Tricking Trich – TLC Retreat Notes
Credit Sue Price notes - TLC Conference Session
TTM: Tricking Trich - TLC Retreat notes
September 2002
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**This was originally an email sent to me from a remailer - so these are
Sue P's notes from a Session at the recent TLC Retreat (Sept 2002).
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**(If you don't already know what TLC is, it is the Trichotillomania
Learning Center - and the only Not-for Profit Association for
Trichotillomania. Their Website is www.trich.org. They have encouraged
me and others to post and distribute our notes from the TLC Retreat
sessions, in order to help as many people as possible!) I recommend that
you look through their site ... the Calendar section lists events and
Support Groups (who know they may be in your area).
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TTM: Tricking Trich - TLC Retreat notes
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"Tricking Trich", Ruth Golomb, M.Ed., LCPC / Sherrie Vavrichek, LCSW,
C,BCD
!
This, as always, was one of the most popular sessions at the TLC retreat
because it gives people insights into their pulling triggers, and lots
of concrete ideas for how to combat them.
They have written a book in workbook format based on these principles,
"The Hair Pulling 'Habit' and You: Solving the Trichotillomania Puzzle."
It's geared to kids but if you find the principles in these notes
helpful you would probably find the book even more helpful, because the
book has a lot more info and tips.
!
!
FIDDLING S-H-E-E-P Trich Quiz
copyright Golomb and Vavrichek, 1999
Take this quiz to learn about your pulling triggers.
!
Each question asks "Do You Pull..." in a certain situation.
!
Circle:
0 for Never
1 for Sometimes
2 for Often
3 for Almost Always
!
The questions are in groups of three. For each group of three questions,
add up your answers to get a score from 0-9.
!
!
Do you pull. . .:
1. when you are reading? 0 1 2 3
2. when you are watching TV or on the phone? 0 1 2 3
3. when you are antsy and in the car? 0 1 2 3 Total score for this
group: _____ (0-9)
(Fiddling)
!
!
4. when your scalp feels itchy or tingly? 0 1 2 3
5. and then play with or touch the hair to your mouth, face or hands?
0 1 2 3
6. and find the sensation pleasant? 0 1 2 3 Total score for this
group: _____ (0-9)
(Sensory)
!
!
7. without realizing it? 0 1 2 3
8. when your head is resting in your hands? 0 1 2 3
9. using the same motions each time? 0 1 2 3 Total score for this group:
_____ (0-9)
(Habit)
!
!
10. in certain rooms or places? 0 1 2 3
11. using a mirror and/or tweezers? 0 1 2 3
12. sitting in a certain chair? 0 1 2 3 Total score for this group:
_____ (0-9)
(Environment)
!
!
13. when you are upset? 0 1 2 3
14. when you are excited or happy? 0 1 2 3
15. when you are bored, tired, or hungry? 0 1 2 3 Total score for this
group: _____ (0-9)
(Emotional)
!
!
16. hair that is the wrong color or texture? 0 1 2 3
17. in order to "even things out"? 0 1 2 3
18. when you have had a "bad" pulling day, because what's the point of
trying? 0 1 2 3
Total score for this group: _____ (0-9)
(Perfectionism)
!
!
SCORES:
!
For each group, the score 0-9 means:
0-1: This is not a trigger area for you
2-5: This is a trigger area for you
6-9: This is a STRONG trigger area for you
!
The trigger areas:
!
FIDDLING: you need to keep you hands and/or mouth busy
!
S - Sensory: your skin craves to be soothed and/or stimulated
!
H - Habit: you pull automatically, sometimes without being aware you are
pulling
!
E - Environment: something in your environment triggers pulling behavior
!
E - Emotional: various emotions trigger you to pull
!
P - Perfectionistic thinking about your hair or yourself triggers
pulling
!
(put it all together, you get "FIDDLING S-H-E-E-P")
!
!
Their presentation:
!
pulling serves a need -- it is often an attempt to regulate one's
nervous system: to perk yourself up, or calm yourself down. Often
pulling happens when you're in a state of what Ruth called "body
boredom" -- the body is still but the mind is alert, and the body craves
a physical outlet.
!
They went over the 6 trigger areas (FIDDLING S-H-E-E-P) and we did the
quiz. Once we had an idea of what our personal primary trigger areas
were, they talked about how to combat them. The idea is to do many
strategies at a time, whatever the situation calls for. They've found
with their patients that pulling situations tend to involve at least
three of those trigger areas, and in order to keep from pulling, you
need to combat all those triggers associated with that situation.
!
These lists are not meant to be exhaustive.
!
FIDDLING: use hand toys like koosh ball or Klixx, knit or crochet, etc.
(Something like a paper clip might not work at first, you made need a
koosh ball because it's more like hair, but over time a paper clip might
be sufficient.)
!
SENSORY: meet sensory needs with a loofah, silk, eye scrubs, use
wide-tooth
combs, have hair brushes everywhere so wherever you are in the house,
you can give your scalp stimulation or relieve the itch . Koosh ball can
also help here. Scratch your head while in the shower (this is safe for
most people because we don't pull wet hair)
They note: we need to be willing to compromise, because these
substitutes aren't as good as "the real thing". That's what makes it
hard, at least at first.
!
HABIT: create a barrier - bandaids on fingertip, ace bandage around the
elbow, hat or bandanna, hairspray on your hair. Anything to keep you
from pulling mindlessly.
!
ENVIRONMENT: cover mirror, get rid of tweezers, use a different
bathroom,
sit elsewhere, put up notes reminding you to "do strategies". All this
you
would tailor to your particular environmental triggers.
!
EMOTIONS: address emotions directly rather
than swallowing them, exercise,
journal, set boundaries with others, take care of yourself, do
relaxation exercises, etc. Get enough rest if being tired is a trigger.
!
PERFECTIONISM: if hair that looks "wrong" is a trigger, don't look in
the
mirror. Try not to be perfectionistic about pulling. See recovery as a
process and learn from slips, rather than letting a slip cause you to
pull more. [Side note: the "If You Slip" passage from the addictions
book I've mentioned has done more to get me into this mindset than
anything. If you'd like to see it, let me know and I'll send it to you.]
!
!
They suggest planning ahead for your high-risk situations. In their
book, they take you through exercises to determine what your main danger
situations are, and figure out what trigger areas apply. If watching TV
is a trigger, maybe you'd plan to: sit in a different chair that doesn't
have arms (Environment), wear a hat (Habit) and make sure a koosh ball
is right there (Fiddling). Of course you'd tailor it to your trigger
areas, but the idea is to have plans for how you will combat all of
them.
!
They also suggest rewards for using your strategies, to keep your
motivation high. Small rewards, under $5, can be earned in less than a
week. Medium rewards, $5 - $20, can be earned in 1-3 weeks, and large
rewards, $25 - $100, can be earned in 1-3 months. (They had lists of
suggested rewards.)
!
**Do NOT tie the rewards to whether you've pulled. Reward yourself for
doing your strategies, whether or not you have pulled.**
If you do pull, problem-solve. Understand what happened and what to do
differently next time. Maybe you need to shift/supplement your
strategies for that situation, or maybe you didn't really do your
strategy. It's a process, it's learning through trial and error, it's a
lifestyle change.
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