced forms of thinking.

As we rarely stop to reflect on our thought processes and what these may be doing to us, this form of therapy provides a way of highlighting some of the hurdles and blocks that different forms of negative thinking can have on our lives. Challenge the negative thinking and a whole range of possibilities may be illuminated.