Trichotillomania and Me: How a BFRB Both Scarred and Saved Me
Trichotillomania began haunting me when I was ten. I was sitting in my fourth grade classroom when I found myself slowly pulling out my eyelashes, and piling them neatly on my desk. One by one. I felt horrified and confused by what I was doing, but also oddly satisfied. My nearby classmates, however, felt no satisfaction — only horror and confusion.
Same with my parents. I was a good kid, driven by innate sensitivity and conscientiousness, heightened by fear of my parents who took an authoritarian approach to raising me and my two siblings. I don’t remember how they asked what was happening to my eyelashes, I only remember the shame I felt when I lied.
They took me to the doctor and he told them what I couldn’t — I was pulling them out. And that was that. If it had been 1990 or 2000 instead of 1980, the doctor might have made a mental health referral and I might have begun therapy and medication. Even though “trich” is almost as common as bipolar personality disorder, much less was known about it back then.
And mental illness was much more stigmatized. It’s possible that my doctor did make a referral, but my parents didn’t follow through. We were conservative and Christian, and while both sides of the family were rife with alcoholism and mental illness, my parents didn’t have the support, much less the vocabulary, to properly deal with mine.
So they dealt with my first mental illness the way they dealt with most parenting dilemmas — through strict control and swift punishment.
Before I started pulling out my eyelashes, I’d picked my nails. Unable to make me stop through other means, my parents resorted to an autocratic strategy: inspecting my nails every Saturday night, then spanking me once for each nail that was “picked.” The spanking was meted out with the same tool as our standard spankings — with a long ¾-inch wooden dowel. One hid in the kitchen among the wooden cooking utensils standing stiffly in a large jar on the refrigerator. Another lurked inside the bedroom closet with a nifty loop hanging by a nail.
Some Saturday nights I got whacked 20 times. But I didn’t stop.
I would have stopped if I could. Again, I was a good kid — a very good kid. I got straight A’s. I was almost always awarded “Good Citizen of the Month”, and usually for the first month of each school year. I played classical piano, composed music, read voraciously, and wrote stories and poems. I was identified as gifted, and I always did my homework. I made things out of wood, mud, fabric, and yarn. I stayed out of trouble in the neighborhood, kept quiet in church, excelled in Sunday School, and did what grownups told me to do.
But I couldn’t stop pulling out my eyelashes. It felt like I was possessed. I was horrified by the way I could suddenly do this awful thing to myself that I absolutely loathed. Dark-haired and genetically well-endowed in the lash-and-brow department, I looked particularly horrible with no eyelashes — and as a girl, it was especially humiliating. Sometimes my pulling caused painful eyelid infections that got puffy and red, making me look even more like a monster.
But in the midst of the intense horror and shame, I noticed that I often felt relief after pulling. I also noticed that sometimes I pulled after something stressful had passed.
And although I wouldn’t have recognized it at the time, I was under tremendous stress. Research about the causes of trich is still ongoing; over my lifetime it’s been viewed as maybe an OCD-spectrum disorder, an impulse control disorder, an out-of-control grooming disorder, or self-harming behavior akin to cutting. The debate continues. But what seems to be clear is that trich is a genetic tendency triggered by environmental stressors.
As a trauma-informed resilience practitioner, I now understand that my parents didn’t meet my basic emotional needs as an infant and child. Such lack causes intense stress in children. Caught up in their own (intergenerational and personal) trauma responses, my parents were unable to mirror me, soothe me, or provide me with a felt sense of safety. Their nervous systems were chronically dysregulated, so I never learned to regulate my own.
Lacking healthier options, my genius body found ways to soothe itself when I became overwhelmed, even when they came at tremendous cost. When the strategy of picking my nails was beaten out of me, my body turned to uprooting my eyelashes.
But there was no one to explain my body’s adaptive genius to me or my parents. So they took my behavior personally, and relied on their default mode of control and punishment to make me change.
My mother was my main tormentor. Our regular seats at dinner were across from each other, and every evening she scrutinized my face from across the table for the latest signs of my self-destruction. Hers was not a gaze of loving concern, but of disappointment and contempt. In a futile attempt to hide, I became practiced at avoiding eye contact with her — in fact, I avoided eye contact with most people for many years as a result.
If Mom thought she detected new losses in my facial hair department, she usually just scowled or made belittling comments. But once when I was standing over her, talking as she lay in bed, she spotted my balding eyelids from below. That time, she was physically rough with me.
But I didn’t stop pulling out my lashes. I couldn’t. So my parents doubled down on the scrutiny and humiliation. They recognized that their one-spank-per-nail approach would be too extreme with dozens of hairs at play, so they tried other militaristic methods.
Once I desperately needed new shoes. I was an enthusiastic user of my public school’s rough asphalt playground, so I developed holes in the toes of my blue-and-grey Vans. Mom said she wouldn’t buy me new shoes until my eyelashes were ¼-inch long. I was neither popular nor an outcast ay school, but I was definitely a weirdo. Holey Vans added a whole new layer of dorkdom to my homemade outfits and my fragile persona — not to mention class-based shame. My school was solidly working-and-middle class, but clothes still mattered, and this was before rips and holes became cool.
On my own to stem the bleeding of my fragile self-esteem, I visited my mother’s sewing basket. I found some fabric scraps and used these to create patches I hand sewed onto my shoes. While close in color to my Vans, the patches were far from inconspicuous. While they did the trick of keeping playground sand out of my socks, they elevated my dork factor.
To hide my embarrassing shoes, I developed a habit of curling my feet around the legs of my desk. This became a soothing habit I repeated daily, well into adulthood. I also tried to master the impossible art of walking without people seeing my feet. One year I made all-city band, which required me to attend rehearsals at a nearby school and walk across an infinitely vast playground from the bus to the auditorium. I felt like I might die of embarrassment if the terror of my shoes being noticed didn’t kill me first. I don’t remember anyone ever making fun of my shoes, but they didn’t have to. I felt humiliated by having to wear those shoes, and by my inability to “earn” new ones. Even worse, I had no one to talk to about all these feelings, and no way to soothe or process them — other than pulling out my hair.
Somehow I rallied enough grit to leave my eyelashes alone until they grew to ¼ inches. I got my new Vans. Then, relieved, I pulled out my lashes again.
At some point, my hair pulling expanded to my eyebrows. First, I started picking at the inside edges of my then-bushy brows. Bit by bit, like advancing clear cutting, my fingers munched across the length of my brow bone. It was around this time that I found an ancient brow pencil in my mother’s toiletries (she’d stopped wearing makeup years before) which I used to crudely mask the damage. When that didn’t work so well, I resorted to using one of my peel-off crayons with the string pull sharpener.
The crayon color closest to my brows was black, but black crayon was severe against my white skin. I started growing out my bangs (or did I cut my hair and create bangs?) to conceal my crazy crayon brows. I especially dreaded any activity involving water or wind on my face — like swimming. When swimming in the pool at a nearby high school, I arranged my hair underwater so I could break the surface with my secret intact.
I don’t know how intact my secret really was. Once, my friend Bunhom, a recent refugee from Cambodia, teased me with his limited English, saying “cut” over and over while making a scissors gesture next to his eye. I think he was curious more than trying to be mean, but it didn’t feel nice to hear.
Another time, I didn’t want to go to the movies with my friend Pam and her family as planned, because I’d just completely deforested my face. My Dad, never very emotionally intelligent or skilled at interpersonal relationships, advised me to call Pam and tell her what I’d done. I don’t think he was trying to shame me — I suppose he thought “honesty is the best policy” and that perhaps my self-disclosure would ease the weirdness. I don’t remember the phone call, but I do remember the awkwardness that radiated from Pam and her family all evening.
When I began high school, my parents finally allowed me to wear actual makeup. I became an expert at eyeliner, mascara, eyebrow pencil, and the art of enhancing whatever brave hairs were sprouting around my eyes. My parents relaxed their hyper vigilance over my face and turned their intense attention to other topics like my sexuality and how I spent my time.
I left home right after high school, and trich had her violent way with me many times during college — especially when studying. Once time I turned that violence outwards towards my boyfriend. We were talking about my issues, and he was sitting on my bed when he said “no quiero una novia que se quita las pestañas.” While linguistically fluent in Spanish, I wasn’t yet culturally fluent enough to understand that this was quintessentially Mexican phrasing that — while still passive-aggressive — was intended to demonstrate support for change. Instead of hearing “I would love it if my girlfriend didn’t pull out her eyelashes”, I heard “I don’t want you as my girlfriend because you pull out your eyelashes.”
All by itself, my body walked across the room and punched him in his astonished face.
In that instant, I connected briefly with a vast ocean of unexpressed rage fed by multiple currents of dismissal, disrespect, shame, and abandonment over my then-22 years of life. I’d also witnessed my body’s single-minded mobilization against a threat to “my” trich.
Years later, that threat mobilization system activated again in therapy. I was talking about “my trich” — and not for the first time — when my earnest, compassionate therapist offered, “I’m not trying to take trich away from you, but …” I don’t remember what she said after that. I think it was something like “maybe this is serving you in some way”, a possibility I vehemently denied. But I’d been hit by lightning with the new awareness, facilitated by her sincere phrasing, was that there were parts of me that absolutely did not want trich to go away. Ever.
But how could this be? I hated my trich!
I had many reasons to hate it and its relentless oppression. Not long before, I’d graduated from face picking to scalp picking. One day I had too much dandruff, scrubbed my scalp too vigorously to get rid of it, and left a small scab. My fingers became obsessed with the scab and picked until it bled, releasing that familiar hit of relief and satisfaction.
One scab multiplied into two, three, and more. I discovered that I could get at the scabs easier if I pulled out the hair on and around them. I did so with the meticulousness of a surgical serial killer, taking tweezers to my scalp and checking my progress with a mirror. Once my scalp got irritated enough, the skin gave up the hairs more easily, which would exit their follicles with a big juicy sigh, root intact. The rush I got at the sight of those little hair bouquets on my tweezers and the quiet ripping sound was intensely fulfilling.
As in childhood, the horror and shame was just as intense. Large gaps opened up on my scalp like crop circles. I experienced soreness that only drew my attention more to my scalp. After a lymph node on my neck got infected and enlarged, I learned to cleanse my wounds with alcohol. Then I’d go right back to prying them open. I started using makeup pencils — even pens and crayons — to color in the holes. Once again, I dreaded wind and its power to blow my hair out of place and reveal the truth underneath. I dreaded going to the hair salon and having to explain trich — again — to an uneducated stylist who would start giving me advice about stopping.
What heightened the pain of trich was the sense of being crazy and utterly alone. I was (finally!) diagnosed with trich in my early twenties, but almost never saw another “trichster.” I was about 12 when I first spotted a fellow alien. Her name was Leslie Dawes and we never spoke. I don’t remember whether she was in all-city band like me, or the MGM gifted program like me. I just know she went to a different school, and for a time I saw her regularly on the bus, bald eyelids like mine. But I desperately wanted to make friends, tell her I was like her, and learn how she managed to stay alive.
But I never had the courage, and neither did she. We were trapped in our respective cages of shame and stigma.
I’ve now been living with trich for 42 years. I’m 52, and I’m still a trichster. While I’m more hypervigilant than most about my eyelashes, and more eager than most with eyebrow tweezing, I no longer pull out my facial hair for relief. I’m supremely grateful that my long-suffering eyelashes have the awe-inspiring ability to grow after all they’ve been through. They will never be as long and abundant as they were in childhood, nor strong and complete enough to support eyelash extensions. But that’s probably a good thing, because I’d very likely start pulling on them once the extensions started thinning.
Further north, I’ve overgrazed my eyebrows to an extent that their ecosystem will never recover. However, the wonderful art of microblading has allowed me to look “normal” and avoid any tempting creep during my diligent tweezing.
But I still pick my scalp. Thankfully, a side benefit of switching my antidepressant a few years ago was that I no longer have the urge to pull out hairs on and around my scabs. For some reason, Lexapro takes away that urge while Celexa didn’t. Go figure. We’re all still learning. But there are still weeks — like the last two — when I pick my scalp bloody.
What’s different now is that I no longer feel the same shame as I did earlier in life. I do feel some shame. I’ve never been willing to show anyone my “scalp holes” or scabs. I’ve often resisted identifying as a trichster because when I see photos of people with a more visible BFRB (Body-Focused Repetitive Behavior) I often feel disgusted. I want to protest “I am not one of them!” or “I’m not that bad” or “that’s not me anymore.”
And yet, as I wrote that last sentence, my right hand left the keyboard and went up to my scalp.
Still, what’s different now is that I no longer feel like a bad person because of my trich. Or a helpless person because of my trich. Or a possessed person. Now I’m better educated about my disorder. Now I’m a trauma-informed practitioner who understands what happens to kids (like me) who experience abuse, neglect, and trauma. Now I understand how people of all ages organize around their wounding not by choice, but by necessity. Now I appreciate and celebrate my body’s incredible genius and creativity to keep me safe under unmanageable circumstances with few-to-no-resources.
What’s different now is I avoid beating up on myself about trich (most days), and I finally have those resources. I have somatic tools to calm my nervous system. I have therapists and coaches who facilitate my healing and help me see myself and the world more accurately. I have friends capable of providing safe, secure attachment, and reliable support.
I don’t identify as having a BFRB. I prefer “trichotillomania” over “BFRB” because I believe in accuracy and honesty, and a Greek word that says “hair-pull-madness” captures the reality of trich far better than a sanitized, cute-sounding acronym. I’m now resilient enough to own my illness without experiencing shame about what it’s called.
Trichotillomania — “my” trich — has both scarred and saved me. It scarred me physically by causing permanent damage to my tissues. It scarred me psychologically by being a catalyst for shame, neglect, and abuse in my family of origin.
But it also saved me. I’m not touting greeting card romanticism here. I’m not jumping on the “what doesn’t kill you makes you stronger” bullshitwagon or attending the “I’m grateful for my suffering because it made me the better person I am today” hogwashfest. Fuck that noise. What doesn’t kill us more often weakens us or maims us for life. Suffering turns us into psychopaths, addicts, assholes, or ghosts more reliably than it makes us saints.
But those sentiments don’t sell cosmetics, books, TV shows, or coaching programs.
When I say that “my trich” saved me, I mean that without the strategy of hair pulling that provided necessary relief to my overwhelmed nervous system, my body would have turned to a different strategy. It might have chosen destruction of property or people instead of self. It might have chosen addiction to heroin, food, or sex instead of picking hairs and scabs. It might have chosen to take me out of life entirely to make the pain stop.
I did not need trich to make me a better person. I did not need it to build my character. While I’ve learned valuable lessons from living with trich for 42 years, I didn’t need trich to learn those lessons at such a high price. But trich has helped keep me safe when no one else did, and for that I will always be grateful.
