Applied Buddhist Psychology	Home Courses Information menu

BUDDHIST PSYCHOLOGY IN THERAPY SETTINGS

Working with Trichotillomania

The following account of working with Buddhist Psychology concepts was sent to us by reader Bill McCrackens I have a lot of ideas of how to integrate Buddhist Psychology with practical applications such as cognitive therapy, gestalt techniques, and EMDR. I really think the idea of Rupa is extremely powerful. I have a girl I am seeing in therapy that has Trichotillomania, which I am sure you know is very difficult to treat. In using the idea of Rupa and the aversion/attachment that follows, I was able to work with her using positive and negative images. Here I am using the idea of Rupa as an image. The negative Rupa is her self, relieved from discomfort through pulling her hair. In working with her bringing up this image, we describe its objective components. Such as its shape, color, hot or cold, where she feels it in her body. Then we explore the negative cognitive messages associated with it (Samskaras). Then I ring a bell as we continue to bring up these points and measure her responses to emotion and discomfort on a self scale. This is done to increase her awareness of her aversion to discomfort and the suffering that this image is creating. Then we begin to explore what positive images that may be available to her. She described her positive image as a "pillow wall." So, we worked with that. The positive image was associated with positive cognition such as running fast and hard through the pillow wall which feels like floating on clouds. So we again repeated theses associations and used a bell to mark the cognitive/affective points of the new image. She was able to bring her emotion and discomfort level from a 7 to a 5 and then to a 2. I also used some of Thich Nhat Hanh's techniques in repeating key points of the positive phrase followed with the bell. It seems to have worked very well with her. When she came in this week I could see that hair was starting to grow where she had been pulling which is clear evidence that she has decreased her pulling. Also, this positive image was supported by an actual positive Rupa of wrist malas. She is a Catholic and wanted to begin using the rosary in daily meditation practice. She has a set of rosary beads for around her neck, but I suggested ones for the wrist so she can see them when her hand reaches for her head to pull hair. She went out and bought beads and made her own bracelet. She says this works very well. We are working on replacing the lakshana of her being a Trichotillomaniac with her more positive image.