Skeletons in My Closet

Trichotillomania, according to the internet, is an “impulse control disorder” wherein the person suffers from the (oftentimes uncontrollable) urge to pull out their hair. Dermatillomania is its sister disorder, only dermatillomania causes the urge to pick at ones skin. The two often go hand-in-hand and frequently occur in people who suffer from OCD, anxiety, and/or body dysmorphia.

Thanks to my anxiety and OCD, I have them both! Lucky me.

I can’t remember when the picking started; my earliest memory is of lying about the scabs on my scalp sometime during late middle school or early high school. At some point I just started… picking. At anything. At everything. Blackheads, scabs, ingrown hairs, skin tags, cuticles, random bumps, really anything 3D that could be detected on my skin. In addition, I started pulling at my eyelashes and eyebrows. At this point, I have scars from scabs and pimples that weren’t allowed to heal on their own, as well as a receding hairline at my temples from picking and rubbing at my scalp too much. I routinely over-pluck my eyebrows and then have to fight myself not to keep plucking them as they grow back. I also suspect the carpal tunnel in both my hands is a product of so many years spent repetitiously running my hands over my skin and picking or pulling at whatever I found. I’m luckier than many, especially those who have trichotillomania and pull their hair out in chunks, but if you know what to look for, you’ll see the signs on me as well.

Like any compulsion, trich and derm provide an emotional release for the sufferer. Some people pick when nervous or upset, and the sensation or pain offer a kind of comfort. For me, it’s more that picking is satisfying. I can’t properly describe what I feel when I pick off a particularly nice scab, but it’s a weird mixture of victory, physical pleasure, and productivity. When I have nothing to pick or I can’t see what I’ve picked at, I feel frustrated and disappointed. It’s fucked up, I know. I don’t enjoy the pain associated with picking, but it’s not enough to stop my fingers from digging at unhealed scabs or things that aren’t really pickable at all. Unfortunately, I’ve learned that if you pick at anything long enough, you’ll eventually tear into the skin and voila! New scab.

It’s a disgusting habit, I know, and one I can’t really hide. I pick, especially at my scalp, in a totally thoughtless, automatic way throughout my waking hours – I have to be very mindful and constantly vigilant when somewhere where I can’t pick, such as a meeting or other professional setting. Even then, I still find myself attacking my scalp while I sit at my desk, and I’m sure my coworkers know something is seriously weird with me. Honestly, I’m surprised my picking hasn’t chased my girlfriend off, as she’s definitely talked about how gross it is to run her hands through my hair and feel a bunch of scabs. Even while I write this, I’m picking at my skin. I’ll probably continue to do it for the rest of the day, and for at least 20 minutes in the bathroom mirror while I’m getting ready for bed.

The problem is that, unlike people addicted to substances, I can never get away from my temptation. My hands are always with me, and there’s always something to pick at somewhere on my body. Wearing gloves 24/7 is obviously impractical, and cutting my nails just makes the job harder but the victory more rewarding. I have methods of decreasing my picking, like pulling my hair back and wearing a spinner ring I can fiddle with, but those only work for so long. The maximum number of days I’ve gone without picking is four  – but I’ve only managed that once. My average is one, and that’s if I’m doing really well. Most of the time I can’t bring myself to even try. This issue seems insurmountable and I feel exhausted just thinking about thinking about trying to fix it.

I don’t have any advice for others in this situation, as I clearly haven’t even begun to get a hold of my compulsion. Therefore, I can only speak to others, to those who might have someone in their life who struggles with something similar. To those people I say, have patience and be kind. Compulsions aren’t just “bad habits” and your loved one isn’t doing it to annoy you. Chances are they hate the compulsion even more than you do, and they’re actively toning it down whenever you’re around. Yelling at someone, demanding they stop picking, or asking them why they pick isn’t helpful at all – all you’re doing is reminding this person that you don’t understand the issue and aren’t trying to. Instead, show your support by giving them gentle reminders to stop picking, to use their redirection methods, or to find something that puts both their mind and hands to action. Be supportive of your loved one and try to remember that this is most likely a life-long battle, not something that can be cured overnight.

To my fellow pickers and pullers, I can only say, you’re not alone and you’re not gross. I know it’s an embarrassing compulsion, but you aren’t your disorder. You aren’t your trichotillomania, your dermatillomania, your OCD, or your anxiety. These things affect you, but they aren’t YOU. Take one day at a time. You’ll get through this.