It is nothing you have done that causes a person to pull out hair. Trichotillomania is a disorder. A person with trich is a NORMAL person who has a disorder. Any loved one would want to solve the problem . but the solution ALWAYS comes from the person themselves and the best you can do is to empower them to make their own decisions.

You don't have to understand, and certainly don't have to pretend that you do. Listen, without making suggestions or offering advice. Supply plenty of praise, hugs and above all, acceptance.

Offering praise will boost the trichster's self-esteem and someone who feels good about themselves, is less likely to self abuse. You cannot control the puller's actions, but you can control your own reaction to it. Be strong, be positive. Be accepting.

Please try to treat trich as a disorder separate from the person. The trichster is a terrific person, deserving of a lovely, full head of hair and eyebrows and eyelashes to match.

Pulling probably remains an issue for life. Some days it's unnoticeable and other days rampant.

However deeply it hurts you, this isn't about you, and the trichster hurts a million times more. They blame themselves enough and don't need more blame from you! This isn't a habit. It isn't something people deliberately do . it is like being taken over by a trance. Scalp pullers often feel like there are tiny insects crawling under the skin and the itch creates an urge to pull.

You've tried ignoring, shouting, distracting . but each individual must heal themselves. You can't do it for them. I know that hurts like hell and it's okay. If you need to get your anger out, write letters to the trichster that you later burn without sending but always appear supportive.

Trich hurts like hell when it's at its worst, but it overwhelms you with its warmth too. Most trichsters form loving, caring relationships and function well in all other areas of their lives.

So what should you do when you're sitting down comfortably in your warm environment, perhaps watching television, and out of the corner of your eye you notice someone pulling?

Distraction would help ... hand them a cup of tea (sorry, English answer to everything!), or ask them to check some figures for you. Engaging the logical brain can often stop the subconscious pulling process. Invite them out for a walk. Getting out or even just moving from place to place, helps. Reading and watching TV are triggers for pulling. Play chess, computer games or anything which involves the hands. Cross stitching is helpful. Try to keep them active and interested. Boredom is really bad for trich.

Incentives help, but please, if you've promised a reward, don't withhold it if there has been a little relapse. Try to be understanding that trich is not always within the person's control.

Take care of your loved ones and look after yourself.