It is difficult to describe the joy I felt when I bought gel finger grips from Staples on a Monday evening. The closest thing I could compare it to would be getting a puppy, or perhaps planning an exciting vacation, mostly in the sense of feeling like I finally had something all figured out.
I waltzed into my office the next morning, donning my new accessories with the same confidence as if I were wearing a bold lipstick. My coworkers, with their acute attention to detail, noticed immediately. “What happened? Did you hurt yourself?” one of them asked. I explained myself matter-of-factly and no one even blinked. Without missing a beat, the questions turned to whether my new strategy was working, what the grips felt like, and whether they ever became annoying. It was no more shocking than talking about rush-hour traffic, which is what the discussion turned to next. Having only known this group of people for eight weeks, I’d call that a tremendous success.
Whenever I’m getting to know someone new, I cut to the chase and reveal what used to be my most shameful secret: I pull out my own hair.
Trichotillomania, also known as compulsivehair-pulling, entered my life after an ugly haircut when I was 11.
All of a sudden, something about my hair felt inexplicably wrong, and I found myself subconsciously believing that if I pulled enough from the right places, my unruly new hairdo would “even out.”
Trichotillomania, according to the Mayo Clinic, is “a mental disorder that involves irresistible urges to pull out your hair, despite efforts to stop.” It’s an inherently sensory disease. Something about hair, maybe the texture or appearance, sets off an urge, a mental alarm bell. Personally, I’m a sucker for hair that’s brittle or makes a crisp sound when I snap it. The urge is impossible to resist, and, if you have trichotillomania, it will make you intolerably anxious if you try. I was never good at resisting temptation, so I would succumb to every urge, winding up with the imperfect hairs all over my clothes and bedroom floor, and never even being close to having only the “right” ones.
I would’ve been mortified if anyone discovered what I was doing. Throughout high school, I refused to wear my hair up, even during volleyball practice, for fear of the sides of my pale scalp peeking through a thin and patchy layer of hair.
Things changed when I started university and decided I wanted to be an academic researcher focused on trichotillomania. By then, after almost a decade of pulling, my self-induced impending baldness was old news. I started to trust in people more often by disclosing to them, and an interesting thing happened—people, in turn, started disclosing their own hair-pulling struggles to me.
Everyone in college was encouraging and supportive; they even pushed me to get diagnosed my senior year. And yet, when it came time to apply for graduate school, I had my mentors telling me that I should not, under any circumstances, let on that I suffered from a Body-Focused Repetitive Behavior (BFRB), even if that’s what I wanted to study. The general hesitation was that people who study a disorder they suffer from may bias their work, or they may be disinclined to learn about anything else. Besides, it was simply too personal for an admissions committee. The real world might not be so accepting.
BFRBs are the elephant in the office space: impossible to hide for long. I have the luxury of having enough hair that I can style it certain ways to conceal my bald spots, but some people don’t. Others pull from their lashes or brows, leaving less to improvise with. Skin-picking disorder, another BFRB I suffer from in a milder form, is the same, with lesions on the face or extremities being time-consuming and burdensome to disguise.
The crux of these disorders is that we feel like our imperfections are on display for the whole world to see, and that our value as people will be determined by our anomalous appearances.
This sentiment is echoed tenfold in an office, especially in biopharma, where I work. All the women I’ve worked under in healthcare seem superhuman—funny and charming with amazing style, while at the same time displaying the utmost professionalism and excelling at their jobs. Educated, powerful women seem to be unable to show weakness in the workplace. If they express one modicum of worry or insecurity (let alone baldness), they risk not being taken seriously. I strive to be one of these high-status women myself, but I refuse to get there on anything but my own terms.
So, when I started a new job two months ago, I promised myself I’d be proactive and tell my new colleagues about my hair-pulling before some of them noticed what I was doing. During my first one-on-one meeting with my new boss, I took a moment to say, “Listen, I have this condition, and it isn’t something I have much control over, but I try not to let it interfere with my life or my work performance. It’s still something I want you to know about, and we can talk about it anytime.” I was extremely nervous, but she looked back at me without flinching and said, “I really appreciate you letting me know about this.”
It was a tasteful response for something so unexpected. Later, I wondered if anyone had come forward to her about a mental health issue like that before. I certainly had never been on the receiving end of any such thing from a coworker. At previous jobs, I used to keep my diagnosis to myself unless someone specifically asked. But there’s no way for someone to offer support unless they know your situation.
Though unsolicited, telling my boss up front was something I had to do, because trichotillomania could—erroneously—make me look like a substandard employee.
My typical workday usually consists of sitting either in meetings or in front of my computer, which are both triggering for trichsters, who sometimes find themselves pulling without realizing it, especially when they are understimulated. Some people pull as a way to cope with negative emotions, but others, like me, fall into a spellbound state where our hands, decoupled from our minds, scan for the next oddly textured hair to pull.
What flips the switch for these “automatic” pulling episodes is not boredom per se, but inactiveness. In meetings, it’s not uncommon for me to be typing vigorously with one hand while the unoccupied hand is buried in my hair, scanning away. At my desk, I’ll end up noticing a brunette split end against the light of my computer screen, and in the blink of an eye, thirty minutes of searching for every last one will have passed. Frankly, behaviors associated with my hair-pulling make me look like I’m bored or not paying attention. I didn’t want anybody in my new office to think poorly of me, especially when I pride myself on doing my best in spite of my compulsions.
In my experiences, people at work aren’t outright malicious when they encounter a trichster; rather, they speak through their silence. Sometimes the sensation of someone’s gaze on me is palpable. I can feel them staring at me during a meeting, or watching as I attempt to discreetly clean a tangle of displaced hair off the carpet. I’ve caught the grimaces and double-takes in my periphery, but I’ve never overheard anyone actually talking about me, with one exception: In an office where my coworkers were particularly snobby, I once heard someone say, “Does she just not realize how disgusting that is?”
Believe me, nobody chooses to have a BFRB. And nobody enjoys having a BFRB, either, even though our behaviors provide us with tremendous relief in the moment. That relief is fleeting, and as the moment passes, it is pushed out by humiliation and disgust. I am averse to hair, mine or anyone else’s. When I have to clean up after a pulling episode, no one is more disgusted than me.
But when I break the ice, the reaction I most often get is surprise. It never ceases to amaze me that in medicine, no matter how esoteric the therapeutic area, so few of the educated and scientifically-minded folks I’ve worked with know what trichotillomania is without my having to tell them. I’ve had people who study diseases that affect less than a million people ask me to tell them more about a disorder that affects 2-5 percent of people in the United States alone, according to the TLC Foundation for BFRBs. I’m happy to do it, because I’m used to being a self-appointed advocate. But the barrage of questions may be too much for someone who is still coming to terms with their disorder.
Over the past few years, and certainly in the past two months, I’ve learned that openness yields openness.
When people are comfortable with you, your quirks don’t bother them so much. All my coworkers know about trichotillomania now, and my hope is that someday, when I’m a powerful, pantsuit-wearing scientist, the people in my future office will all already know what it is. Like my own boss, I want to encourage people to talk about mental health in the workplace. I know what a huge relief it is to not feel like I’m hiding a part of my identity.
Most of all, the support of my colleagues gives me the flexibility to try different recovery strategies without worrying what anyone thinks. I’ve tried them all by now—tallying on a sticky note every time I pulled, having a stress ball in hand at all times, taking a lap around my cubicle when I felt an oncoming urge, you name it.
I’ve found that the recovery process starts by accepting yourself and coming to terms with your disorder.
It didn’t take long to realize that when I focused too hard on not pulling, I’d relapse even harder than if I’d just gone with the flow and stopped thinking about it for just one hour at a time. A month of abstinence from pulling always starts with an hour, and giving in to an urge is a temporary lapse, not the end of the world. The game is to figure out the best cognitive strategies that work for you, which you can learn either from a lifetime of trial and error, or a really good therapist. Either way, trichotillomania is most often a chronic, lifetime condition, but lots of people do recover, and recovery is a team sport.
Later that week at work, it seemed like everybody was curious to hear about the efficacy of my new finger grips. I’m pleased to report that at the time of writing this article, it’s been eight days since I last pulled at all, thanks to the grips (which I’d highly recommend to anyone with trichotillomania) and my terrific team. I may not ever stop for good, but I’m off to a pretty good start.
By Kimi Vesel