Behavior Therapy Week 3 This 5 week Behavior Therapy Program was designed by a Therapist that also suffers from Trichotillomania. If you would like to talk to others that have tried this therapy go to BrendaC's Message Board Home Page Introduction and Week 1 Week 2 Week 4 Week 5 Hi everyone, We tend to be creatures of habit. We do everything in the same old dull and boring way every day. Sometimes doing things the same way makes sense. We go to work the same way every day because it's the quickest way or the safest way or has the least traffic etc. We sit in the same chair because it is the most comfortable for us for whatever reason. After a while we are just doing these things automatically. Have you ever thought of how your trich might be related to doing all these things in the same way every day? Think for a moment about the smoker. You might even be one. The smoker drives to work the same way every day and habitually lights a cigarette at the same set of traffic lights every single day without thinking about it. Your favourite chair might assist in being a a trigger for pulling while you watch TV. It might not be just the act of watching TV. A whole set of circumstances might set the pulling behavior in motion and not just a stressful event preceding the pulling or the act of relaxing. WE NEED TO TRICK THE TRICH!!!!!!!! We need to change the pattern of our behavior. Any things that you can think of that you do every day in a particular way must be changed for several weeks. If you get up, have breakfast, feed the dog then have a shower in the morning try feeding the dog, having a shower and then having breakfast. If you sit in the same old chair all the time, then change the chair you sit in. Do these things even if they are not directly related to your pulling. Change the way you go to work . REPATTERN your life.The more things you change the better. This will be one of your activities for this week. Have a look at your caffeine intake for the week. Did you notice any patterns between your caffeine intake and you pulling. Caffeine and alcohol are physical stimulants and mental depressants. They are stressors and are therefore a bad response to stress. Because they are stressors and pulling is often associated with stress they are possibly triggers for some people. They can also create fatigue which is a known common trigger for trich. We all have a fight or flight mechanism which gives us strength in the face of danger. Not long after drinking caffeine, it enters the bloodstream and the body reacts to fight it off. The heartrate increases, blood vessels constrict and the blood pressure rises. This is interpreted as a 'lift'. The body then seeks a state of equilibrium in order to get back the energy lost when fighting the caffeine. It goes into a state of physical depression. This is interpreted as fatigue. Fatigue can trigger pulling. So try reducing your caffeine and alcohol intake and see if it helps. An important point to remember is DON'T ALLOW YOURSELF BECOME TOO TIRED OR HUNGRY OR YOU WILL EXPERIENCE FATIGUE. I have a breathing and relaxation script here. It is good to use as a distraction in your delay times (hours when I've asked you not to pull). Familiarize yourself with the script (read it through a couple of times) then you might like to try tape recording your reading of it. Read it in a slow relaxing voice (or get someone else to read it for you) onto the tape. You can the use this tape to help yourself relax whenever you like or when you are stressed as a distraction from pulling during delay times or when you are fatigued. If you do it often, you can help yourself learn to relax as a better response to some triggers. It depends what the trigger is of course. Exercise is a good way to release tension. Exercise is sometimes good for stress because of the tension it releases. Relaxation exercises are good for the fatigue that is sometimes related to stress. You will need to decode your urges and work out what it is you are actually feeling and try to replace your pulling response with some more appropriate response. Deep Breathing and Relaxation Script 1. Sit comfortably and quietly in the chair. Close your eyes. 2. Scan your body for tension. Become aware of how your body feels. 3. Place one hand on your stomach and one hand on your chest. Breathe in - slowly and deeply through your nose, feel your stomach fill, pushing your hand. Breathe out - feel your stomach empty. Your hand on your chest moves only a little and in tune with your stomach. (REPEAT TWICE). 4. When you feel at ease with your breathing, smile to yourself, and slowly breathe in through your nose and out through your mouth, making a quiet, relaxing sound like the wind, as you blow gently out. Your mouth, tongue and jaw are now becoming relaxed. Still taking long, slow, deep breaths, feeling your stomach rise and lower. Focus on the sound and feeling of breathing, as you become more and more relaxed. 5. As you continue to take long, slow, deep breaths- Become aware of any sensations in your scalp and face, and on your outward breath let go and relax - softening your face and scalp. Still breathing slowly and deeply - move on to your: neck, shoulders, arms, hands, chest, back, abdomen, buttocks, legs, feet (SAY THIS WITH 5 SECOND GAPS). 6. Now take 5 slow cleansing breaths, letting go of tension throughout your whole body. 7. Feel - your stomach moving up and down, the air moving in and out, a growing sense of relaxation from your breathing. 8. While you continue to breathe slowly - Imagine a safe place. It may be real or imagined. Enjoy how you feel in this place - relaxed, calm, peaceful, warm (SAY THIS WITH 5 SECOND GAPS). 9. Now take 5 energizing slow breaths. Slowly becoming aware of surrounding sounds. When you feel ready, slowly open your eyes. Take your time. Sit quietly for a few moments. Review your notebook from last week. Are you learning something about your pulling behavior and about yourself ? Did you watch out for self-pity? Are you beginning to choose to respond diferently to stressors? Add up the amount of time you spent pulling (or resisting urges etc) last week. DON'T COUNT HAIRS!! You shouldn't be focussing on these. These are the objects of our obsession. ACTIVITIES FOR WEEK THREE 1. Continue to record all pulling sprees, urges, pre-pulling behavior or one off hairs (as for last week). 2. Record what preceded the pulling (or urge etc), where you were, what your feeling were surrounding the pulling incident (this will help you find something more appropriate to replace the pulling response with), what you did to control it and what you did afterward. 3. Use your imagination when distracting yourself from pulling during delay times. Don't always use the same method of distraction that you have always used unless you find it very effective. You are not just trying to get through urges but you are trying to work out what caused the urge so that you can come up with a satisfying response that will replace pulling. You don't want to spend your life fighting urges!! 4. Contiue delaying pulling for one hour after eating, upon waking and before going to bed.Delay pulling for one hour after starting to watch TV or after beginning to read (any material - as for week one) 5. Delay pulling for one hour after drinking caffeine drinks and alcohol. 6. No pulling whilst talking on the telephone or whilst emailing anyone or posting messages. 7. Repattern you life. Refer to message 30 on this thread for instructions. This is very important. All rituals msut go!! 8. Declare your bedroom and your bathroom(s) no pulling zones. No more pulling in these rooms. 9. Do not stand closer than 1 and a half feet (50cm) to a mirror even when applying make-up. 10. Continue recording caffeine and alcohol drinks in notebook (as for week 2). 11. Change the hand you pull with. No more pulling with your usual hand. Also change the fingers you pull with. If you usually pull with your thumb and index finger change to something like thumb and ring finger of the opposite hand. This is inconvenient but so is trich. You will probably end up poking yourself in the eye so be careful, but this really does help break the habit. 12. After pulling, put it in a throw away bag and don't look at it. Tell yourself that you are not interested in what you got. Then do the distraction listed last week at point 5. 13. Eat three good meals everyday and healthy snacks in between. Don't allow fatigue if you can help it and don't allow yourself to become overly full. That "full" feeling is a trigger for some. 14. Continue adding to your list of reasons for not pulling anymore and READ THESE EVERY DAY. Also read your goals every day. 15. Still no pretty hair accessories etc. and still keep your hair things in a different place from usual. 16. Add 5 minutes of exercise to what you already do (doesn't have to be strenuous - walking is fine). Check with your doctor first if you don't exercise at all. 16. Try to get a good night's sleep every night - especially while you are working through this if you can. Lots to do this week. Hope you are all going well. If you slip or forget to do something it doesn't mean it won't work now. You just keep going on and tell yourself you'll try to do better. If you happen to pull hair in a delay period it doesn't mean you will not be successful. This is a learning program. You are learning and you will get there. Just keep going !! .Website maintained by BrenDakota.