"Our annual budget is about $110,000 and that is almost completely internally generated by our membership. We do get donations. We had one school in Canada send us $150 collected on a jeans and hat day [teachers pay $1 for wearing jeans and students $1 for wearing hats] because one of their students has trichotillomania. A Boeing employee who has trichotillomania put us in their Good Neighbor Award, and so we get $600 or $700 per year in contributions from Boeing. These moneys come because those with trichotillomania reached out to their environment to ask for help for this organization," she said. "We also had a fund-raising drive to our membership asking for assistance, and we did receive $10,000."
TLC has also established a research fund and has asked its membership and others for help.
"There are several developments in research," Pearson said. "Richard O'Sullivan at Harvard, and associates have done some functional magnetic resonance imaging scans [fMRI] with 10 controls and 10 women with trichotillomania and have found some structural differences in the putamen and globus pallidus. This is the first hard science that shows a structural difference in trichotillomania. That's a wonderful stepping-stone to the next level, showing that trichotillomania is not just a habit, but a complex disorder manifesting in a myriad of ways.
"While the functional MRI is probably the largest breakthrough, we also know that serotonin plays a role in the disorder just as it does in OCD. The problem with medication is that the effect of selective serotonin reuptake inhibitors (SSRIs) on trichotillomania seems to wear off over time, yet it doesn't seem to do that with classic OCD...Brain scans show trichotillomania to be probably closer to Tourette's disorder than to OCD, although it overlaps both. I believe it has enough power and impact to stand on its own."
Regarding treatment, Pearson said a multimodal approach is best.
"It can include medication, and definitely behavior therapy. It also requires a personal/spiritual commitment to development of self-awareness. With a good treatment provider who is aware of these modalities, a person can go far. Hypnosis is helpful for some, as is changing diet, reducing stressors, and using habit reversal techniques. Most of us who have pulled for years and years find there is a mixture of different patterns of techniques that work at different times," Pearson said. "One of the things about having trichotillomania is that one needs to be flexible and open-minded, because what worked yesterday may not work today."
An open mind is also an important quality in the helping professional, Pearson said.
"Any treatment providers who work with trichotillomania need to be open-minded and to understand how difficult it is to work with a condition where you might not see a lot of improvement. That can be very hard on somebody who is devoted to helping others. I urge you to stay upbeat, because we are discovering new pathways."