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Trich or Treat?

Trichotillomania (trick-o-till-o-may-nee-uh) or “trich”, also known as hair-pulling disorder, is characterized by the repetitive pulling-out of one's hair. Trichotillomania is one of a group of behaviours known as body-focused repetitive behaviours (BFRBs) or impulse-control disorders (ICDs) in which individuals pull out their hair, pick their skin (dermatillomania or excoriation disorder), or bite nails (onychophagia), resulting in severe damage to the body. Research indicates that about 2 or 4 in 100 people experience trichotillomania in their lifetime.

I used to pull out my hair for as long as I can remember. My first memory of my hair pulling was back in the fifth grade when I first started suffering from intrusive thoughts and anxiety. I ended up pulling out the hair from the apex of my head and left a bald patch there. I couldn’t go to school because I didn’t want anybody to see me like that. I couldn’t tell my parents what I had done because I was so ashamed of it. They ended up taking me to a dermatologist who gave me antibiotics and obviously that didn’t make much of a difference. The patches would grow back in about a month and I would trim the rest of my hair to match the length of the newly grown hair.

But these episodes kept happening again and again. For the next few years, around every six months, I would again end up doing this to myself. The other kids began to notice the damage and would ask me about it endlessly. I avoided school and socialising as much as I could but I knew I couldn’t do this forever. So, I came up with ideas like using hair styling gel to set the hair around the patch in such a way that it concealed the patch. If the patch was smaller, I would fill it in with eyebrow pencils. I started using an OTC solution called Amexidil 5 to make the hair grow quicker.

By the start of high school, I could divert my attention to my eyelashes and eyebrows instead of my hair and slowly I stopped developing the bald patches but that brought on a whole other set of problems because now I wouldn’t have my upper eyelashes and eyebrows. Going out in public was still a big challenge for me. Cameras would still scare me and I began to want fewer and fewer of photographs taken of me. This was around the time a broadband connection was installed at our home and I could finally give a name to my disorder: trichotillomania. It was a disorder on the obsessive-compulsive disorder spectrum. I looked up treatment regimens and found online support groups which gave me the courage to finally confess to my family that I pull out my own hair.

When I came to Kolkata for my undergrad studies, I made a determined decision to not let a disorder dictate how I lead my life. I wanted to not be afraid of being photographed. So I went to Dr. Era S. Dutta’s clinic and she put me on a few medicines and suggested little lifestyle changes to reduce the anxiety which she thought was the cause of my hair pulling and for the first time, I could consciously stop myself from picking at my hair. Within two months, I had eyelashes for the first time in ages. Whenever I would feel my heart racing or my throat clench, I would pop a pill and make the intrusive thoughts go away. This was all good until we had to reduce the dose since she didn’t want me to be dependent on medication throughout my life. She highly recommended that I go see Dhwani Shah so that I can better handle my anxiety disorder.

I was initially extremely sceptical about seeing a psychotherapist because I was completely sure that it was ineffective. Back then had you asked my opinions regarding it, I would place it next to voodoo. But my sister convinced me to go for one session to see how things work out. I remember visiting Over a Cup of Tea on December 29, 2017 with my sister. It was wonderful. Ms. Shah is one of the most wonderful listeners I have met. She is patient and understanding and we arrived at the conclusion that my hair-pulling and even skin-picking were a consequence of my anxiety which itself was a consequence of my poor self-worth.

For the next few sessions, we worked together on my distorted self-worth and she taught me to see how a lot of my thoughts were irrational and how they were the cause of my lack of self-worth. For example, my belief that a person’s worth was only the sum of his successes and talents would make me compare myself with others, which would ultimately make me feel that I am not good enough. That would then result in me worrying endlessly about my academic performance and I would stay up nights before exams. Once I learnt to identify and not act on my irrational beliefs, I felt really liberated.

Then there were the stories that I had chosen for myself— I am not good enough, I cannot converse with new people, I am a bad person and so on. I chose to live that story for a portion of my life while doing everything I could to prove otherwise. I believed my story, and I lived it out, every day. Ms. Shah and I sat together with these thoughts. I came to conclude that all of it was just a story and that it was not accurate. I learnt to love myself and not judge myself too critically.

During my sessions, I also learnt to alter my thinking and perception towards situations for the better. I now realise that we may not have a say about the circumstances in our lives, yet we do have a say in how those circumstances affect us. Our perception and beliefs can bring drastic changes in the outcome. This change in perception has made me see things in a new light; circumstances that I previously believed were against me now look like opportunities that I make the most of. I am no longer scared of being photographed. I like getting to know new people. And so much has changed in my life since the first time I went to see Ms. Shah Over a Cup of Tea. These things are very hard to put words to.

In a way, I think that the experiences in our lives are like the chapters of a novel. And every great novel has some sad chapters. But our story is more than just those chapters and we have so much more to look forward to in our lives.

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