Cognitive Behavioral Therapy Step 1 – The Diary

“A consciousness of wrongdoing is the first step to salvation…you have to catch yourself doing it before you can correct it.” – Seneca

All highly trained clinicians that specialize in trichotillomania use Cognitive Behavioral Therapy (CBT) as their primary tool to help trichsters overcome pulling. Why? Because it works extremely well at shifting the beliefs AND actions that trichsters deal with. Instead of a passive counseling, CBT helps trichsters take massive action that leads to a great reduction in symptoms. Many people have drastically reduced their urge to pull and overcome trich by using CBT. Studies have shown that when CBT is combined with NAC supplementation, results come even faster. In this article I’m going to start with the first CBT action step.

STEP 1 – CREATE A DIARY: The first step involves creating a diary where you track how many times you pull throughout the day. This self-monitoring process makes you more aware of your urges, pulls, and the emotions you feel when doing it. Trich behavior can often be unconscious, awareness can be improved by starting this pull diary. The very act of recording the behavior can also interrupt the process and reduce the pulling behavior. This is such a simple, yet powerful step you can take. You will be amazed at the progress you will make with just this step alone.

HOW YOU DO IT: Each time you pull, you simply add a tally mark to the current days entry and add a short blurb about your mood / location / circumstance at the time when you pulled. Later, if you decide to take nutritional supplements, you can keep track of that in your diary as well. I used Evernote to keep the diary online, so that I could access it from anywhere with my phone or laptop computer. Evernote is completely free and private to use. I’ve used it for years and highly recommend it.

To give you an example of what a diary looks like, here is an excerpt from my trich diary leading up to the last day I pulled.

As you can see from my diary example, the first line consists of the date  and # of pulls. The second line is used for the context of the pull.. what i was feeling, what was going on during the day, etc. The final line is used to track supplement usage.

This should be more than enough to get you started on your own diary. Remember, this is what professional that are experts at dealing with trich, with PhD’s and many years of experience will tell you to do. This is a critical step you must take to getting better. Don’t procrastinate any longer. Start your diary right now.