Parenting a Child with Trich

I got this book from Amazon, Stay Out of My Hair: Parenting Your Child with Trichotillomania. It's a quick read; I read it in two evenings. And I found it to be extremely eye-opening.

The book explains, in very simple terms, what is known about trich and what is not. And largely, the causes are unknown. Most of the research has been done on adults with trichotillomania; relatively little is known about how and why it starts in children - especially very young children - how it progresses, and what the long-term prognosis is.

I was apparently right in my assumption that it is not in any way related to self-mutilation, which is typically brought on by trauma and used to create physical pain in order to obliterate emotional pain; and that it is closely related to other habits such as nail-biting. To some degree, it is true what I've concluded - that in the end, Annabelle is going to have to own her hair-pulling. However, she is a little girl, and as her parent, I have a responsibility to help her navigate this because she can't do it alone. And unfortunately it's foolish to assume that she might grow into an adult with trich who is perfectly happy and well-adjusted. She might, but it's just as likely that if she doesn't master some strategies to control the impulse to pull, she might grow into an adult with trich who has resulting depression, shame, embarrassment, and self-esteem issues.

What became clear as I read it is that (a) my approach and reaction to Annabelle's hair-pulling has been all wrong, and (b) my approach and reaction to Annabelle's hair-pulling has been very typical of parents of children with trich.

The book presents a number of case studies, and Annabelle's hair-pulling matched one of them very closely: a little girl who, as a toddler, began twirling her hair as she sucked her thumb. Eventually, the twirling progressed to pulling, but it was more a result of over-zealous twirling, and not necessarily purposeful pulling. However, over time it became an ingrained habit, and the little girl continued to pull her hair in combination with thumb-sucking as a self-soothing mechanism, as when going to sleep, and out of boredom. This is Annabelle exactly. I truly believe that her pulling is not anxiety- or stress-related, but rather what has become a habit originally born out of hair-twirling, that she is largely unconscious of when doing it, and one she engages in as a self-soothing tool (in combination with finger-sucking) to go to sleep and during times when she's bored or idle.

The common responses of parents to their child's hair-pulling, according to this book, are:

• Impatience (as in wanting/expecting the child to just stop the habit NOW)
• Blaming (as in assuming the pulling is completely within the child's control and that they should just therefore stop doing it)
• Policing (as in inspecting the child's hair regularly to monitor hair loss/hair growth)
• Too much focus on hair/trich (as in allowing the child's hair-pulling to become the focus of the majority of interactions with the child rather than devoting attention to other issues, as well as all of the child's attributes, talents, and achievements)

I've had all of these responses to Annabelle. And it's all harmful to the child and to the relationship between parent and child. These responses cultivate feelings of shame and low self-esteem in the child, as well as making the child feel responsible for the parent's emotions and reactions.

I'm ashamed that I've done this to my daughter.

And when the book explains how many bad habits many, many people develop, and how difficult they are to overcome, I realized, maybe for the first time, that Annabelle's hair-pulling is not something she can just stop doing, just like that. When I think about all the times I tried to quit smoking . . . ack. Many times before I finally succeeded. And just like smoking, or overeating, or any other habit that a person has engaged in for long enough that it's become ingrained in their daily routine, they can't and won't stop until they're ready to. Which means that just because I'm ready for Annabelle to stop pulling her hair (and sucking her fingers) doesn't mean she's ready to, and I can't just demand that she be ready.

The truth is that I often find myself feeling embarrassed about Annabelle's hair. And because she's a twin, and her twin has long hair, I'm often asked why Annabelle has short hair (because, I guess, people assume that twins should look the same). I hate it when people ask me this, and I don't know how to answer. I find myself just being honest and saying that she has a hair-pulling habit (partly in the hopes of de-stigmatizing it), and that I have to cut it regularly to even it out. I don't know if this is how I should be handling it. I do know that it's probably not my place to feel embarrassed by her hair; at this age, she couldn't care less about how her hair looks. So why do I? Am I so shallow that I see my kid as a reflection of me? Yeah, probably something like that.

What I can do is commit to be gentle with her; no more snapping at her to leave her hair alone, no more reprimanding her for twirling or pulling, or demanding that she just stop it. I can be patient, and remind myself that habits are often very difficult to break, and it doesn't happen overnight; she may not even really be ready or motivated to stop. And the biggest thing is to accept her as she is, hair-pulling and all, and to make sure she knows it. I need to tell her and show her that she is loved no matter what; that she is beautiful no matter what kind of hair she has; and that she is a wonderful little girl with lots of talents and positive attributes.

There is a lot of guilt resting on my shoulders for likely having failed thus far in making sure that she is absolutely secure in the knowledge that she is loved and accepted exactly the way she is, hair-pulling and all.

But guilt is only useful if it motivates positive change. So rather than becoming mired in regret, I really want to move forward and make some positive changes that will hopefully help Annabelle.

The discouraging aspect of trich is that there really is no way to know a long-term prognosis, especially for people who start hair-pulling in early childhood. Additionally, it is apparently a condition with a high susceptibility to relapse; so, even if we get to a point where it looks like she's stopped pulling, there are no guarantees that the impulse to pull won't at some point return. This makes it all the more important to develop strategies to help her deal with those impulses.

The approach we used recently of trying to limit her hair-pulling to the chair in the playroom was a joke. It probably could have worked, and even might have worked, had it been attention-seeking behavior that we were trying to curb. But her hair-pulling is definitely not attention-seeking behavior. Live and learn.

Blocking her ability to pull (and finger-suck), as with tape or Bandaids is actually a suggested strategy - BUT not against the child's will. Then it becomes punitive and shaming, which is counter-productive. And lord knows I taped Annabelle's fingers against her will many a time. So it's not out of the question to use that strategy again, but only if Annabelle is a willing participant.

In Annabelle's case, I think she is just a very tactile and fidgety kid, so I'm thinking of putting together a box of tactile things she can use with her hands (think Kooshie balls, furry chenille stems, Play-doh, strings of bumpy beads, etc.) during times she typically pulls.

But she has to be ready and willing to try to overcome this habit. I can't force her. And if she's not ready, I need to make sure she knows it's okay.

So, long story short: I'm hoping to take a more positive approach to this whole thing, and I highly recommend this book to any parent out there who has a child with trich.

Sentimental

When Kevin turned 2, I got him this little pine table and chairs for his birthday - someplace of his own where he could sit and color, play with play-doh, and whatnot. It was important to me to get a table with four chairs rather than just two, as I envisioned him gathering with his little friends here, and maybe even a sibling or two.

I remember that it came in a million pieces and I put it together myself. He was very excited to get it (although, if I recall correctly, not quite as excited as he was about the trike his grandma and grandpa brought him for his birthday).

That was a little over eleven years ago. This little table and chairs did, in fact, seat Kevin and his little friends, and four siblings (Finn hasn't yet mastered sitting in a chair without doing a header off of it). It withstood eleven years of abuse: being tipped and dragged, made into a fort and a makeshift operating table when the kids play doctor, being colored on, painted on, gouged with toys, stood upon, danced upon, and jumped from.

And it's started falling apart. Heck, it's been well on its way to falling apart for a while. It's rickety and wobbly, and screws fall out spontaneously.

So we got a new table and chairs, which I put together and snuck into the playroom last night after the girls were asleep so they could wake up to it this morning:

It's really cute and sturdy, and they love it.

But it was a little sad putting the old table and chairs out by the curb this morning. We figured someone would come along and take it, and hopefully fix it up and use it for their kids.

Kevin, though. He was upset. "Can't we save it?" he asked. I'm sentimental (I've hung onto each of my kids' umbilical cord stumps for goodness' sake!), but you have to draw the line somewhere, right? "How about just one of the chairs?" he implored. Ack. Guilt! I really felt bad. And I was really surprised! I had no idea he felt such an attachment to it; it's been a number of years since he's even played on it - he's far too big for it now.

The table and chairs was gone within a few minutes of being put out by the curb, just as expected.

I have no doubt that it will be just as sad when the last kid outgrows the new table and chairs.

Mother's Little Helper

Okayyyyy . . . switching gears here, I'm going to give a shameless plug to Omaha Steaks. Did you know they're not just about steaks (although their steaks are delish!)? Did you know that you can order entire meals from them and have them delivered right to your door? I didn't know, either, until some friends and I got together and had a bunch of Omaha Steaks meals delivered to a pregnant friend who was on bedrest (great gift idea, by the way). Then the lightbulb popped on above my head and I thought, "Hey! This could be just the ticket! After all, I hate cooking! And I despise meal-planning!" And then a $20 coupon came in the mail from OS, and it seemed as if the gods were trying to tell me something. So I went online and ordered a boatload of food, and when it was delivered last Friday, I could be found hootin' and hollerin' for joy (seriously, this was very exciting).

Two BIG coolers packed with food (all kept frozen solid with two small slabs of dry ice, which the science geek in me found awesome and amazing) -

Yes, they even threw in a set of knives.

Here's what we got:

And the really great part? All this for under $200. There must be a dozen dinners here, all for under two hundred bucks. With shipping, it was just a smidge over $200, but that's a super great deal in my book - and very high quality stuff here.

And the dry ice? Check this out:

Delayed Reaction

Three days after the letter from my mother arrived, I'm crying. It's taken that long for me to break down. I have found myself so full of anger - and yes, pain - but also determination: I will not let her hurt me, I will not let her break me. And yet, here I sit in tears, too much to hold in.

I hear so much about forgiveness. Even my closest friends in whom I've confided some of the darkest details preach to me about forgiveness. I get it. I understand the concept of forgiveness, and I understand that in most cases it's more for the person doing the forgiving than the one being forgiven. I understand that it's possible to forgive someone without even communicating it to them. And I understand that forgiving someone doesn't necessarily mean allowing them into your life. Forgiveness, as I understand it, is letting go of the anger, of somehow finding peace in your heart.

I am struggling so much with this. I don't know how to forgive her. And although I don't want this anger and pain to eat me alive, I'm also not sure I even want to figure out how to forgive her. My anger is an armor, a hard shell that grew over many years and that served to protect me. I don't know how to let it go. And in some ways I think that forgiveness is overrated.

It's been many years that my mother and I have been estranged; I have not spoken to her or laid eyes on her for almost eleven years now. And the truth is, I don't give her much thought at all these days. She rarely enters my consciousness. The mother I was supposed to have - the one every child deserves to have - never existed. The one I did have has been gone to me for a long, long time. Although there's a certain longing at times for a mother, I've just gotten used to not having one. It's not until she intrudes in my life again that all these feelings come bubbling up to the surface.

It's not so much the content of her six-page letter to me this past week - I know my own heart and character, I know the truth of myself and my past. My life, as it was and as it is, speaks for itself. It's knowing that this is my mother, who still, after all these years, seems determined to inflict pain, to lash out, to tear down. My mother. She's still an abuser. The comfort I take is in knowing that now, unlike before, I can choose not to be victimized by her.

*****

Dear Mother -

I would feel sorry for you if I weren't so sickened by you.

Go fuck yourself.

Warmly,

Lisa

P.S. I am better than you.

*****

Like I said, I'm struggling.

Toxicity

From the Merriam-Webster Dictionary:

Main Entry: ¹tox·ic

Pronunciation: \ˈtäk-sik\

Function: adjective

Etymology: Late Latin toxicus, from Latin toxicum poison, from Greek toxikon arrow poison, from neuter oftoxikos of a bow, from toxon bow, arrow

Date: 1664

1 : containing or being poisonous material especially when capable of causing death or serious debilitation 2 : exhibiting symptoms of infection or toxicosis 3 : extremely harsh, malicious, or harmful

******

I am often asked about my family by casual acquaintances. I think people tend to assume that having a lot of kids myself, I must come from a close family, and that that family must play a large part in the family I've created. I hate the questions. I hate having to explain that I do not have a relationship with anyone in the family into which I was born. In some ways it's easier to talk about my dad. "He died eleven years ago." People understand this. But explaining estrangements, that's a lot tougher. It goes against everything society wants family to live up to.

What kind of mother emotionally strangles her child and then blames that child for acting out?

What kind of mother apologizes while pointing her finger and demanding that her child accept accountability for "contributing to the chaos" of that child's formative years?

What kind of mother involves herself in the emotional and legal upheaval of a marriage that has imploded, taking the side of her daughter's abusive spouse? What kind of mother believes the stories fed to her by an alcoholic, drug addicted, wife-beating, lying son-in-law without giving her daughter any benefit of the doubt, without making one iota of effort to seek out her daughter's side of the story?

What kind of mother sends her daughter a six-page, single-spaced, type-written litany of her daughter's childhood offenses and crimes - a letter containing some truth, a lot of twisting, many glaringly omitted facts, a lot of inaccuracies and outright lies? A diatribe of that daughter's wicked nature, deplorable character, and general unworthiness. And what is the point of such a letter? What does that mother hope to accomplish with it? What kind of mother is still in the business of tearing down rather than building up?

This is what I come from. I will not be a slave to my roots. There are some people who are so toxic that cutting all ties is the healthiest, most positive step that can be taken in the endeavor to rise above it.

The Princess and the Hot Dog Bun

The Princess and the Hot Dog Bun

A Short Story About Choosing Your Battles

Once upon a time, there was a little princess who was three years old. Let's call her Princess Lulah. She lived with her brothers and sisters, her daddy, The King, and her mommy, the Mean Queen, whom we'll call Moi.

One morning, Princess Lulah woke up and went into the kitchen, where her mommy, Moi, was preparing lunches for her children to take to school. Lulah spied something on the kitchen counter.

"I want that for breakfast," she said to her mommy, pointing to the package.

"You can't have that for breakfast! Those are hot dog buns!" Moi replied.

"But I want one!" Princess Lulah said.

"No, absolutely not," said Moi.

"But I want one!" insisted the little Princess, stamping her pretty little princess foot.

"Hot dog buns are NOT for breakfast. You may have cereal or waffles. Which will it be?" asked Moi.

"I want THAT!" demanded Princess Lulah.

Moi opened her mouth to sternly repeat to the little Princess that she could not have a hot dog bun for breakfast . . . and then suddenly, I - er, Moi - realized, "What's the big deal? Why can't she have a hot dog bun for breakfast? It's whole wheat, and really no different than toast after all."

So she let Princess Lulah have a hot dog bun for breakfast. And sunshine poured in through the windows, a dazzling rainbow appeared right over their very house, and the angels sang. And Moi lived in peace and harmony with her children from that day forward.

Okay, that last part? Not really. But the rest? I'm just saying.

THE END

Trich, revisited

I wanted to go a little more in depth about our experience with Annabelle's hair-pulling, and my thoughts on it, since people have asked some questions about it.

My understanding is that trichotillomania, while still in large part a mystery, is generally believed to be associated with anxiety and/or OCD (although I just read on some website that it's not considered a compulsive disorder, but rather an impulsive disorder). Annabelle has never been formally diagnosed with trich, but I assume that's what it is since it's gone on far too long to be considered "a phase," as our pediatrician believed it to be when I first discussed it with him.

Here's how it evolved in Annabelle's case: I first noticed her pulling her eyelashes out as I was nursing her when she was about ten months old. I can still picture it. It alarmed me, because it just seemed so strange. At that time, I had never heard of a condition or disorder involving hair-pulling. Shortly after that incident, Michael and I just happened to land on a documentary on TV about this condition where people pull their hair out called trichotillomania, or trich for short. I was horrified. Could my baby daughter have this? But her eyelash pulling was short-lived. She stopped doing it as suddenly as she had started, and I breathed a big sigh of relief and then pretty much forgot about it.

She's been a finger-sucker since she was an infant. She discovered the middle and ring fingers on her left hand as a little baby and began sucking those two fingers as a self-soothing mechanism. Over time, she began twirling her hair in the back as she simultaneously sucked her fingers. The two activities went hand in hand. No big deal. Except she began twirling wicked knots into her hair which I then had to cut out.

I don't know exactly when she started pulling her hair out instead of just twirling it. I discovered it right around the time she turned four, I think. I saw her doing it, wrapping strands of hair around her index (or twirling) finger, as she sucked the two fingers on the other hand, and ripping the strands of hair right out of her scalp. Just the sound was enough to turn my stomach and break my heart. And I began finding her pulled-out curls randomly on the floor.

I tried to reason with her to get her to stop. And as I've documented, I taped her fingers (the sucking fingers and the pulling finger) pretty much every day for over a year. And her hair did grow out while her fingers were taped, but whenever the tape wasn't on, she'd go right back to sucking and pulling. Then I tried just washing my hands of the whole thing and telling her if she wanted to pull, fine, but she could only do it in a specific chair in a specific room of the house. Well, that didn't work either. So I tried tape again, and very shortly thereafter discovered that even the tape wasn't stopping her from pulling anymore. So now we're trying the stuffed animals as a redirection tool. I can't really say how it's going; she's carrying the stuffed lambs with her almost everywhere, and sleeping with them, but I suspect she's also still pulling (I know she's still at least twirling because I've seen the telltale corkscrews sticking out from her hair).

So.

I don't know what drives her penchant to pull. I suspect that it started out as a sensory thing - at least the twirling part. And that it, for some reason, evolved into pulling. I wouldn't say that she's an overly anxious child. She certainly wasn't an overly-anxious baby or toddler. She and Daisy were both colicky, crabby infants, but by the time Annabelle started messing with her hair, she had outgrown that. In fact, she's always been mischievous, happy-go-lucky, just lookin' for a good time. Our little party girl. Daisy is the one who's had all the anxiety and phobia issues, but man, oh man, has that girl come a long way. She's overcome so much of that. However, some of the phobias seem to have transferred to Annabelle recently. Those twins, I tell ya - a science experiment in action. Anyway, although Annabelle has developed some phobias of things she didn't use to be bothered by (like animals), I still wouldn't classify her as overly-anxious.

Now, the compulsive vs. impulsive. There might be something to that. I would not say that Annabelle has any compulsive leanings, but she definitely has impulse-control issues. She does very well in structured situations (like at school), but when she's got free time on her hands, like at home, she's willy-nilly. So, yes, I can see the hair-pulling being some sort of impulse thing with her.

But I've been thinking a lot about this whole disorder thing. Without having done much research, I'm only speaking here as a lay person and a parent. I wonder, though, why exactly trich is considered a disorder or condition. A friend once asked me if it's the same type of thing as self-mutiliation. No, it's not. Self-mutilation, I believe, usually comes on the heels of some severe trauma. Hair pulling, it seems to me, is more along the lines of nail-biting. So why is it such a bigger deal? I mean, lots and lots and lots of people bite their nails - often down to the bloody nubs. And although it's an unattractive habit, it's pretty accepted. Does trich have such a stigma simply because we are an appearance-focused society and the appearance of someone's hair (or missing eyelashes or eyebrows) is harder to overlook than bitten-down nails? I don't know the answer to that, but it's something I've been thinking about.

The truth is, trichotillomania is more prevalent than most people realize. Since I started blogging about our trials with Annabelle's penchant for hair-pulling, other people with trich have come out of the woodwork. A couple of my friends in real life have confided in me that it's something they deal with. And I never would have known. Look around you - chances are, if you're in even a small gathering, there is at least one person there who pulls their hair (or eyelashes or eyebrows or other body hair) out. And here's the thing: you wouldn't know it unless they told you. They function. They deal with it. It's troublesome, but it doesn't consume their lives (although I'm sure there are people with severe cases of trich whose lives it does consume, but I have to think that those people have other, compounding issues).

Ultimately, I have to hold onto this for Annabelle. I can read all the books and try all the tricks to try to get her to stop, but one day she's going to be a grownup and I'm not going to be able to hold her hand through these kinds of things. She will have to find a way to deal with it, by herself. Whether I can find it in myself to let go of it now or not, the truth is that some day I will have no choice but to let go. She will have to own it. And I have to trust that she'll find a way to deal with it, and that she'll be okay.