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 François 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''.

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

Samaritans                                     Pieta House                                 Turn2Me

Ireland: 1850 60 90 90                   Website: www.pieta.ie                 Website: www.turn2me.org

 

The Porcelaine Throne

I don't know why either?

But if you think that's bad it could be worse. In 1976, Middlemist and colleagues carried out an experiment in which they measured the time to onset and the duration of urination of men in toilets at a college. The ''purpose'' of the research was to study the effect of personal space on a measure of physiological arousal (urination times).

 

The students were observed while alone or with a confederate of the experimenter, who stood at the next stall or at a more distant stall in the restroom. The presence and closeness of the confederate did have the effect of delaying urination and shortening the duration of urination. The situation is one that men experience on a regular basis, however one can question whether the invasion of privacy was justified.

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Whether you squat in an alley or sittin' on a porcelain throne, don't really change the moment, now do it?
                                                                                                                                                       ~ Omar, The Wire

Depressive Disorders

The causes of depression are mixed. There is no one cause for depression - even for a single person. And so we think of it as a risk factor model: where depression develops in the context of risks, and when those risks get high enough, the person goes over some threshold to develop this self-sustaining depression. Those risks might be divided into three categories; psychological, environmental and biological.

On the biological side we have genetics and other physiological factors which can give the person a predisposition towards being depressed. The psychological aspect can include thinking patterns or cognitive style personalities that may leave a person at a greater risk for depression. While environmental factors can include the stressors the person faces and a lack of social support. When the sum total of all these risk factors get high enough, then that can push us over some threshold and we go into a period of clinical depression. For some people, one of those three factors may be stronger than the other but it's unlikely that there is one cause - there's usually some balance of all of the factors. Nevertheless, all of the risk factors should be attended to.

As depression begins to take hold, people stop performing behaviours that previously provided reinforcement, such as hobbies and socialising. Moreover, depressed people tend to make others feel anxious, depressed and hostile (Joiner and Coyne, 1999). Eventually, these other people begin to lose patience, failing to understand why the person just can't snap out of it. This diminishes social support even further and may eventually cause depressed people to be abandoned by those who are most important to them (Nezlek et al., 2000). Additionally, longitudinal studies show that reductions in social support are a good predictor of subsequent depression (Burton, 2004).

 

In short, behavioural theorists believe that to begin feeling better, depressed people must break this vicious cycle by initially forcing themselves to engage in behaviours that are likely to produce some degree of pleasure. Eventually, positive reinforcement produced by this process of behavioural activation will begin to counteract the depressive affect, undermine the sense of hopelessness that characterizes depression, and increase feelings of personal control over the environment.
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''If you know someone who’s depressed, please resolve never to ask them why. Depression isn’t a straightforward response to a bad situation; depression just is, like the weather. Try to understand the blackness, lethargy, hopelessness, and loneliness they’re going through. Be there for them when they come through the other side. It’s hard to be a friend to someone who’s depressed, but it is one of the kindest, noblest, and best things you will ever do.''
              ~ Stephen Fry

The Chameleon Effect

According to authors Chartrand and Bargh ,"The chameleon effect refers to nonconscious mimicry of the postures, mannerisms, facial expressions, and other behaviors of one's interaction partners, such that one's behavior passively and unintentionally changes to match that of others in one's current social environment." (Journal Of Personality and Social Psychology, 1999).

 
How many times have you yawned after viewing another person do it? Or noticed your tone of voice depended on the company you were in. What about meeting up with people from where you used to grow up and now realising that your homeland accent has suddenly started coming out of your mouth...

 

The chameleon effect can happen naturally and frequently because we feel a rapport with people who mimic our moves. Most of us do it automatically to varying degrees, we mimic the people around us all the time without even realizing it.

 

In one study of the chameleon effect, Chartrand and Bargh found that students who rated high on empathy were more likely to imitate others. "Those who pay more attention mimic more," says Chartrand.

 

We also mimic the facial expressions of other people. This is so hardwired that one-month old infants have been shown to smile, stick out their tongues, and open their mouths when they see someone else doing the same (Meltzoff & Moore, 1977).

Unintentional mimicry and imitation functions as a social cohesive. The chameleon effect actually becomes a warm response that facilitates social interactions. Mirroring a persons language shows that you understand your conversation partner, and that you are an empathetic listener.

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''When you are in the company of lunatics, behave like a lunatic. When you are in the company of intelligentsias, speak with brilliance...that is how a chameleon behaves, the territory changes it, and it adapts to the changes.''
                                                                                                                    ~ Michael Bassey Johnson