What is the Hair Pulling About?

Hair Pulling – called Trichotillomania may be seen in SPD children and adults. Is not as uncommon as we may think! This is one of many self stimulating or self soothing activities we may see in SPD children and adults. Unconsciously, he or she may be regulating internal functions, also referred to as the interoceptive sense. Let me explain how:

In order to be able to function normally, our bodies must maintain a number of different systems in a state of balance, called homeostasis. This internal regulation affects body temperature, blood pressure, heart rate, respiration, and internal levels of stimulation. With an SPD child or adult, if stimulation is too great, it results in stress to the body. If too low, the child or adult falls into a state of sensory deprivation. There is scientific evidence suggesting that in order to function at an optimum level, we all need a certain level of stimulation that is neither too high nor too low. With an SPD child or adult, their nervous system seems unable to easily and automatically regulate and manage these levels. When not working properly, the individual feels compelled, not even being aware of it, to seek sensory input.

In seeking sensory stimulation, people tend to go to the sites where there are many nerve endings. Hands, feet, mouth and scalps are common places. Many different behaviors could be used to perform this balancing function externally. Hair pulling, skin picking, nail biting, cheek biting, nose picking, *grin* are only a few of many that I have seen. While any or all humans may engage in these behaviors sometimes, the difference with SPD kids and adults, (whose behaviors have become extreme versus those who are doing them on occasion) are having difficulty regulating their internal levels of stimulation, and are utilizing these methods for self stimulation or self soothing.

This behavior provides an SPD person with Tactile Stimulation, by touching, stroking, tugging and pulling hair. Visual stimulation occurs when watching or observing hair during or after pulling, and Oral stimulation by chewing or sliding through teeth.

Why this could be helpful to an internal state of regulation to satisfy both or either under-and over stimulation comes with the understanding that each type of stimulation is the polar opposite of the other on a continuum of sensory stimulation levels. It can be either soothing…or stimulating, and bring about changes and more balance to internal regulation.

How Can We Help Treat This?

What to do? Is it becoming too much, destructive even? If this person has already been diagnosed as an SPD child or adult, I would recommend speaking to their therapist. Ask him/her about better ways to learn to self-regulate. Find other, less destructive sources of stimulation.

There are also medications that have been used to help in severe cases. Consult with a physician concerning that. There are also emotional, and even environmental reasons a person may be hair pulling. If this person is not already under the care of an Occupational Therapist, I would suggest beginning with Michele Mitchell’s comprehensive SPD Checklist for Children, or Adult and Adolescent Checklist to determine if an evaluation is needed.

One of the methods I like to see, is when we teach our SPD kids and adults how to discover and identify how they are feeling. To recognize when they are over or under stimulated. Then work together to find activities, with each of the senses, to “feel better”. The program “The ALERT Program – How Does Your Engine Run?” may help anyone learn alternative healthy ways to seek input, that may be used so the person doesn’t feel the NEED to pull hair.

Providing preventive methods, such as decreasing sensory overload, as needed, to balance internal regulation when feeling the need for less stimulation, as when overwhelmed or stressed, by providing calming activities to soothe. And conversely, adding more sensory stimulation when seeking, or craving more. The hair pulling habit itself can be difficult to overcome, but I have seen improvements, by offering different choices of stimulation. This is the most common method I have seen utilized – substituting other forms of stimulation to replace unhealthy, destructive or unsafe activities.

— Written by Michelle Morris, 2007