You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
In ordinary conversation, one frequently hears such remarks as, “I was so angry with her, I could have pulled her hair,” or, “He deserves a good hair-pulling.” Similarly, but with the punishment introjected, it is a common custom to represent a person in anguish, despair, or grief as clutching at his or her own hair. Such usage may perhaps be considered of doubtful psychological significance or consequence and attributed entirely to the well known figure-of-speech, hyperbole, in which an exaggerated statement is purposely made for rhetorical or literary effect. This explanation, despite its superficiality, might appear quite reasonable were it not for the fact that hair-pulling is indeed a form of punishment frequently resorted to in every-day life and also that most of us have, at one time or another, experienced states of perplexity or tension during which we reflexly grasped our hair.
This problem is of special interest to the psychiatrist, for a commonly present symptom in neurotics, and psychotics, is the compulsive plucking out of hair, particularly over the scalp, and on the average ward of any mental institution can be found several patients with areas of alopecia resulting from such activity. The symptom is so obviously psychogenic in character that the scarcity of its mention in psychiatric literature is rather surprising. Aside from the recent psychoanalytical contribution by Berg, (25) most references on the subject have appeared in dermatological and pediatric treatises. Sutton, (1) under the subject, “Trichotillomania,” in his text book on skin diseases, says, “Trichotillomania, the ‘Trichomanie’ of Besnier, (2) is an affection which is characterized by an abnormal desire on the part of an otherwise apparently sane individual (Italics are mine) to extract forcibly one or more of his own hairs. The impulse is seldom cyclic, but is as sudden as it is uncontrollable, and Raymond's designation of ‘tic de l'epilation’ is not an inappropriate one. The scalp,