Why Can’t I Stop Pulling My Hair? Trichotillomania Explained | Ep. 514

In this episode, I’m joined by Aneela Idnani to explore hair pulling, skin picking, and other BFRBs, and how understanding what’s underneath the urge can help us respond with more awareness, compassion, and choice.

In this episode, we’ll talk about:

• Why hair pulling and skin picking can feel so automatic, and what may be happening underneath the behavior.
• How to identify your personal triggers, including stress, boredom, overstimulation, exhaustion, and unmet physical needs.
• Why simply trying to “stop” or white-knuckle your way through an urge may not address what you actually need.
• How sensory needs can play a role in BFRBs and how to find alternatives that better match the sensation you’re seeking.
• How to plan ahead for the times and situations when you’re most likely to pull or pick.
• Why recovery doesn’t have to mean never pulling or picking again, and how self-compassion can help you move away from all-or-nothing thinking.

Hair Pulling and Skin Picking: What Your Urges May Be Trying to Tell You 

If you struggle with hair pulling, skin picking, nail biting, or another body-focused repetitive behavior (BFRB), you may know this cycle well:

You notice yourself pulling or picking.

You tell yourself to stop.

Maybe you manage to resist for a while.

And then, before you know it, your hand is right back where it started.

For many people, what comes next is frustration, shame, or some version of, “Why can’t I just stop doing this?”

In this episode of Your Anxiety Toolkit, I sat down with Aneela Idnani, who has lived with trichotillomania, or hair pulling, for much of her life. Aneela is also the co-founder of HabitAware and the author of Anila, Where Are Your Eyebrows?

And our conversation brought us back again and again to an important idea:

What if the goal isn’t simply to force yourself to stop?

What if you can learn to understand what is happening underneath the behavior?

When Hair Pulling Becomes Something You Have to Hide

For Aneela, one of the most pivotal moments in her journey happened after she pulled out all of her eyebrows.

She had spent years hiding her hair pulling. But one morning, her husband looked at her and simply asked, without judgment, “Aneela, where are your eyebrows?”

She described that moment as the beginning of something completely different.

Her secret was finally out.

And instead of responding with criticism or judgment, her husband responded with curiosity, love, and compassion.

For so many people with BFRBs, the fear of someone noticing can become almost as painful as the behavior itself. You may spend enormous amounts of energy covering bald spots, hiding damaged skin, avoiding situations, or worrying that someone will notice something is different.

That shame can make it incredibly difficult to ask for help.

But understanding the behavior is an important place to start.

Why Do We Pull, Pick, or Bite?

One of the questions I hear frequently, particularly from parents, is:

Why is this happening?

Why does my child pull their hair?

Why do I pick my skin even when I desperately want to stop?

Why does my hand seem to move there automatically?

There isn’t necessarily one simple answer.

For Aneela, hair pulling often functioned as a form of self-soothing. She noticed that urges could increase when she was stressed or anxious, but they could also appear when she was tired, bored, hungry, or physically uncomfortable.

This is something I often talk about when treating BFRBs.

Imagine a continuum between understimulation and overstimulation.

Some people are more likely to pull or pick when they are overstimulated, stressed, anxious, or overwhelmed.

Others notice it when they are understimulated, bored, tired, or zoning out.

And some experience both.

The work becomes getting curious about your own patterns.

Start Asking: What Happened Before the Urge?

This is where awareness becomes incredibly powerful.

Instead of noticing the behavior and immediately thinking, “Stop doing that,” see if you can become curious.

What was happening right before the urge?

Were you tired?

Hungry?

Bored?

Overwhelmed?

Trying to concentrate?

Feeling anxious?

Sitting in a particular location?

Watching television?

Working at your computer?

Aneela realized that work stress was one of her triggers, but there was more happening underneath it.

She would become so focused on getting work done that she wouldn’t eat. She wouldn’t drink enough water. She would put off going to the bathroom.

Her body was asking for care, but she was continuing to push through.

Once she began taking breaks, eating, drinking water, moving her body, and responding to those physical needs, she noticed that she could return to her work feeling more regulated.

This is an important distinction.

Instead of only asking:

How do I stop pulling?

We can also ask:

What might I need right now?

The Behavior Can Become a Signal

I loved the way we discussed this in the episode.

What if pulling or picking becomes a signal?

Not a signal that you’ve failed.

Not proof that you lack willpower.

But a signal to check in.

Maybe your hand reaches toward your hair and you notice:

“Oh. I haven’t eaten in six hours.”

Or:

“I’ve been sitting at this computer stressed out all afternoon.”

Or:

“I’m exhausted and I need to go to bed.”

Or maybe there is an emotion that needs tending to: anxiety, uncertainty, sadness, dread, frustration, or overwhelm.

That moment of awareness gives you an opportunity to respond differently.

Aneela described it beautifully as a kind of self-care alarm.

Instead of immediately entering a battle with yourself, you can pause and ask:

What do I need?

Awareness Creates Space for Choice

One of the challenges with BFRBs is how automatic they can feel.

You might be watching television and suddenly realize you’ve been pulling.

You might find yourself scanning your skin without remembering when you started.

You might even intentionally get your tweezers while still feeling as though the behavior is incredibly difficult to interrupt.

For Aneela, increasing awareness became a critical part of changing this pattern.

Her experience eventually led to the creation of the Keen bracelet, a device designed to recognize certain hand movements and vibrate to bring awareness to the behavior.

But the important part isn’t simply being told, “You’re pulling.”

Awareness creates an opportunity to ask:

Why?

Once Aneela began tracking when the behavior occurred, she started seeing patterns.

And when we can see a pattern, we have more information about where we may be able to interrupt it.

Don’t Just Block the Behavior. Meet the Need.

This is where I think we need to be thoughtful about tools like fidgets and competing responses.

They can absolutely be helpful.

But simply putting something in your hand isn’t necessarily the whole intervention.

Imagine that every afternoon you start pulling your hair because you have skipped lunch.

A stress ball may temporarily keep your hand occupied.

But it hasn’t fed you.

The underlying need is still there.

A fidget may be useful because it creates a little bit of space between the urge and the behavior. And sometimes the fidget itself may meet the need, particularly when you are looking for a specific kind of sensory input.

The question is:

What job is this tool doing for me?

Get Specific About the Sensory Experience

For some people, BFRBs aren’t only about stress or emotion.

There can also be a very specific sensory component.

Maybe you’re searching for one particular coarse hair.

Maybe you like the feeling of running your fingers across a certain texture.

Maybe you want to dig, scratch, smooth, squeeze, or find the hair that feels “just right.”

That information matters.

I once worked with someone who frequently pulled while driving. Part of what she enjoyed was the tactile experience of searching for the “right” hair.

She came up with an incredibly creative alternative.

She kept popcorn mixed with M&M’s between the seats and would search through the popcorn to find the smooth M&M’s.

It gave her fingers something to search for and provided some of the sensory experience she had been seeking through pulling.

The point isn’t that everyone should go buy popcorn and M&M’s.

The point is to get curious and creative.

If your need is sensory, what could provide a similar sensation without causing the consequences you are trying to avoid?

One Fidget Probably Won’t Solve Every Urge

This is also why I like the idea of having multiple tools available.

Your needs may change throughout the day.

Sometimes you may want something soft.

Sometimes you may want something rough or crunchy.

Sometimes you may need movement.

Sometimes you may need food.

Sometimes you may need rest.

Sometimes you may need connection.

A basket full of fidgets isn’t necessarily helpful if none of those tools addresses what is actually happening.

The goal isn’t simply:

Keep my hands busy at all costs.

The goal is to build enough awareness that you can begin matching the response to the need.

Don’t White-Knuckle Your Way Through the Entire Day

Aneela shared an analogy that I think is incredibly helpful.

Imagine shaking a can of soda all day long.

You keep resisting.

You keep pushing through.

You don’t take breaks.

You ignore your stress.

You don’t eat.

You don’t rest.

You don’t allow yourself any release.

And then you finally get home.

Eventually, that soda can is going to explode.

This can happen with BFRBs too.

If your entire strategy is to grit your teeth and resist urges all day, you may eventually reach a point where you have very little capacity left.

Instead, consider where you can build small moments of regulation and care throughout your day.

Take the walk.

Drink the water.

Eat lunch.

Step away from the computer.

Take a few slow breaths.

Call someone.

Go to bed when you’re exhausted.

You don’t have to wait until you’re completely overwhelmed to respond to your needs.

Plan Ahead for Your High-Risk Times

Awareness also allows us to become proactive.

Maybe you’ve noticed that your pulling almost always happens at night.

Or while driving.

Or while studying.

Or during work meetings.

Or when you’re watching television.

Once you know this, you don’t have to wait for the urge to surprise you.

You can plan for it.

If the bathroom immediately after work is a common pulling or picking time, maybe you take a short walk before going inside.

If you pull while watching television, perhaps you have several sensory tools nearby.

If exhaustion increases your urges, maybe part of your BFRB plan involves protecting your sleep.

We aren’t trying to create a life in which you never experience an urge again.

We’re building a plan for what you can do when the urge arrives.

Recovery Doesn’t Have to Be All or Nothing

This may be one of the most important parts of the conversation.

Recovery does not require perfection.

Aneela shared that she still sometimes pulls a few hairs.

The difference is that she now has awareness and choice.

She can notice what’s happening and ask herself what she needs.

And if she pulls more than she intended?

She can respond with self-compassion rather than turning that moment into evidence that she has failed.

This matters because all-or-nothing thinking can quickly become:

“I pulled one hair, so I ruined everything.”

And that can lead straight back into the behavior.

Instead, we can practice:

Okay. That happened. What’s going on? What do I need now?

You haven’t erased your progress because you had a difficult moment.

Keep Doing What Works

Aneela left us with another incredibly important reminder:

When something is helping, keep doing it.

This sounds obvious, but we humans have an interesting tendency.

We start feeling better and think:

“Great! I don’t need to do those things anymore.”

But often, those things are part of why we’re feeling better.

If wearing your awareness tool helps, keep using it.

If regular walks help, keep walking.

If eating consistently helps regulate you, keep prioritizing meals.

If therapy is helping, continue using the skills you’ve learned.

If your sensory tools help during certain situations, keep them nearby.

Recovery isn’t necessarily something you finish and never think about again.

Sometimes it’s a collection of choices you continue making because they support the life you want to live.

Respond to the Urge With Curiosity, Not Criticism

If there’s one thing I hope you take away from this conversation, it’s this:

Your urge doesn’t have to become an invitation to criticize yourself.

It can become an invitation to pay attention.

Notice the behavior.

Pause.

Get curious.

Ask what is happening underneath it.

And then see if there is a compassionate way to respond to what your mind or body needs.

You may not get it right every time.

That’s okay.

We aren’t looking for perfect recovery.

We’re practicing awareness, flexibility, and compassionate action over and over again.

And sometimes that tiny pause between noticing the urge and responding to it is where a completely new pattern can begin.

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Transcription: Why Can’t I Stop Pulling My Hair

Kimberley: Eyebrows. Most of us don’t even give them a second thought, but for my guest today, eyebrows were a source of shame and anxiety and guilt, and today, because she spent years pulling hers out. There’s a name for this. It’s called trichotillomania. It’s a body-focused repetitive behavior. My guest today is Anela Idnani.

 

She wrote the most incredible book called Anela, Where Are Your Eyebrows?, which is such an amazing title, but underneath that is a story of someone who has experienced trichotillomania, or hair pulling, and she talks about the hiding, the shame, and what actually helped her to stop pulling her hair. If you’ve ever pulled your hair or picked your skin or done some kind of other body-focused repetitive behavior, this episode is exactly for you.

 

Let’s get into it.

 

Welcome, Aneela. I have so many questions for you. 

 

Aneela: I’m so grateful to be here. I feel like now the nerves are just hitting because I’m realizing I’m on a podcast of a psychology star. So thank you for having me, and thank you for being a friend, and thank you for being an OCD and BFRB and compassion advocate and all of those things together.

 

Yeah, I’m so excited to be here. 

 

Kimberley: Oh, right back at you. Thank you. I feel like you are the superstar in this arena, and I’ve read your book. It is absolutely wonderful. I’m gonna get straight to my main question because I really wanna hear in real time what you think. So your book is called Aneela: Where Are Your Eyebrows?

 

Which is, like, literally top-notch best book title on the planet. But if you could share for folks, um, what was that moment actually about? Like, can you tell us what that real moment was like for you? 

 

Aneela: Yeah. So, “Aneela, where are your eyebrows?” are the sweet, kind, loving words that my husband asked me fateful days some 10 years ago, 13 years ago, timed my, my son’s pregnan- my first son’s pregnancy.

 

I, at, late at night, the night before, I pulled out all my eyebrows. It was a combination of pregnancy hormones, lack of sleep, stress at work. And up until that point, so, you know, 30-ish years of my life, 30, mid-30s of my life, I had been able to hide my hair pulling, um, disguise it, and allow it to happen, but also control it enough that it didn’t ever get to that…

 

Well, not didn’t ever, but didn’t often get to that point of full eyebrows missing. And then that morning, I woke up, looked in the mirror right at my bedside, and was like, “Oh my God, what did I do?” You know, the, the, the usual self-blame, anger, like, “What’s wrong with you, Aneela?” And with that fear held tight in my belly, I jumped up and ran to the bathroom to get my black eye pencil, which is my partner in crime for the last, all of my life, basically.

 

And my husband was standing in the, in the, you know, the, the doorway of that. Bumped into him, and he just looked down and said, “Aneela, where are your eyebrows?” And it was without judgment, just with pure love and curiosity. And that was the day I shared my hair-pulling secret, and that was the day that kickstarted my own healing and a movement that has allowed so many others to find healing.

 

Kimberley: What a profound moment. It’s funny, I felt this when I was reading your book, and as I’m even hearing that, I felt this panic come over me of, like, I’ve been found out. Like, I think we all in the mental health, if you’ve had a mental health struggle, to be found out, like I literally, I can feel my hair standing up on the back of my head just ’cause that panic of being found out is pretty horrible and scary.

 

Aneela: Yeah. It’s because it’s such a shameful act, in a sense. Like, we, we live with that shame, and most of that shame is from this fear of being found out from the judgment we’ve gotten from the little kids in our class who are asking, you know, questions or, for me, it was sometimes just, like, people s- looking and staring at my face, and I could see, like, their foreheads wrinkling like they’re trying to figure out what’s wrong, but they couldn’t tell that it was my eyelashes missing.

 

Hmm. You know what I mean? So it was like… And then that’s also my perception. Maybe they were just, like, thinking about their math homework or something. Yeah. So it’s just, it’s n- it’s amazing how the mind really messes with us in so many different ways, and a lot of this journey is around getting control of that.

 

Kimberley: Yeah. So for listeners who have never heard of the word trichotillomania or body-focused repetitive behaviors, can you first just give us just a quick understanding of, catch us, people up on what is trichotillomania? 

 

Aneela: Yeah. So I wanna preface, I’m not a treatment professional. Um, I’m someone with lived experience and expertise in helping Tens of thousands of people, hundreds of thousands of people with this condition, uh, through my work.

 

But for me, hair pulling or trichotillomania is… And this does align with what you would find in the DSM-5, it’s a repetitive behavior that you can’t stop that causes distress, mostly from the physical damage, if you will, the bald spots, the fear, right? And it, and because of that fear, because of that distress that it causes, it causes a person to not live the life that they deserve and that they want.

 

That’s how I des- would describe it. 

 

Kimberley: Right. And you and I were just chatting about this, because so often when we have clients come through our center, and let’s say it’s a parent and they’re coming to us to bring their child with, with hair pulling or skin picking or other BFRBs, body focused repetitive behaviors, they wanna understand why this is happening.

 

Why are they pulling their eyebrows out? Now, I wanna quickly just go over some of the reasons that you think that people engage in this type of behavior. ‘Cause like you said, it’s a, it’s, it can be a very automatic behavior that happens that some people even wake up from sleeping and their eyebrows are gone.

 

So what do you… Why do people pull their hair? 

 

Aneela: Yeah. So my understanding is these behaviors are rooted in the subconscious, so it’s not a choice, but we can get to that point where it is a choice, uh, if we do the work. And because it’s subconscious, to me, these behaviors are self-soothing. These behaviors are the brain’s way of something’s knocked us off balance, off of our state of, like, baseline calm, and the brain feels that, and the brain says, “I need to get back to balance.”

 

And in a way, we are missing other signals to take care of ourselves, and so the brain kinda goes to this, like, default. And for those that have the condition, it feels good in the moment. That truth of it feels good in the moment keeps people stuck doing it because they refuse to see that it actually doesn’t feel good moments later.

 

Kimberley: Hmm. 

 

Aneela: Ref- you know, that pain of it, they, they’d rather stay in the pleasure of it other than the pain of it, and that makes it very hard to make the change, right? Right. So for me, why do these behaviors happen? They, they happen because we’re not taught healthier self-soothing as, as kids, and when we grow up and the brain has to find ways.

 

So, you know, it’s gonna be hair pulling, it’s gonna be skin picking, it’s gonna be drinking, it’s gonna be smoking, it’s gonna be all these different things, overeating, right? All of these behaviors are coping mechanisms, and if we can find a way to start teaching ourselves healthier strategies, healthier habits, we can make that change and retrain the brain.

 

Kimberley: Yeah. And I, and one thing that we teach, and I teach in the courses we have for hair pulling and skin picking, is that there’s a continuum, right, of overstimulated to understimulated. And there is sort of like this section in the middle where people are fine. They don’t need to hair pick and s- you know, pick their skin and pull their hair and so forth.

 

Whereas often with each person, they sort of, when they cross over a line into overstimulation or understimulation, that’s when that behavior starts to show up. And it’s about getting to know what that is. Yeah. Some people are like, “Oh, it’s fine. If, if I’m bored, I’m totally fine, it never pulls. But if I’m overstimulated, yeah, I’m always gonna pull,” or vice versa or both.

 

So was that the case for you? 

 

Aneela: Yeah. For me, you know, it took decades to figure out what were the reasons for me, but there is always a why. Um, you know, it… And for me, yes, that overstimulation, like it could be the stress, the anxiety, the understimulation, the tiredness, the boredom. And then for me it was also things in between like Physical discomforts of hunger, of going, needing to go to the bathroom.

 

And so those were things that I would push off at work because I was stressed that I had to get the work done. So it was a combination, right? It was stress- Right … leading me to not take care of myself physically. I would skip lunch. I wouldn’t drink water. I wouldn’t eat. I would just work, work, work. And then in order to work, work, work, I was pulling, which also part might actually be, be the ADHD that I think I have helping me focus on writing those.

 

So it’s, it’s all of those things combined. 

 

Kimberley: Yeah. 

 

Aneela: But learning to just take the breaks for water, just take the breaks to go to the bathroom, take the breaks to eat, all of that started helping soften and rebalance. And so when I did sit at the desk, I could concentrate better. I could finish the work, you know?

 

Like it was, it was, there was still stress existing, but because I had taken care of myself, I wasn’t like bouncing my knee and, you know, having all these other, pulling my eyebrows. Like it was just calmer to be able to get that work done. So- 

 

Kimberley: Yeah … 

 

Aneela: it’s really is this inward work of, well, what is the thing that’s guiding me out of alignment and If I meet that need, then I can realign and get back to the thing that I wanna be doing, which goes back to my definition, which is you’re not living the life you want.

 

Kimberley: So many people, when they show up in our office with hair pulling and skin picking, will say, “I actually really enjoy hair pull- pulling and skin picking, but I don’t like the consequences of hair pulling or skin picking.” And that’s a really difficult thing to reconcile because, you know, there are behavior, let’s sort of say other, maybe more OCD compulsions, like they don’t want to have to wash their hands for two hours.

 

It’s a behavior that doesn’t bring them any pleasure, and they don’t like the consequences, that it took them time, and then now they’ve got cracked fingers and all the things. But when it comes to hair pulling and skin picking, they do enjoy this behavior, or they do get pleasure or relief from this behavior, because that’s one of the biggest roadblocks in treatment, right?

 

Because you wanna stop, you don’t want the consequence, but in that moment, you kinda want that feeling. What was that like for you, or was that your experience? 

 

Aneela: Yeah. I think, you know, this goes back to what I said before. To me, saying it feels good is the biggest lie we tell ourselves to hold on to this behavior because we’re afraid of what will happen if whatever we’re trying doesn’t work.

 

And so yes, like, like I said before, it feels good in the moment, but the aftermath, no way does that feel good. 

 

Kimberley: No. And 

 

Aneela: so we allow ourselves to ignore that aftermath, to give us… Like, that is the choice we’re making, you know? To give us the freedom and the leeway to say, “Well, it feels good, so I’m gonna keep doing it.”

 

But it doesn’t feel good because then you look at, like, how much do people look in the mirror and get mad at themselves for the bald spots they’ve created or for the, you know, the hole they’ve dug into their face, or, you know, me with nose bleeding or cheek biting. Like, my mouth is sore after, you know, engaging in that behavior for so long.

 

There still is the pain. We just, we just refuse to allow ourselves to see it because we don’t wanna deal with it. 

 

Kimberley: Talk to us about, you know, here on Your Anxiety Toolkit, people love in-the-moment skills, and I’d love for you to walk us through. So, okay, you’ve- Being found out, your husband finds out. You, I’m guessing, had to navigate that day, really.

 

I don’t know how you navigated that day, and if you wanna share, you can. But then you had to sort of build a new life. You had to build a different outcome. Would you be able to share with us as much as you’re okay sharing, like, what was that like? Because I know a lot of people who listen or, you know, are in treatment, they’ve never met anybody else who’s done this.

 

Aneela: Yeah. And I think being able to meet other people in the community is one of the things that is part of that recovery. So that’s one, one tool, if you will. So for me, that day after he asked that question, I told him what it was, trichotillomania, because by that point, I had actually in my 20s Googled or Yahoo’d, I don’t know, whatever was around back then, why do I pull out my hair, and I found the Trichotillomania Learning Center, which was a nonprofit that no longer exists.

 

And so I had known that word, and I gave him that word, and he went to work, and he read everything he could about that word and, and the people with this condition. And for him, he was trying to understand, “Why didn’t she tell me?” And his… He came away understanding the shame. And then, you know, we just, he met me with love and compassion, and we just started talking about it.

 

And then one day we’re on the couch, and I’m watching TV with him, and I’m pulling my hair, and I don’t realize because it is a trance. It is that subconscious brain. Like, even people will say, “Oh, I know when I’m engaging in the behavior. I know when I’m pulling. I know when I’m picking.” And even I would know I was getting up and going to the bathroom and getting my tweezers and pull, pull, pull, but I didn’t have control.

 

It was still the subconscious that had its claws in me, right? And so it is about shifting it to the conscious and- On that couch, he knew what was happening. He saw it was happening. He took my hand, and that was this aha moment of, “Oh my God, I wish I just had something that notified me.” So to your question of how did I kind of figure out how to make the change, it wouldn’t have happened without that moment and without me saying, “I wish I had something that notified me,” and without building it.

 

So that’s the Keen bracelet. The company we started is called Habit Aware because we help make people aware of their healthy habits and take control of their lives. And so the way it works is it uses gesture detection to recognize when you’re playing with your eyebrows, when you’re picking your nose, when you’re biting your nails, when you’re picking your face, and sends a vibration.

 

And that vibration instantly shifts it to the conscious. It allows you to say, “Oh, my hands are not doing what I want them to do. Why?” And then through that work, we’ve been helping people since 2017, so almost 10 years. So over the past 10 years, we’ve come up with our own methodology that is rooted in the evidence base of habit reversal training, but also brings in some DBT skills and brings in– DBT is dialectical behavioral therapy.

 

It brings in acceptance commitment th- uh, th- therapy, which, which I didn’t know at the time that that’s what it was doing, right? This is just all coming from our heart of we need to figure out how to tackle the shame. We need to figure out how to tackle the physical behavior. I think a lot of the current treatments are so focused on the physical behavior and not so much on the mental aspect of it, which is, is a mental health condition, so the thoughts that go along with this stuff.

 

So how do we get to both? And that methodology that we’ve created is what I talk about in the book. It’s called Love, Strength, and Awareness, which is T-shirt I’m wearing right now, which is our ethos. It is how I sign off every single email I send because

 

Kimberley: Now, as you know, I have a private practice. I have six amazing therapists in Calabasas, California. However, we do not take insurance. Now, if you are looking for insurance-covered OCD or BFRB treatment, I wanna let you know about NOCD. NOCD provides face-to-face live video sessions with specialized licensed OCD therapists.

 

Now, their therapists use exposure and response prevention. We know this is the gold standard for OCD, so you can be absolutely confirmed that you’re in the right place there, and they have a clinically proven app that helps you stay connected to your therapist and others who have OCD between sessions, so you’ll always feel supported.

 

Now, the cool thing is NOCD is available in all 50 US states and even internationally, and they accept most insurance plans, making it affordable and accessible. We love that. Now, if you think you might have OCD or you’re struggling to manage your symptoms, you can book a free call. Just click the link in the show notes at nocd.com.

 

I am honored to partner with NOCD. I want to remind you that recovery is possible. Please do not forget that. Now, big hugs, and let’s get back to the show 

 

Aneela: It transcends these conditions. It’s just backwards. So it’s the awareness which the bracelet can give you to summon the strength, to take that moment of pause, to make that choice to say, “Oh, wait a minute.

 

I’m doing that thing that I like,” in quotes, “that really I don’t like. Let me choose love. Let me take care of myself. Let me meet the need.” And so when we do that, we start retraining the brain. So for myself, it was through that work. It was through manually tracking every time this vibrated, uh, every time the prototypes vibrated.

 

You know, we didn’t have the app that allowed for the tracking. I would manually track, and I would finally understand, like that example I gave you before of, uh, stress at work, not eating, not going to the bathroom. I didn’t realize that until I had this to tell me that, right? So looking at the data, looking at the trends, and identifying those patterns, and then when you know the patterns, you can cut the cycle.

 

You can start a new cycle. You can say, “Oh, okay, I need to go to the bathroom. Oh my gosh.” Just doing that, then I would come back to my desk, and I wouldn’t be hair pulling. Or late at night, just go to sleep. Or when I’m stressed or anxious, walk away from the computer, go take a walk, do some deep breaths.

 

And then a lot of preemptive work. Eating better. I cut soda. I don’t drink a lot of caffeine. I, you know, try to eat better, but I’m sorry, like, there’s some foods that I just have to have. Pasta and sauce included. You know, g- moving more, so I try to do walks as often as I can. We got a dog partly because I needed something to make me go take a walk.

 

Um, and I try to do 6:00 AM walks. I’ve noticed I’m a people pleaser, so I can’t get out of bed to go to the gym, but if I have committed to someone else to go for a walk with them at 6:00 AM, I am up and at ’em. Um, so if anyone ever wants to go for a walk, we can do it by phone. Call me. I need the wake up.

 

That external stimulation, that external… That’s something I’m working on, but to create that habit. But all of these things, you know, as a very sedentary, you know, eating s- like chips late at night, like st- all of these things add up to your body needs to self-soothe, and if you’re not taking care of yourself The brain is gonna choose these ways because it does feel good in the moment.

 

Kimberley: It’s almost like the hair pulling is the signal that you need to be taken care of, right? The hair pulling isn’t the problem, it’s just a signal, it’s a way for you to know I have an opportunity to take care of myself. I have an op- opportunity to be kind or meet my needs and so forth. Or, or tend to an emotion like uncertainty or anxiety or doubt or dread or depression or whatever it might be.

 

That’s hard though, right? That takes some, a lot of courage and a lot of work to take care of yourself when you haven’t, or it’s sort of culturally not encouraged. Um, what brings, what comes to mind for me is the client who understands now that they have this condition. They are pulling their hair.

 

They’re trying to, with all brute force, get through an urge- Mm-hmm … or a wave of, of that urge to pull, ’cause it can feel like an actual urge. I mean, people will say like, “My fingers are tingling”- Yeah … or, “My eyebrows itch, and I just…” Or, “My eyelashes itch, and I just wanna pull them out,” right? Yep. And it’s a ful- self-fulfilling pro- Like it- if you pull your hair, eyelashes out, they have to grow back, which causes it to itch, and you don’t like the feeling of the itch, so you wanna pull it again, and it can keep you stuck.

 

But in that moment, it takes a lot of courage to tolerate that feeling. I’m wondering what you have had to practice to get through that wave or whatever you wanna call it, that urge. You know, how it is for you to get through that. 

 

Aneela: Yeah. First I wanna address that idea of this is a signal. Like, when we can shift to that, right?

 

A lot of people grow up with hair pulling, skin picking, nail biting, and they see it as a monster in their life, as a, a demon, as a, a really bad thing, and this is another thing where people probably wanna punch me because I’m like, “Nope, it’s there to help you.” Yeah. It’s your signal that you’ve gone off baseline and you just need to answer that call.

 

And even we have, at HabitAware, so the bracelet is called the Keen Bracelet, and so the people who have the Keen Bracelet are customers, I call them our Keen family because we’re in this together. And one of our Keen family members a long time ago said this bracelet is their self-care alarm, their signal that they need to take care of themselves.

 

So to me, that idea of 100%, I’ve, there’s definitely been… I mean, right now I’m feeling an urge. You know, my, my eye is tingling a little bit, but I have a mantra, “Don’t pull it, put it back.” And with picking, it’s, “Don’t pick it, patch it,” right? And so with both of those, when I’m feeling that urge and the pokey hairs that you mentioned for the regrowth, oh my gosh, those are the ones that, like, just have to get.

 

But what I realized was when I put Vaseline or I put coconut oil on my brows and my lashes, then they stay soft, less pokey, less urges. So it’s all about meeting that need and finding ways to reduce those urges. And for me, also this idea of, like, urge surfing. You know, in habit reversal training, the main method is make a fist, and to me, that’s not meeting the need.

 

If the whole day long you’re making a fist and trying to surf the urge, you know, then when you get home and the kids don’t have their shoes straight, you just, that one little thing makes you snap, right? And so it’s like creating this soda can effect of shaking that soda can all day long and then boom, as soon as you get home, like, like I’ve heard people say, “As soon as I get home from work, like I go into the bathroom and I…”

 

Oh, because they need to get, they’ve held it together all day long. Yeah. Right? I mean, even as a parent, we talk about how sometimes as a parent we get the worst of our kids because they have to hold it together all day long. Like, my t- kids’ teachers are like, “Oh, Yash and Marin, they’re angels. They’re such great kids.

 

They’re…” And I’m just like, “Really? Are you sure?” Because at home, oof, they can let it out, right? And it’s the same thing with us. We hold it together all day long. We’re not giving ourselves moments to release and relieve ourselves. As soon as we get home, the brain says, “I’m not going for a run. I’m going to tear out all my hair.”

 

And so we have to give ourself those moments all day long so that we don’t have that shaking, that, that soda can that’s just gonna explode when we get home. 

 

Kimberley: Yeah. It’s very similar. I mean, I don’t, didn’t have a BFRB, but I had an eating disorder and it was the same thing. Like, noting the, the urge to compulsively exercise or to restrict or to binge, it w- it did take a moment of like, pause, what do you need?

 

Like, and learning how to take care of that. And I think you mentioned before also planning ahead. Like- Yeah … knowing that when you get home, that’s your high temperature time where things usually fall apart. What can we do to pad that or prepare you for that? Because it is hard. Like, again, I think, you know, you and I were talking before we started recording, and we’re talking about, like, this being a habit or not a habit.

 

Mm-hmm. And I think at the end of the day, it is something we have to prepare for like it’s a habit because you, and you clearly said, like, ’cause it is. Yeah. You know? Because it is. So if you know that your evenings are your red hot times- How can we set together a safety, like a safety loving plan for that evening knowing that it’s still going to be hard?

 

It, there’s nothing that will make the urges go away. 

 

Aneela: Yeah, exactly. And you know, like it, it is a habitual cycle in the moment, right? Something happens or you’ve been feeling something, and then you pull and you get that immediate reward of relief, and then it creates that loop. That’s the habit loop right there.

 

And so how do we break it? Through awareness of the behavior, but then also of the why, and then through new action of instead of pulling, I’m going to take a sip of water. I’m going to, if I know the bathroom as soon as I get home from work is my release time, well maybe before I, after I park the car, I go for a quick walk around the neighborhood and do a few deep breaths or call a friend or say a prayer or whatever it may be that works for you to release without having to, to pull, pick, nail bite.

 

Kimberley: Yeah. I always tell this story. It’s my fav- It’s one of my actual favorite therapy stories of all time because I do think we have to get really creative with treatment sometimes. And maybe I would really l- actually love to hear your opinion on this because I, we talk a lot with our clients about this and, and I’ve talked about this in other resources.

 

There’s also a very tactile feeling that we’re going for when we pull. Yes. Um, some people want to feel that feeling of like, “I’ve got the perfect hair,” or I have that just sort of right feeling when it comes out. I’ve had other clients, and this is a, this was many, many years ago, and I’ll change some of the details for her confidentiality, but for her it was about the, the dig.

 

It was about the dig of the right, the best hair, and she would do it in the car. And so what she did out of her own idea was she would pop a, a very generic, um, thing of popcorn into a bowl and she would pull in the car, so she would put it between the two seats and she, instead of pulling, ’cause she would pull.

 

She said, “I’ll go home and they’re gone. Like whatever is left, they’re gone. I didn’t even know. I couldn’t have caught it. It was done.” That she would have the, the popcorn. She would pour a packet of M&M’s into the popcorn, and the whole way on the way home she had to dig with one hand. I mean, it’s probably not the safest, but she would drive with one hand, but she would be digging for M&M’s.

 

But that tactile feeling of feeling through crunchy popcorn to find the soft- smooth M&M’s hit the spot. It hit the spot. And I was like, “How on earth did you come up with this?” But it worked. It worked for her. It was the tactile need that she had to dig and, like, um, excavate, like there was an excavation need she needed, and there was that sort of like the win, “I got one,” and then she got the reward of being able to eat the M&M’s.

 

Now, I know, like you’re saying, eating a, a bag of M&M’s mightn’t be the healthiest choice, but it was what got her to get a new habit in the car. 

 

Aneela: Yeah, and no judgment, right? If they’re taking care of themself in other ways, then a few M&M’s a day is not a big deal, right? It’s 

 

Kimberley: not. 

 

Aneela: Um, and as we’re sitting here, you know, I’m busy, like, playing with my two forefingers because that is where the tactile for me always came in.

 

Like, there must be nerves here that just need to feel that, like, pokiness, and so for me, it was a, um, mascara brush I would just sorta tap on. Yeah, I think it, it’s important to, again, understand what is the need. So if it is tactile, if it is sensory, finding… I mean, what a cool… You know, it’s, it’s that level of awareness now to understand.

 

Like, I didn’t know until now, like more, you know, very recently that I needed that sort of- Yeah … sensory here, right? And so you need to understand that, but then also understand, like this person, they had the awareness to understand that it was tactile for them, it was sensory for them, and to understand what was creating the reward mechanism for them, and then s- the creativity to come up with- 

 

Kimberley: Mm

 

Aneela: something that gave them something similar, stimulation, that allowed them to still take care of themself in a healthier way. 

 

Kimberley: I have a couple quick, like, fire, rapid fire questions for you. So, um, how much of your personal recovery depended on having habit blockers and competing responses, like fidgets and fiddles, and now they have even, like, these little pickie pads and all the things.

 

Yes. Like, what is your experience? I’ve had clients who found them very helpful, clients who have not. What’s your experience? 

 

Aneela: Yeah. So I never really used fidgets as much. Like, I think the, um, the mascara brush is probably the closest to a fidget s- meeting a very tactile need. I personally don’t like the just use a fidget mentality of…

 

And, and this mostly comes from well-meaning family and friends that don’t understand the conditions or untrained treatment professionals, um, which I know you are not. Um, to me, it is about not just use a fidget, but like this person that you just mentioned, use a fidget if it meets the need. Yes. Right? And then my, my fear with those pickie pad things is it reinforces the picking or the pulling behaviors rather than replacing them.

 

Like, I think t- uh, and this is, this is where the science and the research I would love to see s- you know, it would be cool to put, like, to, to look at the brainwaves and see does that, you know, mimic the hair pulling? Do those pickie and pickie pads and stuff mimic the hair pulling or Like, I would venture to guess that by me choosing to meet my needs in other healthy ways, like going for a walk, et cetera, it’s gonna light up different areas of my brain than the hair pulling.

 

And so that’s what I would wanna see, because it just, that’s what scares me about it, is that I’m still basically doing the behavior, which means I’m not teaching my brain something else, which means that if that Picky Pad’s not around, it’s gonna still go to the pulling. That’s my concern there. 

 

Kimberley: Yep.

 

Absolutely. And I think that that is the point, right? Is it’s not just throwing, um, all of these fidgets and competing responses on you. It’s, and we talk about this a lot, is identifying what is it that you need. A fidget can be something to fulfill that need instead- Yes … of pulling. Yes. But you first need to identify what is the need that, like if

 

I’ll often say to people, “If you’re gonna have a fidget basket, have a bunch of different tactile,” ’cause there’ll be times where you want a soft feather to run your fingers over. There’ll be other times when you’re agitated where you might want, like, something a little more like crunchy and grabby or whatever.

 

But, um, have more than that just one tool in your tool belt- Yeah … because, y- you know, we’ve gotta rotate them and have multiple tools in your tool belt. 

 

Aneela: 100%, yeah. And, and you know, like, there would be days at my office back in the day when I was working in advertising and just pushing through work, you know, if I had a stress ball there, fine, it’s going to block me from pulling, but it’s not meeting the need of I needed to eat, right?

 

Yeah. So, if we’re not meeting the need, it’s gonna, it’s again, that soda can effect. So fidgets are good as blockers. Fidgets to me are good as allowing you to, to create space between to think and address the true need. Um, and so with that, and then often, and then there, and then there are gonna be those moments where the fidget is meeting the need, like you mentioned, if it’s tactile, having the, the feather, like, that sounds, like, so cool to have running over my fingers in this moment specifically, ’cause I’m feeling that zing, that tingle right now there.

 

Um, so it really is this, this level of awareness, not just of the behavior, but of the why and what will really help in the moment. 

 

Kimberley: Yeah. Yeah. And the thing I love about what you’re saying is it’s all done with love, not white-knuckling, shame, you know, mean words. Like, there has to be that compassion component to get, you know, to make it light up that part of your brain.

 

Aneela: 100%. This is just the way I… Another way I like to explain it to people is this is just our inner baby crying, right? It’s saying, “Take care of me.” When a baby cries, do they need a diaper change? Do they need milk? Do they need a hug? Do they need playtime? It’s the same questions and, and if a baby cries, y- you, you jump and you go check on them, and you care for them, and you hug them, and you love them, and that’s all that this is about, is when you meet your own needs, you are showing yourself, “I love you.”

 

And it’s really hard to say that out loud, but we need to do it. We need to, we need to act with love for ourselves, and that’s how we get to the point of truly loving ourselves. And, you know, there’s a whole bunch of us that don’t like ourselves running around, and I think that’s why we have a lot of the problems we have in this world, if we just looked inward a little bit more.

 

Kimberley: This has been such a beautiful conversation. I’m so grateful for you, and the work that you’ve done and the Keen bracelet, which I know has helped so many people, and I’m so grateful for you. Is there anything you want the person with, uh, hair pulling or skin picking to know? Like, what would the be the message you would wanna give them?

 

Aneela: Yeah. I mean, there’s so many messages. Um, the… I would say the biggest three are you are definitely not alone. Um, it’s just that so many people are afraid and scared and, and you just don’t know, you know? Like the person sitting next to you on the bus or someone else in your class is going through this.

 

So you are not alone. Um, it takes work. Everything in life, nothing is easy. It takes work, and when you do it, it is so, so very rewarding because you get to be the person you wanna be, the person that you deserve to be, the person that you are, that you are afraid to show the world. And the last thing I’d say is keep doing what’s working, meaning I would go through these cycles of, “Oh, I’ve got it under control.

 

I don’t need to wear the bracelet. I don’t need to do the strategies. I don’t need to go to w- I don’t need to walk. I don’t need to drink water. I can have a Coke. I can have another Coke,” you know? Keep doing… I can even, you know, during my breast cancer stuff, my, my… I went to a therapist just for that kind of, and she was like, “Okay, I think we’re done here.

 

You’re like, you’re, you’re feeling good.” And I’m like, “No, I’ve learnt now, keep doing what’s working.” So now I see her every s- every six to eight weeks, right? Instead of every week. And so just that idea of if it’s working, do not stop doing it. 

 

Kimberley: Mm. 

 

Aneela: Like if you’ve gotten to the point where you’re good, keep doing all those things that kept you good.

 

Don’t stop. Keep going. Right. Because that’s how you maintain your life, your good life that you’ve created for yourself. 

 

Kimberley: Yeah. And I notice you’re still wearing your bracelet, so it, it’s proof that, like, you just keep do- like you’re saying, just keep doing what’s working. Don’t… And that’s true of so many mental health conditions or so much of life, right?

 

Like, it is… We sometimes go, “Yay, I lost 20 pounds. I don’t have to go to the gym anymore,” or, “Yay, I’ve, I’ve completed my OCD treatment.” But it’s like, no, but you have to keep not doing compulsions to keep those benefits. So I think that is a, a, a very humble lesson for us all in many respects. Yeah. Yeah. 

 

Aneela: And I am wearing the bracelet, but it’s, it’s not charged.

 

I wear it just as a reminder of all the people that we’ve helped, and I have built my awareness. Like, I know when I’m pulling now, and I still pull a little bit, right? I still allow it. I have the choice where I allow it, not where I… And, and, and I use those first few hairs, like you said, as a signal. “Aneela, what do we need right now?”

 

And sometimes, you know, there’ll be a little patch here that I’ve pulled out a little more than two hairs. It’s okay. I understand why. I’m just going through something stressful. I understand why, and then I still took care of myself in the right, in the right healthy way, and it’s okay. So that compassion.

 

Kimberley: That’s really powerful. Thank you for sharing that. I think that that is important too, is it’s not all or nothing. Recovery isn’t all or nothing. It, I think we can get caught up in the all or nothing, which just sort of reins- reinforces that criticism cycle of like, “Ah, you’re not perfectly cured,” and they, you know, and that’s what usually starts a huge complete pull, like, com- pull festival, right?

 

When you’re coming from that black and white perspective. Aneela, tell us where people can hear about you, your book, Keen, all the things. 

 

Aneela: Thank you so much for having me. I hope that anyone listening that feels connected to this, please find us at habitaware.com. We are on Facebook, TikTok, and Instagram @habitaware.

 

My memoir is called Aneela: Wear Your Eyebrows. You can get it at, on Amazon or on bookshop.org if you wanna support your local independent bookstore. And I, my, my doors are always open, so my email is Aneela@habitaware.com. I would love to hear from you if there’s anything we can do to help you. We have tons of resources, the smart bracelet, our online community where we take people through all of these methodology changes and mindset shift changes.

 

Um, we have parenting workbooks for, for those folks who need help supporting their kids, and we do peer coaching as well. So we have lots where we support the community, and I do a ton of work in advocacy and raising awareness, so if you ever want tips on that, we need more voices, so, so reach out. 

 

Kimberley: Yeah, you’re a rock star, truly.

 

Truly. It’s really, really cool. Thank you for being here. 

 

Aneela: Oh, thank you for having me. I’m, I’m so grateful.

 

Kimberley: Please note that this podcast or any other resources from cbtschool.com should not replace professional mental health care. If you feel you would benefit, please reach out to a provider in your area. Have a wonderful day, and thank you for supporting cbtschool.com.