I am a female, 31 years of age with chronic depression and anxiety. I’m currently on a wait list for a new psychologist but I could be waiting a long time. I have an embarrassing habit that I’m concerned is something more but have been too embarrassed to admit to my therapist in person and I can’t find much similar online. The habit is plucking out my pubic hair. Not with tweezers in a maintenance way but often when I’m naked (which is a lot of the time honestly) I’ll find my hand just wanders down there and starts plucking out hair. It doesn’t seem to be when I’m stressed or anxious and or anything in particular like that and isn’t sexual either but is almost kind of Zen and calming. I can lose half an hour or more just zoned out feeling around for hair long enough to pull out with my fingertips. It isn’t a concious decision to start and as a behaviour it’s puzzling. Could the pain/pleasure it causes be an unconscious form of self harm? Is it a strange way of self soothing? Do other people do this? Is it worth getting the courage to mention it to my new therapist when I get one? Ann

Thank you for your question Ann.  What you have is a condition called trichotillomania which means hair pulling disorder and can involve hair on any part of the body. Trichotillomania is considered an obsessive-compulsive disorder characterized by repetitive pulling out of one’s hair resulting in noticeable hair loss.  Often people experience a rising tension or anxiety before pulling out the hair.  After hair pulling many people experience a sense of gratification or relief.   About 0.5% to 2.0% of the population experience this disorder which is about 1 to 2 people in every 100.   

Trichotillomania is considered a disorder; however, many people are focused on hair removal.  It is important to remember that hair removal is common, and most people cut, pluck, wax or shave their hair.  Trichotillomania is similar to nail biting or skin picking and some researchers have theorised that they are all forms of pathological or excessive grooming. 

I understand your embarrassment in discussing this behaviour with your psychologist, but this is the type of problems we discuss with clients regularly.  It is important that you are able to find the courage to tell your therapist about this habit.  There are a few reasons it would help your therapist to know about this behaviour. 1) Any habit forming behaviour is often a way to reduce stress, however in the long run they can increase stress. If you are using hair pulling rather than the skills your therapist teaches you to reduce stress you will not learn new more helpful ways to find a calm state.  2) A large part of therapy is developing a trusting relationship with your therapist.  If there is an important part of your life you are unable to discuss in therapy this can decrease the effectiveness of therapy.   

There are a range of treatments which have been found to be useful for trichotillomania.  Using habit reversal training as a component of Cognitive Behavioural Therapy has been found to be effective.  However it is important to remember there are usually other areas that need to be addressed in addition to this habit to achieve long term recovery.  The PsychHelp Psychologists would be able to assist you to reduce this behaviour if you do not feel able to discuss it to your current therapist.