A Rorschach study of fifteen women with trichotillomania

Abstract

Fifteen adult women (mean age 34.5 years) participated in this exploratory study. The study aimed to identify commonalities in trichotillomania patients’ personality structure and psychological functioning. Relevant historical data were obtained, the Massachusetts General Hospital Hairpulling Scale was completed, and a Rorschach test in terms of the Comprehensive System was administered. The results point to an innate vulnerability in the sample’s personality structure that impedes their capacity for efficient problem-solving, decision-making, and coping behaviour. Other key findings include a distorted perception of themselves, a limited capacity for control and stress tolerance, difficulty in modulating and expressing emotions, the interference of primary process thinking in ideational activity, and the effects of these factors on their interpersonal relationships. Theoretical inferences are made about the probable aetiological roots of these findings. As the subjects’ level of functioning was unexpectedly high in the light of their deep-rooted pathology, the dynamic role and function of self-induced hair pulling as a symptom were considered. Suggestions are made to improve the treatment prognosis of the disorder.