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.


The first step in your Journey – Belief that you can and will get better.

“Be at least as interested in what goes on inside you as what happens outside. If you get the inside right, the outside will fall into place” – Eckhart

There are countless ways one can begin to treat trich, but the most critical piece of the puzzle is that you must sincerely believe that you can and will get better. There are many false beliefs that trichsters carry around with them that prevent them from even taking the first step to recovery. Some of these false beliefs go along the lines of, “There is no hope”, “I’ll never get better”, “I’ve been doing this so long, how will I ever stop”, “the urge is too strong, it’s just hopeless”, and so on. In reality, there is hope. There are countless people who have conquered trich, myself included, that have gone on to live their lives pull free, without the shame, without the guilt and without all the emotional baggage that comes with it. No longer having to live with trich is one of the greatest reliefs someone can experience, and you have the power within yourself to make that happen.

I know that those with trich are some of the smartest, craftiest, and most loving people in the world and one of the main things holding them back from conquering trich is the false belief that they are doomed to have it for the rest of their lives. These false beliefs lead to trichsters ignoring the problem, inaction, and a refusal to even look into treatment options. In truth, there are plenty of methods one can use to get better, from Cognitive Behavioral Therapy (CBT), to sharing your experience with a support group and creating new friendships, to nourishing your mind with the supplements it needs to heal itself. There are plenty of options out there waiting for you.

Just remember, you are not alone, over 200 million people around the world suffer from trich. Everyone is in this battle together and they all have the power within themselves to change, they just have to unlock it. The way to unlocking the power of change is to accept that you are capable and worthy of it. There are countless others out there just like me, that have overcome trich and you can be one of them too. I promise you, as unlikely as it may seem to you right now, as bad as it may be, you can and will get better. There is a better life out there waiting for you, a life where you don’t have to hide, and one where you can be your true self, you just have to take the first step. Every new day is a chance to change your life.