Defense Date

5-5-2025

Graduation Date

Summer 8-8-2025

Availability

Immediate Access

Submission Type

dissertation

Degree Name

PhD

Department

Clinical Psychology

School

McAnulty College and Graduate School of Liberal Arts

Committee Chair

Derek Hook

Committee Member

Lori Koelsch

Committee Member

Annie G. Rogers

Keywords

Trichotillomania, Hair-pulling Disorder, Lacanian Discourse Analysis, Psychoanalysis, Feminist Psychology, Gender Studies, Qualitative Research

Abstract

This dissertation investigated compulsive hair-pulling (i.e., trichotillomania) in women from a psychoanalytic perspective. The assumption, from a psychoanalytic viewpoint, is that the symptom of hair-pulling serves meaningful, and multiple, psychical purposes that should be analyzed rather than immediately removed, as would be the case in the current gold standard of treatment—behavioral therapy with habit reversal training. This behavioral modality leaves little to no room for exploring the historical, relational, symbolic, and emotional dimensions of hair-pulling. This dissertation fleshed out these dimensions and investigated what hair-pulling was doing for the individual, what its function or purpose was, and, indeed, what ideational and emotional content (thoughts, memories, feelings, fantasies, impulses, wishes) it connected to, responded to, or expressed that was otherwise split off from consciousness. This study recruited women, in particular, to investigate how hair-pulling intersected with and reflected gendered experience, as hair is a highly valued and culturally reinforced marker of conventional femininity. With this in mind, this dissertation explored how hair-pulling expressed something significant about the hair-puller’s socio-political and cultural context, and how one’s being-in-the-world as a woman mediated or constructed the repeated gesture of pulling out one’s hair. From a feminist perspective, the symptom of hair-pulling not only reveals something about how individuals navigate their position in the world but also offers commentary on the world itself. Thus, this dissertation explored the psychodynamic underpinnings and sociopolitical dimensions of trichotillomania. By utilizing a psychoanalytic method of interviewing and Lacanian Discourse Analysis (LDA) to interpret the interview data, I investigated, in the case of five women, how personal, familial, and sociocultural contexts contributed to the onset and maintenance of this symptom; what conflicts, fantasies, and internalized relationships (i.e., object relations) were operative in hair-pulling; how hair-pulling functioned as a defense and compromise formation; and how hair-pulling expressed the inexpressible, especially in cases of trauma. This dissertation contributed to the field’s conceptualization of trichotillomania and demonstrated the value of shifting one’s therapeutic stance from strictly removing symptoms to understanding their use and psychical significance. By encouraging the analysand, client, or patient to speak about their most puzzling and aggravating symptom, one may be surprised to discover all there is to be found there.

Language

English

CORSITTO-2025.docx (2026 kB)

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