Conquering with Keen: Helen's story

Helen, from England, has suffered from Trichotillomania for 38 of her 49 years. This is how she is Conquering with Keen Awareness, as told to the HabitAware team.  

A Simple Hair Pulling "Habit"

Helen has had Trichotillomania since she was 11 years old when she started pulling her hair in middle school. She doesn’t remember why she started, but she does remember never really liking her hair. “It’s always been a bit wavy and frizzy. I used to tie it back in a ponytail and I remember all the little frizzy curly bits around my face.” At the time, Helen’s hair pulling habit wasn’t affecting her much and she pulled just a very small patch.  

After leaving school at 15, Helen became a hairdressing apprentice. She had started pulling her hair a bit more by this time. Of everyone at the salon, Helen was the one who would try different hairstyles. She had her hair cut very short and bleached blonde. She enjoyed it very much, but the others at work would tell her she needed to stop hair pulling or they would cut her hair in a style that would show her patch. “Luckily, they never did,” she said.  

I never spoke about it to anyone. Not even my husband.

After three years, Helen became an independent hairdresser. Her Trichotillomania was not yet upsetting her. But then she met her husband, and she grew out her hair. She became more conscious of her Trichotillomania, as she was hair pulling more and was becoming upset. “I never spoke about it to anyone. Not even my husband,” she shared.  

Seeking a Trichotillomania Treatment Solution

Helen eventually talked to her doctor about her hair pulling disorder. “They didn’t seem to know much about it but did refer me to a psychotherapist. She asked me to put every hair I pulled into a bag and bring the bag back with me next time. I did still pull, but not as much, as it was embarrassing to think I was going to have to take a bag of hair back to the doctor.” After a few sessions, Helen stopped going.  

At this point, Helen’s hair pulling condition was getting worse and it started to really upset her.  When she wore her hair down it was more visible, so she didn’t wear her hair down very often. She tried to attach extensions to the short hairs in her patches, but they didn’t stay in well and she couldn’t afford to keep putting them in.  

Helen sought medical help for trichotillomania again and this time was referred for Cognitive Behavior Therapy (CBT) counseling. She would pull less for a few months, then a life stressor would occur, and her hair pulling disorder would grab hold. This cycle repeated itself a few times over several years.  

Living Life as a Hair Puller: Adversity Compounds

Following the birth of her first child, Helen’s Trichotillomania subsided a bit. “I think I was just a bit happier.” But, like many mothers, she put her needs last, and just “lived with it for quite a few years.” When her eldest child went to school, Helen and her husband tried for a second child.  She had many issues attempting this pregnancy, which increased her stress as well as her hair pulling. It was a very hard time for her and her family.

More stress, more hair pulling! Time goes by and you just have to learn to live with Trichotillomania, even though it really upsets you.

After finally welcoming their second child, Helen’s husband was in a terrible car accident. Following a long hospitalization and time away from work, he was forced to find a new job. Helen’s stress continued to increase, along with her hair pulling condition. She started another round of CBT, which turned out to be the most successful of them all. Helen was nearly pull-free for 6 months. “It felt so good!” Then life threw more curveballs at them - the recession hit, affecting Helen’s husband’s employment several times. Her hair pulling came back with a vengeance, and then, her husband had a heart attack. “More stress, more hair pulling! Time goes by and you just have to learn to live with Trichotillomania, even though it really upsets you.”  

Helen’s husband continued to have health issues, including three major surgeries in two years. Desperate, Helen tried hypnosis. After two sessions she was no longer hair pulling, and enjoyed her longest pull-free stretch of eight months. But then, suddenly, Helen started hair pulling once again. “Within a few weeks I was back to square one, but worse than ever. I had bald patches on my crown, the back of my head, and had started hair pulling from my temples. The usual feelings washed over me: Failure. Embarrassment. Ugly. Sad.

Finding Keen: The Awareness Bracelet

When Helen heard about Keen by HabitAware, she had this feeling they would work for her. “I knew how Trichotillomania worked. I needed something to help me take control myself, something I could afford, something I didn’t have to keep making repeated appointments or repeated payments for.” Helen thought, “Enough is enough, I want Keen!”  


After two weeks of wearing her two Keens, Helen said, “The regrowth of my hair was fantastic. I knew Keen would make me aware of my Trichotillomania. I knew they would work. And I was right!” After wearing her habit tracking bracelets for one month, Helen already had days when she didn’t wear them. “I know when I need the Keens and when I can manage without them. On the days when I don’t wear my Keens, I still don’t pull because I am AWARE! I see them now as my safety blanket, knowing they are there when I need them. I’m a happier person. I had a goal of having hair on my 50th birthday and I’m confident now I will make that goal. I wish Keen had existed so many years ago. Thank you, Aneela, and all the HabitAware Team!”

You’re very welcome, Helen.

Keen worked, because you were willing to do the hard work of making healthier choices. Wishing you an amazing & Very Happy Birthday!!! We’re thrilled to help you reach your goal!

Thank YOU for sharing your story with our Keen Family!  

wishing you love, strength & awareness,


About Keen by HabitAware


HabitAware makes Keen, a smart bracelet that helps manage nail biting, hair pulling, thumb sucking, and other subconscious behaviors. Customized gesture detection brings you into awareness and helps you develop healthier habits.

Order now & sign up for our e-newsletter for helpful strategies, news & important product updates:

Silencing the Self Stigma Soundtrack

This article was written by our summer intern, Dureti Doto. Thank you Dureti for sharing your personal experience and knowledge with us all!


My name is Dureti Doto and I have been working at HabitAware this summer as an intern. Before I learned about HabitAware, I did not know what body focused repetitive behaviors (BFRBs) were but I quickly learned that this disorder is something many people struggle with around the world. My values aligns with HabitAware’s mission of increasing awareness, reducing stigma, and helping compulsive nail biters, skin pickers and hair pullers who think they are alone in their mental disorder journey. As a Neuroscience major I was also intrigued to understand how HabitAware’s Keen awareness bracelet helped “retrain your brain.” I personally struggle with anxiety and I wanted to work for a team whose goal was to change the lives and mental healthiness of people around the world. For these reasons I eagerly joined the HabitAware team this summer!


My experience at HabitAware is eye opening, empowering and challenging in many ways. In doing more research, I have a better understanding of how BFRBs affect the emotional and mental state of people suffering from these debilitating disorders. I learned many people self-stigmatize themselves, which affects them in ways that they do not realize. But, self stigmatization doesn’t just affect the BFRB community, it affects almost everyone with a mental disorder.

I know this because it also affected me.

I grew up in a family that doesn’t believe in mental health disorders, or taking care of your mental health. I internalized the things my family said to me and allowed it to impact my life negatively. I remember a time when I had an anxiety attack and I couldn’t breath. When I told my father what was happening to me, he told me that it was all in my head and I needed to just get over it. He always would tell me that mental disorders weren’t real and that I was just crazy, and I believed him even though I didn’t want to. I felt crazy, alone and because of that didn’t try to get the help I needed.

“Change in mindset, changed my life.

I will be entering my senior year at Macalester College this fall, but I did not fully acknowledge that my anxiety until my junior year. College is stressful and for someone with anxiety, taking exams were the most anxiety inducing times for me. I didn’t know how tell my professors that I needed more time for my exams and that taking an exam in a room full of other students gave me anxiety. I felt helpless and felt that I was dumber than all of my classmates when in reality I just needed a better testing environment. Until one day, I was talking to a close staff member and without realizing it, I told her what I was going through. This thoughtful teacher quickly connected me to a resource at Macalester called the MAX Center. At the MAX center, I was able to take the exam in a quiet room  and was allowed more time to finish my exams. I was a little hesitant to take my exams at the MAX center at first because I was afraid of how others would perceive me when I told them I needed accommodations for testing. To get over that fear of judgement I changed my mindset and told myself over and over that it really doesn’t matter what other think of me, even my own family.

This change in mindset changed my life.

Getting testing accommodations was one of the best things I’ve ever done for myself, and I wish I had done it earlier in my college career. Once I stopped internalizing what others had to say about my anxiety and acknowledged that I deserved to get the help I needed, it changed the way I saw myself and ultimately how others saw me. I silenced the stigma soundtrack and changed how I talked about myself when I was around other people. I stopped letting myself say “I am just dumb.” As I started changing the way I talked about myself, my classmates also started to say more positive things about me too!  I was no longer seen as the girl who was hindered by her anxiety. I was seen as someone who decided to take control of her destiny!

When we think of stigma, we tend mostly to think of social stigma - the negative assumptions and judgements that other people make about us. For example, when someone with a BFRB tries to share and open up to a loved one, they are often met with “Ew that is gross.” and “What is wrong with you...Why can’t you just stop!?” Their lack of understanding shows in their presumptive responses. These stigmas can silence someone for a really long time, forcing their disorder into hiding and starting a negative track on repeat in our minds.

And yet, as harmful as external stigmas are, something even more detrimental to one's mental health is self stigma. Self stigma is occurs when someone starts to believe and internalize the negative things that are said about them and allows it to have a negative impact in their life. When you have a mental disorder, listening to and internalizing the negative judgements people share about you is like breathing in polluted air: toxic.

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Self stigma can cause:

  • Distress, anxiety, depression
  • Eroding of self-efficacy, self-esteem, agency, making you feel bad about yourself and who you aspire to be
  • Social isolation to avoid showing your disorder and to avoid judgement from others and
  • Disregarding mental health services, resources, and professional treatment to avoid being shamed

Though I’ll never fully truly understand, since I do not have a BFRB myself, I have seen some common “self stigmatization” themes. One that seemed to keep popping up is that people with BFRBs think they are flawed and ugly in some way because of the physical effects of the hair pulling, skin picking, nail biting or other behaviors. Stephanie, in our Keen Family, feared going out in public because she thought everyone would talk about her:

I wanted to wear my hair up in cute styles even outside of school and clinicals, but it was embarrassing. I felt isolated from my peers because I thought everyone could see it and was talking about me. I did not want to go out in public and I felt ashamed of myself for not being able to “just stop” pulling my hair out. My mother was concerned and kept telling me to just stop and I told her numerous times that it was not that simple, but I knew she did not understand.
— Stephanie
My kids never had playdates because I hated being around other parents whose very proximity to me reminded me that my life still felt like a wreck. My career suffered. I put up with a job that was beneath my skill level working for a boss who loved to humiliate me. But, I didn’t feel like I could present myself as a candidate for a better job the way I looked. I rarely dated for similar reasons.
— Adrienne

Another theme I noticed is a feeling of not being normal. Like it’s your fault you are going through this disorder! It pains me to see that so many feel lost and that nothing and no one can fix them because it means they aren’t seeking out the professional mental health help they deserve. These beliefs can lead people with BFRBs to think lesser of themselves and to deny themselves a good life. Keen family member, Adrienne, let the physical effects of hair pulling stigmatize her intelligence. How could she be smart if she was doing this “weird” thing!?  But then she used Keen and other tools in her tool kit to silence this self-stigma soundtrack with her "self-care alarm" (Keen)!

Get your Keen "self-care alarm" and silence the self-stigma soundtrack TODAY! >

By being aware and trying to understanding that others’ judgements are not self-judgements, you can take the first critical step to breaking the stigma you place on yourself by way of the stigma others place on you.

Here are a few ways to silence the self stigma soundtrack:

  • Knowledge Up - The more truths you know about your disorder, the less impact others' lies will have on you. You can educate yourself about your body focused repetitive behavior here.

  • Seek Professional Help - Talk to a doctor educated on the disorder you have to get the best advice.

  • Get Personal Support - Join an online or in person support group to share your struggles with others. You are NOT alone in this!

  • Nix Self-Stigma with Affirmation - When you catch yourself in a negative thought cycle, use a journal to remind you how great you are, or use these affirmations:

    • I am healthy and strong today.
    • I am strong and confident.
    • I am deserving of everything good in this life.
    • I am worth it.
    • I am love.
    • I am growing into the person I want to be.
    • I am beautiful and whole within myself.
    • I am unstoppable.
    • I am in the process of positive changes.

My favorite is the journaling. Right before a big exam, I scribble down all the ways I'm great before entering the MAX center to take my test in peace.

Because stigma's has nothing on me and I hope you know now that it has nothing on you too!

About Keen by HabitAware

HabitAware makes Keen, a smart bracelet that helps manage nail biting, hair pulling, thumb sucking, and other subconscious behaviors. Customized gesture detection brings you into awareness and helps you develop healthier habits.

Order now & sign up for our e-newsletter for helpful strategies, news & important product updates:


Community Spotlight: Pam Katz, LCSW: Helping BFRB families Live, Love and Support

The Keen team is grateful for the ongoing support of the trichotillomania treatment professional community. We especially extend thanks to Pam Katz, LCSW for sharing her experience and "family first" approach to treating trichotillomania, dermatillomania and other body focused repetitive behaviors below. Thank you, Pam! 


It is not uncommon for a child or adolescent with trichotillomania or dermatillomania to first step foot in my office because their parents have made the decision to initiate treatment. For many of my young clients, they may not have even begun contemplating whether they want to actively work on decreasing their hair pulling or skin picking.

Kids thrive when feeling empowered.
— Pam Katz, LCSW

That young person in front of me may not be old enough to vote or drive. That young person may be supervised all day by teachers, parents, and activity staff. In my office, though, that young person is the expert on him or herself. During that initial session with a client, I ask they be an active part in designing their own intervention plan. Without taking ownership of their plan to decrease their hair pulling or skin picking, I am concerned that their success may be limited. Kids thrive when feeling empowered. I have seen much more success when the young person makes the decision that they want to change. It’s much riskier when it’s the parent or other adults that are pushing for the young person to change.

Kids have amazing ideas on how they can change their behaviors, and how adults can support their journey. As adults and caretakers, we often want to help support our children; however, our ideas of support may not be the same as those of our kids. This is also true when a child is engaged in hair pulling or skin picking behaviors and an adult wants to intervene.

The most frequently asked questions by parents in my office is, “What should I do if I see my child picking or pulling? Should I tell them to stop?”

When this question is asked, I turn to my young client and ask, “What do you want your mom or dad to do if they see you hair pulling or skin picking?” Inevitably, the initial response from the child is, “I don’t know.”

I then tend to ask the question a little differently, part statement, and part question. “Mom and Dad are asking because they want to know what is most helpful to you. Do you think we can come up with some ideas together? I am concerned that if we don’t, Mom and Dad may do something that you don’t want them to do. I would prefer they respond in a way that you are comfortable. What do you think?”


By asking the child how they want Mom and Dad to respond, the child is now empowered. When a parent empowers their child, the child is more likely to be successful in both coming up with strategies and embracing those strategies.  When this happens a happy bi-product is an improved relationship between parent and child.

Perception is Everything: Being Watched vs. Being Watched Over

For example, one young client told his parents he was ok with nonverbal or indirect cues. If his mom saw him pulling his eyelashes, he was ok with her placing a fidget in front of him where he could see it. Another client asked that her parents say her name and ask an open ended question to engage in a conversation bringing her back to the present moment.

This is where HabitAware's Keen awareness bracelet can help a parent shift the conversation as well. My young clients report that they are more aware of hair pulling or skin picking behaviors and are able to substitute, or replace the hair pulling or skin picking sooner because of Keen. Plus they like having Keen's "self care alarm" as it’s like their own private alert system vs their parents.  


A recent client of mine shared with her mom that being in public helps her to curb her hair pulling. The client is also a rising senior in high school and is beginning her work on college applications. Sitting in front of a computer, as well as stress and concentration, typically trigger the daughters pulling behavior.  

Because of the dialogue between mother and daughter about public spaces, the mom suggested to her daughter, “I’ve got a lot of paperwork to do and you have college essays to write, why don’t we both go to the local coffee shop and work there and I’ll treat for coffee."  

Here is why this interaction worked:  

  1. The daughter hears, we both need to do some work so let’s go here and do it together where it’s lower risk for you

  2. The daughter feels loved and cared about vs being monitored and watched

The goal is to do this together.  If the mom had said, “You better go to a coffee shop or the library so that you pull less," that would have made the daughter feel defeated and ashamed. While the daughter might have listened and gone to a public place to start her college essay, the relationship between the two would be strained simply because of word choice. 

Find Common Ground in the Frustration

But what happens when a parent begins to ask a child how the parent can support them and the child shuts down? This can leads to friction and frustration for both parent and child.

Instead of focusing on the behavior -- your child’s hair or skin picking -- focus on YOUR feelings.  Here are a few things a parent might say to child in this scenario:

  • "I feel helpless and I don’t know how to help you."
  • "I’m sad because your sad."
  • "Can we help each other, is there something we can do together to help each other?"

Here's a phrase to stay away from:

  • "I’m worried / concerned / afraid ... that you will go somewhere and someone will comment."

As a parent, we want to take control and taking control ultimately leads to failure.  As parents we have to adopt a mindset of how to work with things we can’t control. For example, we can’t control the weather.  But we can control how we respond to the weather. If it’s raining, we put on a raincoat.

We can’t control our urges, emotions or thoughts that come into our heads, but we can control how we react to those emotions. Start with shifting from "STOP IT!" to "How can I help you?"

 It might take several attempts to get your child to open up. You might feel annoyed, frustrated, and worried. It’s ok to feel the way you feel.

Here's 3 steps for parents on how to deal:

  1. Pause and take 3 breaths
  2. Notice the thought that is in your head
  3. Check in with yourself and ask - "Is what I’m about to say going to help or harm?" and then decide on how you will react to your own feelings
Start with shifting from
“How can I help you?”
— Pam Katz, LCSW

Repairing Relationships

You might be reading this and saying, "I’ve been going about this the wrong way."  Or, maybe you just yelled at your child for skin picking or hair pulling.

Either way, the best way to begin repairing is to say, “I messed up and I could have responded differently to you and I’m sorry”.  Follow that up with, “If I gave you a better response I would have done or said this…”. This interaction allows your child to know that you not only recognize your mistake but you are owning up to it and want to make things better. It also shows them that mistakes can - and should - be acknowledged and fixed.

Everyone is different. If you haven’t had the conversation with your child about how they see you as part of their intervention plan, ASK! You will likely learn that your child has some great ideas and that your relationship together deepens.

About Pam Katz, LCSW


Pam is dedicated to assisting children, adolescents, adults, and families to enhance their strengths, develop new coping strategies and learn to face the challenges in their lives. Pam Katz Counseling utilizes Acceptance and Commitment Therapy and Cognitive Behavioral Therapy to empower positive transformation, restore emotional balance, and to help people reach their personal goals. 

Pam is located in the northern Chicago suburbs and you can reach at her website, or you may call her at 773-425-3845.

About Keen by HabitAware

HabitAware makes Keen, a smart bracelet that helps manage nail biting, hair pulling, thumb sucking, and other subconscious behaviors. Customized gesture detection brings you into awareness and helps you develop healthier habits.

Order now & sign up for our e-newsletter for helpful strategies, news & important product updates:


My Replacement Behaviors for Hair Pulling, Skin Picking or Nail Biting

So you have your Keen bracelet, your "self care alarm," as per our Keen family member, Adrienne. Now what?

Well, now it's time to acknowledge your need for self care when the alarm sounds. How can you do that? Simple, practice replacement behaviors for hair pulling, skin picking or nail biting. These are essentially alternatives to skin picking, hair pulling or nail biting - things to do INSTEAD of engaging in these behaviors that send us into a vicious cycle of negativity and loss

Here are some of my favorite replacement behaviors that have been helping me reduce my hair pulling. These substitutes either help me generally reduce stress in more positive ways than hair pulling does or have helped me replace my hair pulling behavior during the exact moment of need -- when the Keen bracelet "alarm" sounds! 

I hope you will try some of these replacement behaviors for hair pulling, skin picking or nail biting for yourself and let us know what your favorites are in the comments to spark some creativity for others in our Keen family.

All in all, it's basically about taking care of yourself physically, emotionally and spiritually. This is a lot harder said than done, because let's face it, day to day of life gets in the way! But, if you can find even some balance, it will go a long way to helping you reduce your skin picking, nail biting or hair pulling tendencies.

Even if you don't have the Keen bracelet for trichotillomania, skin picking or nail biting YET, these ideas should still be able to help you!

Replacement Behavior 1. Sleep - I have always been a night owl, usually not sleeping until 2 or 3 in the morning, as you may have read about in one of my #WearYourAwarenessWednesday newsletters. For almost a decade I did not realize that sleep was my biggest trigger. Now it's my #1 replacement behavior for hair pulling.

It is only in using my keen bracelet - and tracking my hair pulling behavior with the app - that I was able to see the data sounding the alarm that I really, really, needed to be asleep.

Replacement Behavior 2. Exercise - So, I personally don't make it to the gym. EVER. Instead, I've found subtle ways to ensure my body is getting some movement each day - especially training myself to stretch when I sense my hands 

But, I have found other ways to ensure my body is getting some extra movement each day. I try to take the stairs when I can & at night, while putting my son to sleep I stretch, do plank and sit-ups. At work, I try to use a standing desk to help with my posture. And of course, having my sons & chasing them around keeps me very active!

If you don't think there's time in your day to go to they gym - that is ok! Perhaps like these hotel maids, all you need is a shift in mindset of how your daily activities are really giving you the exercise you need. One of my faves is doing stretches to put the dishes away as I unload! :)

Replacement Behavior 3. Deep Breathing - Among other things, Keen's button will actually initiate a deep breathing guide within its charging light. Essentially, the light breathes in and out with you.

The beauty of deep breathing is that you always have it with you! My personal favorite technique to help me, as taught to me by twitter-friend & psychologist, Dr. Ali Mattu, is thinking of it as smelling a hot, delicious slice of pizza (breathing in) and then blowing out birthday candles (breathing out).

Replacement Behavior 4. Therapy - I'm not afraid to say that I can't overcome trichotillomania alone. A few years ago I went to a therapist to help me uncover and face deeply rooted traumas and negative beliefs from my childhood. In the past few years, I have overcome these issues, which in turn reduced my need to pull out my hair.

Replacement Behavior 5. Block the Hair Pulling, Skin Picking or Nail Biting - In the past, I have tried to simply make it harder on myself to get to my eyebrows or eyelashes and engage in compulsive hair pulling behavior. These are a few of the methods I've used: 

  • Vaseline
  • Fake Glasses
  • Bandaids

Of these, Vaseline is still very much in my arsenal. Not only does it make it slippery, but it also keeps the prickly regrowth smooth, which is a huge trigger for me. 


Replacement Behavior 6. Gratitude - Each night I take a moment to pause and give thanks for one good thing that happened. By focusing on the good, I am able to build my happiness muscles.

My BIG TIP here is to not just focus on good things that already happened, but to give  also give thanks for things that have yet to happen.

All you have to do is complete this sentence with a goal you want to attain in the future:

"I am happy and grateful now that _________."

And of course, one of my "now that" statements of gratitude is "I am happy and grateful now that I have full lashes & brows."


Replacement Behavior 7. Being Nicer to Myself - I definitely suffer from severe negative internal self-speak. I have the perfectionistic tendencies of a Trichster and I tend to beat myself up, often blaming myself for things that are actually out of my control. With the help of my psychologist, and by instituting self affirmations, I was able to reverse this chatter and not be so hard on myself.

Using Keen daily was also one of the nicest things I could have done for myself. It has been a huge help in making me more aware of where my hands are when I pull - and with that new found awareness I am able to truly take advantage of the 6 ideas above and practice, practice, practice until they are now becoming my go-to, automatic responses for my trichotillomania triggers.

Click here to learn why others choose Keen! >

About Keen by HabitAware

HabitAware makes Keen, a smart bracelet that helps manage nail biting, hair pulling, thumb sucking, and other subconscious behaviors. Customized gesture detection brings you into awareness and helps you develop healthier habits.

Order now & sign up for our e-newsletter for helpful strategies, news & important product updates: