Table of Contents




List of Illustrations

List of Tables
1.          What Is Trichotillomania?          
The Diagnostic Criteria                                                                                
TTM and OCD                                                                                          
The Effects of Hair Pulling                                                                      
Patterns and Signs of Pulling                                                                      
How People Pull                                                                                
Disguises and Camouflage                                                                      
Physical Sensations and Pulling                                                                      
Trying to Stop                                                                                          
Testing and Measuring TTM                                                                      
Who Pulls?                                                                                          
TTM Across the Lifespan                                                                      
TTM and Heredity                                                                                
What Gets TTM Started?                                                                      
Disorders That Occur Together With TTM                                                  
Problems Mistaken for TTM                                                                       

2.          The Shame Of It All - What To Do About It                    

The Stigma of TTM  The Emotional Cost                                                  
Destigmatizing Yourself                                                                      
The Self-Esteem Trap                                                                                
Self-acceptance  The Only Logical Way                                                  
Defining Acceptance                                                                                
Acceptance and TTM Treatment Issues                                                            
Mindfulness, Breathing and Meditation                                                            
The Five Acceptances                                                                                
          Accepting yourself                                                                      
          Accepting others                                                                      
          Accepting the illness and the nature of the illness                              
          Accepting the nature of the task of therapy                                        
          Accepting the nature of the task of ongoing recovery                              

3.          The Causes Of TTM - Why Do People Pull?                    

The Psychoanalytic Model                                                                      
The Addiction Model                                                                                
The Behavioral Model                                                                                
The Ethological Model                                                                                
The Neurobiological Model                                                                      
TTM and the Obsessive-Compulsive Spectrum                                                  
          Similarities and connections linking TTM and OCD                              
          Dissimilarities between TTM and OCS                                                  
          Similarities of TTM and Tourette's                                                  
The Comprehensive Model                                                                      
The Stimulus Regulation Model  An Integrated Approach                              
The Yeast Allergy Model                                                                      

4.          Some Facts About Hair                                                            

The Functions of Hair                                                                                
The Structure and Composition of Hair                                                            
How Hair Grows                                                                                
Permanent Hair Loss and TTM                                                                      
Other Causes of Hair Loss                                                                      
Popular Hair Myths                                                                                
Common Hair Frauds and What Really Works                                                  

5.           How TTM Is Treated
Therapy for TTM                                                                                
Treatments That Don't Work                                                                      
          Traditional Talk Therapy and TTM                                                  
          Play Therapy                                                                                
          Energy Therapy                                                                                
          Special Diets                                                                                
          Other Miscellaneous Treatments                                                            
Treatments That Might Work                                                                      
Treatments That Work                                                                                
          Behavioral Therapy                                                                      
          Cognitive Therapy                                                                      
Therapy, the Therapist, and My Feelings                                                            
Behavioral Therapy Steps for TTM                                                            
          Habit Reversal Training                                                                      
          Stimulus Control                                                                      
Behavioral Therapy  A Time Frame                                                            
Knowing When You Need Therapy                                                            
Recovery with Behavioral Therapy Alone                                                  
Only Commitment Brings Success                                                            
Using Medication with Behavioral Therapy                                                  
Behavioral Therapy Can Help Biological Problems                                        
Getting the Right Treatment                                                                      
          Where and how to look                                                                      
          What to ask                                                                                
          What you should know                                                                      
          Choosing a therapist                                                                      

6.          Designing A Self-Help Program                                        

Is Self Help For You?                                                                                
Getting Started                                                                                          
Assembling the Steps                                                                                
          Relaxation script                                                                      
          Brief relaxation exercise                                                            

7.          Medication And TTM  Treatment          
Medication as Part of Treatment                                                                      
Medications Used to Treat TTM                                                                      
Drug Augmentation                                                                                
Prescribing Medications for TTM                                                            
Getting Started with Medications                                                            
Medications - Everything Works for Somebody, Nothing Works for Everybody          
The Best Medication for You                                                                      
How to Tell When Medication is Working                                                  
Long Term Medication and Side Effects                                                            
The Effects of Other Medications on TTM                                                  
TTM, Medication and Pregnancy                                                            
Side Effects and What Can Be Done About Them                                        
TTM Medications and Addiction                                                            
Getting Well Using Medication Alone                                                            
If Your TTM Medication Stops Working                                                  
If Medications Don't Work                                                                      
Discontinuing Medication Once Symptoms Improve                                        
Special Diets or Supplements                                                                      
When You Can't Afford Medication                                                                      

8.          Recovery And Maintenance
Defining Recovery                                                                                 
Relapse Prevention  Staying Well                                                            
Additional TTM Maintenance Goals                                                            

9.          TTM And Your Child
Recognizing TTM in Children                                                                      
          Coming to Terms With Your Child's Disorder                                                  
Explaining the Disorder to a Child                                                            
          The Reluctant Child                                                                                          
          Treatment for the Child with TTM                                                                      
          The Therapy Process                                                                                          
          A Hairpiece for Your Child  Pros and Cons                                                  
Medication and Your Child                                                                      
Medications Used to Treat Children                                                            
Children with TTM and School                                                                      
Childhood TTM and Strep Infections                                                            

10.          TTM And The Other People In Your Life
The People Close To You  Help or Hindrance?                                                  
If the TTM Sufferer Refuses Help                                                            
TTM, Relationships, and Intimacy                                                            
Coming Out                                                                                

11.          Resources For Getting Help
The Trichotillomania Learning Center                                                            
Other Organizations That Can Help                                                            
Support Groups                                                                                          
Resources Online                                                                                
TTM Reading and Viewing List                                                                      
Medical Facilities Offering Treatment for TTM                                                  

          A           TTM, Skin Picking and Nail Biting Symptom Checklist                              
          B           TTM Clinical Rating Scales and Questionnaires                                        
          C           Official DSM-IV Diagnostic Criteria for Trichotillomania                    
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