Trichotillomania: How to stop hair pulling and twisting NOW.
I am concerned about my 4 year old daughter. From the time she was about 4 months old, she has sucked her thumb and played in her hair, particularly while sleeping. I had become accustomed to her waking up every morning with her hair completely undone, whether there were ponytails or braids; she could undo any hairstyle.
About 2 months ago, I noticed that she had begun to twist her hair so tightly that it would be in almost dread-like knots. I talked to her about it and tried to explain that playing with her hair was the reason behind all the trauma of combing it in the morning. But it only seemed to get worse as I noticed small balls of hair around her room; I then noticed that she had a bald spot in her head from pulling out her hair.
I have talked to her Montessori teachers to see if they noticed any changes in her behavior or trouble with classmates, but they insist that she is doing well with her work and makes and keeps friends well at school.
I don’t know what I should do next.
I can understand your concern about your daughter’s current behavior, especially if you have actually noticed a bald spot. It is apparent from your letter that this is something that you have been struggling with for some time.
There are some questions I have that would indicate what direction to go with this situation.
The first thing we need to determine is whether your daughter’s behavior is simply a habit that has gone to an extreme, or if your she has some emotional issues that are bothering her and causing her to be so anxious that she is pulling her hair.
Daytime or Night time or both?
You did not mention whether she is pulling her hair in the daytime, or if you have noticed any tendencies she has to be stressed, anxious, or angry. While you did exactly the right thing to ask her Montessori teachers if they noticed anything unusual at school, it is equally important to specify if there is anything going on at home. You are the best judge of your child’s emotional state.
Stress or Anxiety?
Therefore, my next question would be whether there have been any changes in the past couple of months that may be causing your daughter to feel stress or anxiety. You mentioned that your daughter is four years-old. Did she start Montessori at age three, which is the standard, or did she only recently start school? What is the situation at home? Have there been any changes with members of the family–marital issues, illness, or new experiences? Remember, that positive experiences can oftentimes be as stressful and negativee ones.
Once it is determined whether your daughter’s hair pulling is, in fact, a bad habit, or if she is pulling her hair due to an emotional issue, we will have a better idea of which direction to go to help alleviate the problem. If it is due to an emotional response to something that is going on in her life, discovering what is bothering her by speaking with her directly and carefully observing how she interacts in her environment can help determine which road to take to help her build her coping skills.
Track the Pattern
Pay special attention to her behavior to identify specific times she becomes stressed, anxious, or angry. Write these incidents down and search for patterns. Ask her school teachers to do the same. If it becomes apparent that she is emotionally distraught about something and simply speaking with her and trying to help her cope with the situations yourself is not effective, you may need to consider speaking with a therapist specializing in working with young children.
If it becomes clear that the hair pulling is simply a habit gone to extremes–much like the child who bites his or her nails until they bleed–it is important to interfere with her habitual behavior so it is no longer automatic.
Solution to Child’s Hair Twisting and Pulling
Simple things that you may or may not have tried include:
- have her wear a clean scarf to bed each night, making sure that it is pulled down low on her forehead to make it more difficult to pull it off;
- consider having her sleep in mittens for a time period so it becomes impossible for her to undo her hair;
- let her pick out the mittens and scarf so that wearing them will be fun; and check on her several times a night to determine that her scarf and mittens remain on.
Also, make sure that her hair remains as healthy as possible.
- Dry hair breaks very easily. If your daughter’s hair is well-conditioned and moisturized it will be less likely to pull out.
- You may even want to consider taking your daughter to the hair dresser and having it professionally deep conditioned.
And please remember that therapists specializing in work with young children are available in almost any community if you feel you need additional support.
published in the Communique, the monthly newspaper for the National Association of School
Psychologists. Cheri has a unique perspective on special needs children, as she has experienced the
special education system as a parent as well as a psychologist. She is presently pursuing her second
Master's degree in counseling psychology. In addition, Cheri writes both fiction and non-fiction for
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