Saturday, August 16, 2014

Trichotillomania

Trichotillomania (TTM) is a condition in which people feel an overpowering urge to pull out their hair.  The urges seem uncontrollable and are often exacerbated by stress or other emotional upsets. The term was coined by the French dermatologist Fran├žois Henri Hallopeau in 1889.
 
People who suffer from TTM will pull, pluck, or twist their hair until it comes out. Others may use instruments to achieve this goal. Sufferers will pull hair from any part of their body: scalp, face, eyelashes, arms, legs, or sometimes a combination of these areas. However the scalp is the most common pulling site. Some people may also have the compulsion to eat the hair. Less common is unconscious (or sleep-induced) hair pulling, in which the person doesn't consciously realize he or she is doing it. Symptoms usually begin before the age of 17 and it is more often seen in women, but can inflict either sex.
 
Analogous to self-injury , the act of hair pulling is usually followed by a period of intense self-blame, shame and sometimes anger because the 'puller' knows that the behaviour is in some way self-damaging, yet they can feel helpless to stop.

How many people does it affect?
The true prevalence of TTM isn't exactly clear, since people are often ashamed of their behaviour and are subsequently reluctant to discuss it, even with their GP. So it is therefore difficult to get reliable statistics. Historically it was thought to be rare, but the condition is now better understood and more people are seeking help. Recent estimates range from 1 to 3.5% of the population, depending on the definition used.
 
Treatment
Behaviour Therapy approaches include several techniques. The most central of these is Functional Analysis, or identification of the antecedents (precipitating behaviours, events, emotions, sensory experiences), behaviours (when, where and how does pulling occur?), and consequences (what does the youth get out of pulling?) associated with pulling. Other behavioural techniques include Habit Reversal Training (HRT) which consists of developing an awareness of sensations preceding and during pulling behaviour through self-monitoring and related techniques and the use of competing responses or compensatory behaviours that are incongruous to pulling. Stimulus Control which focuses on reducing environmental or other circumstances that trigger pulling is often included as well. Relaxation and other anxiety-management strategies, cognitive restructuring of thoughts related to pulling and self-soothing, and strategies to enhance motivation for treatment compliance may also be utilized as part of a behavioural approach.
 
 
 
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''It's a bit bigger than what you look like. It does something to you inside. Both happy and sad''.

Friday, August 01, 2014

Warning Signs for Suicide

The best predictor of suicide attempts in both women and men is a verbal or behavioural threat to commit suicide, and such threats should always be taken seriously.
 
One of the most destructive myths about suicide is that people who talk openly about suicide are just seeking attention and do not actually intend to carry out the act. Yet research shows that a high proportion of suicide attempts - perhaps 80 percent - are preceded by some kind of warning (Bagley & Ramsay, 1997). Sometimes the warning is an explicit statement of intent, such as 'I don't want to go on living' or 'I won't be around for much longer'. Other times, the warnings are more subtle, as when a person expresses hopelessness about the future, withdraws from others or from favourite activities, gives away treasured possessions, or takes unusual risks.
 
Other important risk factors are a history of previous suicide attempts and a detailed plan that involves a lethal method (Chiles & Strossahl, 1995; Shneidman, 1998). Substance abuse also increases suicide risk (Yen et al., 2003; Passer & Smith, 2009).
 
There's an enormous amount of pain in the world. Not physical pain but psychological pain. It's an ache in the mind. It's an ache of the negative emotions. It's the ache of guilt and of shame, and of loneliness and rejection. It comes from thwarted, blocked, frustrated, trampled upon psychological needs. And if I were to commit suicide, it would be in terms of my frustrated needs. And if you were my therapist, I would be grateful if you understood me, not in terms of my biology or my parents or my psychodynamics, but in terms of what needs were bugging me.
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''The grief of the worshippers left behind, the awful famine in their hearts, these are too costly terms for the release''
                                                                                                                                                                     ~ Mark Twain

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