Guys Have Trich Too!

Guest Blog Entry by Sebastian Siwiec

“When the Japanese mend broken objects, they aggrandize the damage by filling the cracks with gold. They believe that when something’s suffered damage and has a history it becomes more beautiful.” ~Barbara Bloom

Imagine you woke up one day, and without explanation, you began pulling out your hair. Imagine what you would believe was wrong with you. Imagine that despite all your efforts, you continued to pull, and pull, and pull – day after day, hour after hour. Imagine how demented and defective you would feel. Imagine how alone and isolated it would be, as you shamefully tried everything in your power to hide and avert all attention away from your condition. You know what people will think of you if they ever found out you pull. This isn’t like feeling depressed or anxious, you pull out your hair, you’ve bit and ate your hair, and you do it on purpose and there is nothing, nothing you can do to stop it. You are insane.

Having trichotillomania has, without any exaggeration, been my most difficult and painful journey. My path has pushed me to the limits of my own self-acceptance; trich has brought me to my highest highs, but it has also dragged me down to my lowest lows. I made the decision to write this entry only to share the two things I needed to know when I first discovered I had this condition: that you are okay, and that you are not alone.

I began pulling my hair when I was in my first year of undergraduate university. I was 18 at the time, quite late to develop a condition that typically begins during adolescence (but that’s research on females, we still don’t have a strong consensus on exactly when males develop it, but it seems onset happens a couple years later). Even studying psychology, trichotillomania never came up in any of my studies, and I never learned that what I did actually had a name, was actually ‘a thing’ until 3-4 years after I first started pulling. Part of it was definitely the result of me hiding the condition from everyone including myself. For years I avoided searching and seeking answers to what I had; I was too ashamed to know. Whatever the answer was, it wasn’t something I wanted to hear. Ignorance was bliss. So I thought.

My mom was the first person who ever found out I had the condition, and for years remained the only person that knew. As supportive as she was, she only saw it as a bad habit, as something I lacked the willpower to overcome. She constantly policed and scolded me whenever I was caught pulling, unknowingly creating a level of anxiety, shame, and disappointment that would cause me to pull for hours as soon as I was alone. It took years of her reading and seeing me suffer with the condition before she finally began to see what so many people with trich know all to well; that this was something way more than just a habit.

Part of what I have always struggled with is that we still know so little about where this condition comes from. There is research to suggest that it genetic, biological, hormonal, neurobiological, and social influences all play some sort of role in the condition. It has been suggested to me by several therapists that trich must be a manifestation from childhood sexual and physical abuse. This is common thinking for some therapists, and part of the reason I am so adamant about advocacy and education for the condition. To look at me and assume my trich is a product of having been molested as a child repulses me. You are far, far more likely to develop trich from having a stressful day at school than you are from having been been abused.

And despite knowing so little about the etiology of trich, we know even less about how to cure or treat the condition. The best leads right now include an amino acid n-acetylcysteine (NAC), and variations of psychotherapy – most predominantly acceptance and commitment therapy (ACT), habit reversal therapy (HRT), dialectical behaviour therapy (DBT), and cognitive behaviour therapy (CBT). But these can dull the desire the pull and teach techniques and strategies to manage the condition, not eliminate it. Trich is very much a condition that does not ‘go away’ or cure itself; the cravings, urges, and tendencies to pull almost always linger on, even for those that achieve days, weeks, months, or even years of abstinence. It never goes away. This fact alone has been my greatest hurdle towards accepting this condition, and has challenged me to develop patience and kindness towards myself as someone that could potentially have the condition for a while longer.

Physically, I pull from the top of my scalp (i.e., the Friar Tuck look), along with occasionally pulling behind both my left and right ears. Trich has always puzzled me in the specificity of hairpulling sites. For me (and many others), venturing out in public and having my hair loss exposed is one of the most shameful, anxiety provoking, and frightening experiences I have ever gone through. It was why throughout my university degree, I wore hats for nearly five years. It was why I always stood slightly behind others or positioned myself with my back facing walls and corners – these were strategies for keeping myself ‘safe’ from having my hair loss exposed. With trich I am always keenly aware of where and how I position myself to minimize the chance that my hair loss will be exposed and seen. These strategies became as natural as breathing, because for the longest time I wasn’t emotionally capable of handling anyone finding out about my condition.

In addition to the insecurity caused physically by the condition, the very nature of trich has always profoundly disturbed me. I am educated, smart, and well-adjusted (right?), but behind closed doors I have the inescapable urge to pull out my hair. It doesn’t add up. How come I can overcome immense stress, remain calm and collected in so many other areas, yet feel powerless and helpless when it came to trich?

The psychological toll the condition has created has been significant. As a guy with trich, finding out that 90-100% of trich research has been done on females only exacerbated my isolation. Not only do I have a condition that makes me feel weak, powerless, and so incredibly self-conscious, but I have a girly disease on top of it! And even when I enter support groups and message boards, nearly all the members are female. You connect with the condition, but you always feel similar yet different. Maybe I got the wrong disease?

Many people find incredible acceptance in sharing the condition with others. It seems like a natural part of the journey towards self-acceptance, and a way of relearning that you are a whole and incredible person when for so long trich made you feel like you were so very much less. For me, the journey to self-acceptance came from reading and learning as much as I could about the condition. Learning that trichotillomania actually had a name provided my most significant milestone in my journey toward healing. From there, applying as much of my time towards reading, research, and sharing information about trichotillomania became my advocacy to disempowering the condition. It never felt okay to have to trich, so I spent hours sharing information about the condition with anyone I meet – from academic conferences to pubs in midtown Manhattan – to make it okay.

Thank you letting me share my story with you.

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Sebastian is in Calgary, Alberta and is on CBSN’s Board of Directors. To learn more about him, or contact him directly click here.

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