Case Study Trichotillomania

The person of interest in this case study supposedly suffers from trichotillomania, often known as hair-pulling disorder. The subject chronically pulls strands of hair from different parts of his body, namely his eyebrows and legs. He will feel the targeted area for individual strands of hair that “feel good” and twist them between his fingers, until they eventually come out. The behavior most frequently occurs when the individual is sitting down and has his hands free. His tendency to pull hair comes and goes depending on the day, but he does it to some degree almost every day. When on a bad streak, his eyebrows and legs contain noticeable bald spots from pulling hair. If he is asked about this by others, he will lie and make excuses

While not as widely considered today, early investigations into trichotillomania were based on the psychodynamic model. Theorists believed that the disorder “expressed a conflict between genital-stage sexual impulse and the repressive functions of the ego and superego” (Penzel, 2000). From this perspective, compulsive hair-pulling is seen as a coping mechanism to defend the individual from early sexual impulses. If this conflict is not appropriately addressed, the individual may carry this behavior into later life and use it to cope with any source of stress or anxiety. This, again, is very comparable to how psychodynamic theorists account for OCD and related stress behaviors, perhaps indicating that trichotillomania is closely related to OCD. While somewhat lacking in evidence, psychologists have used Freud’s psychodynamic theories to make a plausible explanation for chronic hair

This model is predicated on the notion that individuals suffer from erroneous and illogical thinking processes, which contributes to the development of abnormal disorders. When considering OCD, cognitive theorists believe that individuals who do not know how to ignore negative thoughts create measures to neutralize them (Comer, 2013, p. 130). Since it is closely related to OCD, cognitive psychologists would likely view the development of trichotillomania in a similar fashion. Hair-pulling, therefore, becomes a means of neutralizing negative, unwanted thoughts. Overtime, this turns into chronic hair-pulling as a means of dealing with stress, anxiety, and discomfort. This explanation is useful in the context of this case study, as the individual finds himself pulling hair whenever he is not doing something with his hands. The behavior may then serve as his neutralizing agent by giving him something to concentrate on when not otherwise occupied. Although there is minimal research support for this interpretation, it may be used in conjunction with the behavioral perspective to create powerful treatment opportunities for those who experience