Interview with a hair puller

I was lucky to interview someone recently who developed hair pulling behaviour as a child and they told me about the first time they pulled out a hair and examined the lipid fat root.  Here is what they said:

"It is weird that I can remember the first time I ever pulled out a hair, but I can.  I remember sitting watching TV,  I must have been about 9 years old.  I had just had a bath and was sitting wrapped in a towel.  My mother and father were also in the room.  Not sure what was on TV but I remember some urge possessed me to pull a hair.  It happened automatically.  It was like some force was driving me to do it.  The body just had a will of its own to do it and once plucked I was surprised to see the glistening white root fatty root.  I plucked a second hair just to see if I could repeat the same result as I had the first.  And I did.  And I just kept on plucking after that.

My family must have seen me do it and I recall my dad told me to stop it on a few occasions, but they never took me to a doctor.  I suppose they viewed it as a bad habit that I would grow out of.  But I wish they had understood the nature of trichotillomania - that it is a real condition and not a passing phase.

The more I plucked the more other changes occurred.  As a child I had very fine, glossy and straight hair but when the plucked hair grew back it grew back thicker, curlier and more dull in colour. 

I plucked consistently until I was into my mid-teens and developed very thin hair on the crown of my head.  To avoid over plucking in a single area I would pluck from alternative places - the sides of my scalp.  Again, thinning occurred.  Over time my hair pulling developed into skin picking as I tried to find alternative ways to avoid direct hair pulling without giving up on the comfort I got from this behaviour. 

To this day I will still dig my nails into my scalp and eat the skin I can scratch off.  It doesn't happen often but I know that the same impulse that affected my as a kid still affects me today. "

These interesting insights reveals the strange trajectory that hair pulling can go in, with manifestation of hair pulling behaviour changing over time.  It also reveals how this condition is very hard to cure outright.  Genetic changes, such as hair quality altering, are also a part of trichotillomania, with changes in hair quality a common phenomenon.  I wish to thank my interviewee.  I hope you found it interesting too.

Human 'captivity' may precipitate hair pulling?

Self-directed behaviours affect animals raised in captivitiy - fur biting, hair pulling, feather plucking...so it is fair to say that environmental disruption is a strong link with these behaviours.  So, can self-directed behaviours in humans also be traced similarly?  The psychoanalyst R.D. Laing famously pronounced that man is a captive animal - which I take to mean that his social boundaries are ones imposed by modern society but are not ones that characterize humanity's evolutionary history.  

When environments go wrong it means that some essential behaviour is being frustrated or unsupported.  For example, the conditions for rest and relaxation require a level of comfort and sense of safety from danger.  But what if drowsiness arouses fear of attack or the loss of control over the proximity of others?  Where the need to maintain wariness and the need to achieve sleep are in prolonged conflict it could mean that the onset of drowsiness could become a trigger for displacement behaviours.  These might serve to resist the transition to unconsciousness until a window of opportunity - where risk to safety is tolerable - arrives.

There are many ways too that people can feel 'caged' by their environment.  Maybe they are being brought up in a home where parents are enforcing certain rules or boundaries too strongly.  Or maybe one of the following situations has arisen:  judging a child by adult standards of behaviour; limiting physical movement; restricting vocal expression; disapproval of touching and grooming behaviour; preventing free playfulness; imposing social separation and isolation for prolonged periods; creating power imbalances; affording limited or unsuitable living space.  With all of these situations there lies the risk that, as with caged laboratory animals, the species specific conditions that behaviours rely upon to get their cue or derive their setting point are undermined. The organism may retain the propensity towards a particular action or state, but  the environment continually fails to allow its expression.  This creates a stop-start-stop-start experience which eventually becomes resolved through a third behaviour which deactivates this whole uncomfortable process but produces a new and unwanted chain of events.

Many parents fail to perceive or understand their offspring as children - but impose the same conditions that were imposed on them.  Any parent who demonstrates behaviours such as nail biting, hair pulling or self-directed symptoms is, in my view, revealing signs of being poorly embedded in their social environment.  The danger here is that if the parent is poorly adjusted the child may be even more extremely affected because the parent IS the child's environment!  In the most extreme of cases, the parent creates a barren cage for its offspring.

World Cup 2014 & displacement behaviour

Hands on head after a missed open goal- displacement behaviour

Keep your eyes open this world cup for displacement behaviour.  It is such a common phenomenon that you may never have really paid attention to it before but in almost every game at certain key moments you will see it.

Those key moments relate to missed goals.  Now, anyone who watches or plays football knows that some missed goals are more painful than others.  The shot that misses the goal by a large margin and which, from the moment it leaves the boot, never looks like going close to goal is never as disappointing as the one that only just misses the target.  When we fully expect the ball to go into the back of the net but at the very last moment the ball veers away or goes past the post and not inside it, an automatic reaction occurs.  

This automatic reaction is one we all know well.  Consider this: excitement builds as the expectation of a goal rises, only to be suddenly and forcefully opposed by the realisation that it has missed and the sense of elation is simultaneously contradicted by one of disappointment.  This process is marked by the hands of the player (or often spectators too) suddenly being raised to the head and the fingers used to comb the hair or scalp in a smoothing or caressing action.  

But why does this happen?  Well, it marks disappointment and a defeated expectation but there is more to it than just this.  Physiologically speaking it indicates that two contradictory impulses are being experienced and producing a behaviour that has in fact no direct relevance to the situation in which it occurs.  I mean, how could raising your hands and passing them through your hair or resting them on your head be of any real use?

Most people fail to really pay attention to this action because it is so common or automatic that we take it for granted as a natural phenomenon of no significance.  But when one stops to think that it occurs at those specific moments when the tension between excitement and disappointment is at a certain point of balance, it assumes new meaning.  It is a classic case of a displacement behaviour, the purpose of which is to deactivate overloaded circuits and act as a reset so that the processing of fresh incoming sensory data can be resumed.  

As well as this act of self-grooming behaviour we often see players grooming each other too.  A player who has missed a goal and looks disappointed will often have his head touched or stroked by a team mate.  Grooming is just an automatic and innate human behaviour derived from our ancestral heritage.

You will see many cases of self-grooming (and mutual grooming) during this World Cup so keep your eyes peeled - especially for those specific moments when celebration behaviour and realisation of failure are at a point of balance and produce displacement actions.

Thwarted again!

When ethologists, who study animal behaviour, looked into the weird behaviours that are typical of many animals raised in captivity they were puzzled.  For example, they witnessed animals biting at their own fur, feathers or hair or at those of other co-caged animals. The range of animals who expressed this sort of thing included parrots, sheep and mice to name but three.  They were puzzled because they could see no relationship to the weird behaviour and the environment in which it took place.  In short, the behaviour could not be directly said to be related or caused by the situation.  It was from this puzzlement that the concept of displacement behaviour emerged.

Three mechanisms are believed to be responsible for these weird displacment behaviours: (1) early environmental deprivation (2) the disruption of habitat-dependent processes and (3) the thwarting of behavioural response rules.  

Firstly, cases of environmental deprivation include animals reared in isolation or away from maternal care.  Secondly, the disruption of habitat dependent processes may include not giving animals the right kinds of foods or nesting materials so that behaviours dependent upon these environmental aspects cannot be properly expressed. Thirdly, animals in captivity are often physically prevented from behaving in natural ways such as a cage that restricts movement or which prevents it from achieving an ongoing goal.

The basic idea is that when an animal is continually frustrated or where the environment means that it cannot find an adaptive solution to an environmental problem the brain wiring is disturbed and these odd behaviours come to the surface.  But why, for example, hair pulling and not a different behaviour emerges is, as yet, unknown.  However, the link between animals in captivity showing this kind of a problem and people who pull out hair seems one too big to overlook in my opinion.

If there is one thing I would hope to get from this blog, it is that more and more people consider these aspects when they seek to understand hair pulling.

References:

 

Akgul, Y., Agaoglu, Z.T., Kaya, A., Sahin, T., (2000) The relationship between the syndromes of wool eating and alopecia in Akkaraman and Morkaraman sheep fed corn silage and blood changes (haematological, biochemical and trace elements). Israel Journal of Veterinary Medicine 56: 23-37.

 Bordnick P.S., Thyer B.A., Ritchie B.W., (1994) Feather picking disorder and trichotillomania: an avian model of human psychopathology, J. Behav. Ther. Exp. Psychiatry 25 (3) (1994), pp. 189–196.

Dias R, Robbins T.W, Roberts A.C (1996) Disassociation in prefrontal cortex of affective and attentional shifts. Nature 380: 69-72.

Kalueff, A.V., Laporte, J.L., Bergner, C.L. (2010): Neurobiology of Grooming Behaviour (Cambridge University Press)

Schrijver N.C.A., Wűrbel, H.: (2001) Early social deprivation disrupts attentional, but not affective, shifts in rats. Behav Neurosic 115: 437-42.

Wűrbel H (2001): Ideal homes? Housing effects on rodent brains and behaviour. Trends Neurosci 24:207-11.

Observations On Young Children

Watching children play or simply behaving in an environment in which they feel relaxed is very informative - as anyone who knows of Piaget's work can testify to.  It is informative in two ways.  Firstly, it is a point of reference to one's own early childhood and secondly it is possible to see in these early stages the way children try to navigate their environment, make decisions, seek comfort and affirmation from others around them. The family environment is the one in which the children will learn the rules of social behaviour, what can and cannot be performed and how to interact with others. 

I spent a few days with my nephews this week - aged 1 and 6 respectively.  They are happy, lively children but not immune to tantrums when their simple desires or wants are thwarted in some way or another.  But on the whole this is quite rare.  It was particularly interesting to see the younger one roaming freely about the house and exploring the nooks and crannies of the lounge and kitchen spaces.  When a child explores its space it does so without inhibition or assumptions towards what it should or should not do.  This open curiosity and undisrupted approach to the world contrasts well with children and animals not raised in such accepting and welcoming environmental conditions.

Children and animals in captivity do not get the chance to explore the world in such a free way.  Their species specific behaviours are constantly interrupted or interfered with.  They are not able to fully express themselves towards their environment and with this comes a retardation of their powers to engage with the world.  This means physical performance and physiological setting points are non-optimal.

Captivity means that an animal or human will feel constantly thwarted, as if the world is continually refusing to permit them to be themselves - or simply saying 'no' at every twist and turn.  The conditions that support successful engagement with the environment are not there and loss of confidence may become pathological.  In such cases the organism's behaviour will no longer be directed towards objects in the world around it but towards itself.

Disengagement with one's environment is a sure precursor to the appearance of self-directed behaviours like hair-pulling.  It constitutes a form of disturbance whereby continuity of expression and interaction has been disrupted.  A child able to roam freely and approach family members without fear of rejection or avoidance of eye contact or touch is much less likely to feel thwarted or displaced.  Fortunately for my nephews, their upbringing is one that allows them the freedom and affection they need to become healthy human beings.  Sadly, this is not the case for everyone.