3 Skills - Trichotillomania Dealings! for May
So I’ve been in Dialectical Behavior therapy for well over two years now, and I’ve learned tons of different skills for mindfulness, emotion regulation, distress tolerance, that kind of thing. It’s a little too much to keep track of everyday actually.
( I have these daily diary cards and I have to tick off all the skills I used each day from this long list of different skills and practices. I like to ignore it all together because it never feels like I did enough, which is a poo feeling )
Also! What I’m about to talk about isn’t exclusive to trichotillomania. I think anybody with any sort of body-focused repetitive behavior (BFRB) can find this helpful. For me, it’s just trichotillomania. that is part of my personal experience.
So I’m trying a new strategy that’s been much more helpful in these last several days since I started, and all I’m doing is choosing 3 skills to focus on for a month. (Now, I started this in the middle of this month, but that’s okay.) I’m gonna see how it goes!
My 3 skills of choice: Self-Soothe, T.I.P.P, and “Check the Facts”
Self-Soothe is part of the “Distress Tolerance” category. It focuses on the six senses. (Wait 6? yes!) Vision, Hearing, Smell, Taste, Touch, and Movement, which is kinda cool. You could go on a walk and take in the sights and sounds of nature. Eat your favorite food and really pay attention to it. Dance to a nice song maybe. It’s really up to what you like. When you’re feeling upset, self-soothe is meant to calm you down by sort of shifting the focus to something pleasant and nice for a bit. It can help you reach a calmer head-space. When thoughts and feelings start to cause me to want to pull out my eyelashes, self-soothe can be an alternative route. It can also be practiced before I’m in any situation with strong urges. Self-soothe can help make my day easier to begin with, so I can use it as a preventative measure in a way.
T.I.P.P. is another Distress Tolerance one. It stands for Temperature, Intense Exercise, Paced breathing, and Progressive muscle relaxation. This skill is for more intense emotions because TIPP makes it easier to grab your full attention away from whatever is bothering you.
Temperature can be like washing your face in cold water for a minute or putting a cold pack on your cheek for 30 seconds (only if you can handle cold water though)
Intense exercise is just taking 10-15 minutes to do something to get your heartrate up like running, dancing, or jumping. I plan to buy a jump rope soon, which will be fun. (same caution for this, only try it if your health permits)
Paced breathing is balanced breathing (using your abdomen/diaphragm, breathing deeply as best you can), and you can do whatever works for you. Something like 4 counts in, 4 counts out for a minute or two. I usually close my eyes to focus or i’ll look at this tree outside my window.
Now, progressive muscle relaxation is tensing different parts of your body one at a time and relaxing them, noticing the difference between the tension and relaxation. I usually go feet, to legs, to butt, to torso and back, to shoulders and neck, to my face (one group at a time. don’t want to cause knots lol)
Check the Facts is the last one for this month. It falls under Emotion Regulation because it’s about recognizing your emotion and experiencing it without letting it control you. It’s like riding a wave instead of being washed over. Checking the facts is simply going over a situation that troubles or puzzles you or whatever. You describe it to yourself, and you state only facts - no speculation. These questions can help - Are you interpreting the situation correctly? Are there other ways to interpret it? Are you thinking in extremes? (all-or-nothing or catastrophic thinking) What’s the probability of the worst happening? Even if the worst happens, can you imagine coping well with it? Checking the facts just kinda helps me to step back and evaluate instead of letting my thoughts spiral.
A good example is that I was texting a guy today about getting coffee and he just disappeared for hours - no response at all. I started thinking like “Ohmygod maybe he meant to text somebody else and I was a mistake !” “he hates me!” Really all that I knew at that moment was that he texted me about getting coffee together, I said yes, and then I didn’t get a reply for hours. I didn’t know if anything happened or if there was a problem, but reminding myself of the facts helped me not to panic and to be patient until I did get a reply.
So I just try to practice these 3 skills everyday. I go on walks, I practice balanced breathing, I tried yoga today ? There are lots of things that can qualify for these skills, and simply focusing on a few makes it a lot easier instead of trying to conquer them all. I’m getting more thorough and thoughtful practice, which will help me in the future.
What usually happened for me was that I would sort of practice skills, but when strong urges came about I felt I had to pull out eyelashes before I could return to my task. I’d try a skill but come right back to a strong, insistent urge to pull.
I have seen progress in myself, however, for sure. I don’t pull as many eyelashes during episodes anymore. Even though I can’t stop it completely, it’s nowhere near as severe. I can step back after a few eyelashes and refresh. I used to not be able to stop myself until everything was gone on my eyelids. Sometimes I relapse, but it’s more spaced out, and I don’t feel the heavy guilt and embarrassment I used to feel. DBT has seriously taught me how to be on my own side. I’ve become a lot more aware of my needs and tendencies too.
I definitely don’t expect to be cured right away. I’m on summer break, which definitely makes things easier. I’m at home most days. But with this better system for practice, I hope that I’m more prepared for the urges that may come with future stress. I noticed the other day when I was working at my computer that I was getting tired and I suddenly preferred to practice a skill instead of the usual “force myself to work until I get frustrated” Retraining your brain takes a while that’s for sure, and I think it’s possible when you invest a little energy into it habitually over time.