7 Ways to Reduce Shame from Trichotillomania

Shame OFF you: 7 Ways to Reduce Shame from Trichotillomania

This article was written by HabitAware co-founder Aneela Idnani

Did you know there is a day dedicated to raising awareness about Mental Health stigma? 

I didn't know this until I saw #NationalSilenceTheShameDay light up my newsfeed on May 5th.

>> While we need to talk about mental health to end the stigma, 
first we need to address an immense mental barrier to speaking out: SHAME. 
How many times have you heard the expression, "Shame on you!"?
It's time to get the shame OFF you!

Let’s Talk About Shame

Shame is a strong sense of humiliation for doing - or being - something wrong. Shame is rooted in our belief systems and feeds off of our fear of imperfection. Shame is a feeling that stems from other peoples’ reactions to our actions, or our own reactions to our actions…our self criticisms.

Many people with Body Focused Repetitive Behaviors (BFRBs) are burdened by shame for pulling out their hair, picking their skin or biting their nails. Hair pulling, skin picking and nail biting are unknowingly thought to be “gross habits,” when in fact they are soothing mental health conditions, known as trichotillomania, dermatillomania and onychophagia, respectively.

Through my work at HabitAware, I am blessed to support tens of thousands of people with BFRBs on their healing journey.  While our experiences are unique, people with hair pulling, skin picking and nail biting are often met with similar confrontations. I’ve heard many of the same stories, over and over.

One person I peer-coached, Malta*, shared a common moment of shame - being exposed:

"I lived with a lot of shame growing up because I pulled out my hair. 
I was so afraid people would find out and think there was something wrong with me… I still remember one day in class when the boy behind me ripped my beanie off my head. 

“Look, all your hair is on the floor,” he laughed and pointed. The response from the kids was thunderous giggles. 

I wanted to disappear and from that day forward I shrank in my seat and tried to sink into the background."

Like Malta, I also lived with a lot of shame for pulling out my eyebrows and lashes. I lived in stealth mode during my middle + high school years - and did anything possible to not call attention to me. I wore muted colors purposefully so I would not be noticed, I declined the solo in chorus because I didn’t want to be in the spotlight, and I rushed through class presentations. 

I hid all of who I was because, above all else, I thought I was a hair puller. 

When you have a condition and it becomes so tied to your identity, it is even harder to shatter the shame.

In a “thank you” email, another HabitAware customer, Jamie shared how her parents well-meaning attempts to encourage filled her with shame:

"Whenever my mom saw me, she would say
“Stop pulling….what do you mean your only pulling from the top of your head? 
I see you playing with your lashes and your hand in the back. Stop already!
…Don’t you want to be pretty and have long hair?”

Turning off shame is not so easy as flicking a switch. If you are recoiling in shame for pulling out hair, picking skin or biting nails, there is hope. 

Here’s 7 ways to conquer shame from a body focused repetitive behavior

(1) Recognize the Source of the Shame

When I was a kid, I never stopped long enough to ask myself “why do I feel so ashamed in the first place?”  

The feeling of shame is often so overwhelming that it’s hard to see it, or the source of it.

So let’s take a step back and recognize that the source of shame is likely two-fold:
  1. the story we tell ourselves about who we are and
  2. letting other people’s opinions of us impact this story we tell ourselves.
When we give other people control over our thoughts, we give shame freedom to grow.

As a kid, I told myself, "I am a useless, ugly, hair puller and I don’t belong."
Why? Because those were the social cues I got from my peers in elementary school - eye-rolling, obnoxious questions, zero party invites.

So first, we need to rewrite the story we tell ourselves - in a way where only OUR opinions, hopes and desires matter. We need take back control over our thoughts from others. When we feel shame creeping up on us, we can recognize its source and remind ourselves of who we truly are.
Once we acknowledge that shame stems from external sources - other people’s judgement impacting our own judgement - we can work on it. We can remind ourselves that the only opinion that matters is our own and we can practice being aware of when other people are influencing our beliefs and decisions. 
Ask yourself, “Am I doing this for their approval or for my own?” and then practice mantras like “I don’t care what others think. I love me the way I am!”

As an adult, I tell myself, "I am safe, I am beautiful, I am caring.”
Take a moment to think of what you want to tell yourself instead.
When our self-opinion is filled with loving positivity, there is no room for shame to grow.

(2) Understand Hair Pulling (Trichotillomania), Skin Picking (Dermatillomania) and Nail Biting (Onychophagia) are Health Conditions.

Often times people think hair pulling, skin picking and nail biting are habits that are in our control. 

And if we are in control, we are at fault, and “must be so ashamed” of ourselves!
I didn’t learn the medical name, “Trichotillomania," until I was 10 years into my "hair pulling habit.” By then the damage to my head - and my mind - was done. Anxiety and fear of being caught pulling, drove many decisions to hide when I was younger.

Before learning the words “Trichotillomania” and “Body Focused Repetitive Behavior,” I thought I was damaged for doing this damage to myself. After eye-brow balding pull sessions, I’d scream at myself in the mirror, crying, “What is wrong with you, Aneela?” 

Once I understood that what I have is a medical condition, I was able to separate my seeming responsibility from the behavior.

Hair pulling, skin picking and nail biting are actually subconscious soothing mechanisms. They are not choices. We are not in control of the thought process.  

But there is hope - with awareness we can pause long enough to train ourselves to take back control. 

And we can use this knowledge to shatter shame - we are not inadequate, we are not broken, we are not a mistake. We just have a medical condition that needs a treatment plan, just like someone who needs to use glasses, or has diabetes. 

(3) Untie the BFRB behavior from your identity.

I grew up thinking, “I am a hair puller.” At support group meetings nearly everyone introduces themselves, “Hi my name is Beth, I am a skin picker…”

By speaking this way, we tie what we do with our hands - our body focused repetitive behavior - to who we are, our identity. 

When we try to stop hair pulling, skin picking or nail biting, those actions are in opposition of this declaration of who we are, making relapse almost certain.

“I am a hair puller” is a false affirmation. I am more than my BFRB - and so are YOU!

To reduce shame and increase likelihood of recovery, we need a mindset shift! We need to change how we see ourselves in relation to our Body Focused Repetitive Behavior. Hair pulling, skin picking and nail biting are not WHO we are. They are, as per the 2nd point, medical conditions we have. They do not need to define us or take up so much space in our lives.

As you reconsider the words that you affirm with “I am…” you make space to learn to replace hair pulling, skin picking or nail biting with healthier soothing mechanisms - because you are not a hair puller, skin picker or nail biter, you are someone who takes loving care of yourself. 

When you unravel the behavior from your identity, you shove shame away.

(4) Take Action to Take Control. 

While we recognized body focused repetitive behaviors are largely subconscious behaviors, we also can recognize that we can shift these behaviors to our consciousness. When we do, we can take control by choosing healthier soothing strategies.

This is why Keen2 is so powerful. The gesture detection and gentle vibration bring us into the awareness needed to make healthier choices. By changing our behavior in the moment, we prove to ourselves that we have the power and ability to take control. These acts of learning to manage our urges and our condition create confidence — and shatter shame.

(5) Share Your BFRB “Secret"

I believe secrets make you sick. For more than 25 years I hid the hair pulling with a black eye pencil. I spent so much time and energy CONCEALING. Trying to hide was such a burden on my mind. I was always fearing I would be caught. When I was caught by my husband, I was also set FREE to focus my time and energy on HEALING. I hope that when you share your BFRB "secret" you will also feel lighter, and be able to let go of fear of judgement and spend less time hiding - and more time healing.

(6) Look for Support from Helpers

Mr. Fred Rogers once said, “When I was a boy and I would see scary things in the news, my mother would say to me, "Look for the helpers. You will always find people who are helping.”

When it comes to your hair pulling, skin picking or nail biting, I’m asking you to “look for the helpers.”

When I was in high school, I had amazing teachers - especially my Spanish teacher. She knew my dad was sick and would always ask how he was doing, and I’d always respond curtly, “fine.” I still see her heart in her eyes. She was trying to tell me, “I am a helper.” And I wish I let her in and sought her support. The helpers will give you cues to let you know they are safe.

Remember, you are not alone and you don’t have to go on the path to recovery alone. When you share your BFRB “secret,” you are then able to build your support team!

From teachers to parents to close friends. Maybe a partner, a coworker, a doctor. And of course, a trained mental health treatment professional. Surround yourself with folks who love you and encourage you. When those shame-filled feelings rear their ugly head, free yourself by leaning on your support circle.

Now, when I feel tension in my neck, the jittery anxiety flowing through my body and my hands playing with my hair, I look for the helpers. I’ll look at my husband, “I am feeling anxious…” and then talk out my discomfort. He helps me put my my worrying thoughts into perspective, calming my mind - and my hands!
And remember, sometimes you’ll need to look for helpers, and sometimes you can be the helper for your loved ones too. 

(7) Be Ready for Bullies

Most of the work to shatter shame is internal - rebuilding our thought and behavior patterns. But let’s face it, the outside world is triggering. We may know who we are and what we have, but others may be ignorant, rude and afraid of looking dumb.
Just as we now have our healthier stories and affirmations, we need to be ready to shut down their shame-spiraling chatter with language too.

And you know what shuts a bully down? 
A response that shows confidence, pushes back with curiosity, and makes them realize their rudeness. These are some ideas:
  • "Shame on you for trying to make yourself feel big at my expense."  
  • "Your weakness is showing." 
  • "Bullies are not welcome here." 
After more than 25 years of hurting in hiding with trichotillomania, I’ve finally conquered shame. I hope these 7 exercises help YOU shatter the shame in your life, so you can create space and conserve energy to go from concealing to healing from your BFRB. I know that tens of thousands in our Keen family are doing the same with our proprietary behavior change methodology + patented smart bracelet. Join Us! 
(*Names have been changed for privacy)
Header Image Photography by Felipe Pelaquim
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