Pregnancy and paediatrics
A compulsive habit, such as hair pulling, can occur at any age and is often a sign of anxiety.
While some of your child’s habits (such as kissing toys goodnight) are a healthy, natural part of growing up, others can be seen as compulsive if they start interfering with their quality of life.
“Compulsive habits, such as hair-pulling, often start at a time when your child feels confused, anxious or scared,” says Ronel Groenewald, a counselling psychologist at Mediclinic Kimberley. “For example, when starting a new school, moving house or because of changes in friendships and routine.”
The severity of the sensory habit of hair-pulling, sucking or twisting can vary. Some children engage in hair-pulling only for a short period of time as a means of self-soothing when they are tired or hungry, while others go on to develop a severe habit, known as trichotillomania.
Signs of this condition include: persistent, excessive hair pulling that results in obvious hair loss; rising tension or anxiety directly before hair-pulling or when trying to resist the urge; and a rush of relief or pleasure when the hair is finally pulled out. Not all children are aware that their behaviour is abnormal and excessive.
“If you notice that your child has started sucking, pulling or twisting their hair to the point of causing damage to their scalp, try hard not to tell them to stop,” says Groenewald. “Don’t show your frustration or irritation as drawing negative attention to the habit of hair-pulling can often make things worse.” Instead, try to figure out the triggers. Do they pull their hair when they’re sitting in the car or on the way to school? Or when they’re watching TV? Or listening to a bedtime story? Once you are aware of when they are more likely to fiddle with their hair, you can aim to retrain your child’s brain by encouraging them to focus on something different.
“Helping your child learn alternative sensory habits is key to reducing the severity of compulsive habits such as hair-pulling,” says Groenewald.
Some options include offering them a long-haired doll to play with, or a squishy toy to help alleviate some anxiety. You can also show your child how to brush their hair – and then leave a brush with them at all times so they can reach for it when necessary. “Make a point of focusing positively on the habit you want them to develop,” says Groenewald.
In older children, treatment can include medication such as SSRIs and cognitive behaviour therapy, a specialised form of therapy that helps your child recognise thoughts, feelings, and behaviours that are linked with hair-pulling.