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| a dislocated elbow...but what about emotional dislocation? |
To me hair pulling behaviour points to a dislocation between an internal impulse (physiological) and its physical expression (behavioural) so that the impulse is constantly repressed or negated. This ongoing tension may be compared to a rocking to and from between two states. For example, a child will feel the need to approach a parental adult for comfort seeking needs, yet if this parent is unreliable and provokes a withdraw response the child is caught between two stools, so to speak. If this situation is ongoing and no alternative adult is available the child will develop coping or maladaptive behaviours and hair pulling fits this category. This is because hair pulling is a displacement behaviour, in my view, which emerges when two opposing impulses such as approach and withdraw are simultaneously activated. The pulling is the nervous system's way of deactivating this short circuit and finding some resolution to the ongoing tension.
Hair pulling reveals that there is something wrong with the hair puller's environment. They are unable to settle or feel at ease. They may feel constantly agitated and hair pulling is a form of relaxation. For example, they may not want to be alone and yet find themselves alone, desire to find some form of relief but unable to do so. So, hair pulling is a form of homeostasis whereby physiological tensions that cannot be mediated through normal social avenues (e.g. approach behaviour) can find some outlet.
I have no direct evidence for this in human studies unfortunately. This is the kind of research I would like to do. But animal studies where fur, feather and hair pulling have been noted do back up the idea, particularly in artificial or captive environments where species specific needs are not supported. This means the animal is striving to attain some internal goal state but cannot achieve it through interaction with its sterile laboratory environment. For example, it may lack materials to build a suitable nest or place of safety and so its attempts at doing so are constantly frustrated and aborted. Body directed behaviour follows, whereby the animal's normal behaviour is shown to have been utterly derailed and its environment utterly unsuitable to allow its behaviour patterns to develop normally.
This line of enquiry is harder to prove with people but there are some key signals I would look for. I would predict that some who pulls hair will be in a state of agitation or feel unsettled to some extent whereby they should be able to report some anxiety towards their environment either before or after the hair pulling episode.
Too much therapy is focuses on the puller and not enough on its environment - by which I mean the environment in which the hair pulling first emerged. This is the situation, along with the developmental needs of the person at the time pulling first took place, that needs closest analysis. Too often we treat the symptoms rather than try to find underlying factors.
