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How is Trichotillomania Related to OCD?

Trichotillomania, also known as TM involves the anxious pulling or removal of body hair. It may sound silly, but to people that suffer from this disorder, it is real. Some disorders are so extreme that it totally disrupts daily functioning. This disorder, one of the many in the OCD spectrum of disorders, is associated with depression, shame, anxiety and outright disgust for people, places or things. It is not easily treated and has had psychologists stumped for years on how to treat such a disorder. It is multi-faceted and is not easily treated by one type of therapy alone.

The term "trichotillomania," refers specifically to the actual removal of body hair. However, there is a process of behaviors or experiences that eventually lead up to the actual hair pulling. TM has been the center of debate for years as to which of four diagnostic categories would best describe it. The official classification of TM exists as an impulse control disorder, and this remains the case even though research suggests that not all TM sufferers have the urge to hair pull.

The most likely diagnosis is probably a habit control disorder. It has been debated for years whether or not TM is an OCD spectrum disorder. This question is still up for debate today, even despite evidence that anxiety plays a very small part in the hair pulling phenomenon. Moreover, more than ten percent of those who engage in hair pulling say that there is no tension release associated with episodes, which is quite different from an OCD related episode. In fact, studies have showed that the results consistently indicate that the differences outweigh the similarities between TM and OCD.

The problem with diagnosing a disorder such as TM is that it is such an enigma, it is very complicated. Researchers like to take the one size fits all approach to diagnosing and treating disorders and it simply doesn't work in most cases, this being one of them. The truth is that cognitive-behavioral psychotherapy is not effective in treating everything and furthermore, not everything that seems bizarre and out of control is actually an OCD disorder.

As described above, one of the most common feelings associated with TM is shame. However, as pervasive as it is with this condition, it has been very minimally researched. When it comes to the shame that is experienced by people suffering from TM, it is generally associated with the fear that people will see their hair loss and see them as crazy, for self mutilating them. It is also not uncommon to have feelings of disgust for engaging in such behavior, and that also brings shame to the patient. And more yet, shame can even be brought on by the existence of unwanted hair in undesirable places. One thing that is true about TM sufferers is that they will go great lengths to conceal or mask the effects of their hair loss. A great deal of time and effort is generally dedicated toward concealing or masking the effects of the hair loss.