December 31, 2024 • 14 mins
Ready to unravel the mysteries of trichotillomania? Prepare to be enlightened as we, your hosts, Stacy and Linton, travel through the Greek roots of this body-focused repetitive behavior disorder, and reveal not only its hidden intricacies but also its potential treatment strategies. Stitch by stitch, we uncover the diagnostic criteria, prevalent features, and potential co-existing disorders. Along this journey, we also use the cycle of abuse theory as an unforgettable mnemonic device, illuminating the repetitive and compulsive nature of hair-pulling urges.
As we journey deeper into the heart of trichotillomania, we shed light on a plethora of treatment avenues. From habit reversal training, contingency management, to additional interventions like Cognitive Behavioral Therapy (CBT), Dialectal Behavior Therapy (DBT), and Acceptance Commitment Therapy (ACT), we examine them all. Join us as we explore how habit reversal training can replace the hair-pulling habit with a competing response. As we reach the end of this enlightening expedition, we extend our heartfelt gratitude to you, our dedicated listeners, for your commitment to creating a happier, healthier world. So set aside your fears and misconceptions, and step into the world of trichotillomania with us. This is more than just another episode; it's a journey into understanding, acceptance, and hope.
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This podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
STACY (00:01):
Welcome therapists to our Licensure Exams podcast.
I'm Stacy.
LINTON (00:05):
And I'm Linton, and today we'll be demystifying a
disorder called trichotillomania, which is a body-focused
repetitive behavior disordercharacterized by the recurrent
urge to pull out one's hair,despite trying to resist the
urge.
STACY (00:23):
You know, linton, for some reason trichotillomania
that's a word that rolls off mytongue like serendipity or
lexadazical.
LINTON (00:31):
Well, here's a fun fact the word trichotillomania is
derived from the Greek roots oftricot, which means hair, tylo,
which means to pull, and mania,which means madness.
So you see, the Greek rootsaptly describe the critical
components of constantly feelingcompelled to pull out one's
(00:54):
hair.
STACY (00:55):
Well, that certainly makes it easier to remember.
So let's start by going overthe diagnostic criteria in the
DSM-5TR or trichotillomania, allright.
All right, starting withrecurrence pulling out of one's
hair, resulting in hair loss,repeated attempts to decrease or
stop hair pulling.
The hair pulling causesclinically significant distress
(01:17):
or impairment in relational,occupational, social or
educational functioning.
And there's that rose memorydevice of yours, linton, to
remember the areas offunctioning.
The hair pulling or hair lossis not caused by a medical
condition, and the symptoms ofanother mental disorder, such as
an attempt to rectify aperceived physical defect that
(01:39):
you might see with bodydysmorphic disorder, do not
better explain the hair pulling.
LINTON (01:45):
Right, and those are basically the key features that
you'll find in the DSM-5TR.
Trichotillomania tends todevelop when.
STACY (01:57):
So it often starts during early adolescence, when an
individual is going throughpuberty, and there's some
hypotheses that suggest hormonalchanges during puberty might
trigger trichotillomania inbiologically vulnerable
individuals, and the conditioncan persist for months or years
if it's not treated.
Periods of remission may occur,but relapse is pretty common.
LINTON (02:20):
Exactly.
Stress, anxiety, boredom anddepression tend to worsen
symptoms.
Let's go over some of thefeatures that may accompany
trichotillomania.
STACY (02:32):
Of course.
So individuals typically feelrising tension immediately
before pulling hair or whentrying to resist the urge to
pull hair.
The hair pulling may bepreceded by an itchy or a
tingling sensation in the scalp.
Hair pulling then leads to animmediate sense of gratification
, pleasure or relief.
However, those feelings quicklygive way to disappointment or
(02:56):
frustration.
LINTON (02:58):
That description reminds me of Lenore Walker's cycle of
abuse theory, which has threestages.
So the person starts with atension-building phase In the
cycle of abuse.
Tension builds as stressorsaccumulate and the abuser feels
(03:19):
frustrated and angry.
Similarly, with trichotomania,the tension and anxiety build
before it urged to pull at thehair intensifies.
Next comes the explosive phase,or hair-pulling episode.
The abuser explodes in angerand violence to release tension,
(03:42):
taking out their emotions onthe victim.
With trichotomania, the clientpulls out their hair for
emotional relief andgratification.
And finally, then there's thehoneymoon phase.
The abuser apologizes and healso makes promises to change.
The client with trichotomaniafeels regret, self-loathing over
(04:07):
hair-pulling and vows to stoppulling at their hair.
STACY (04:12):
You know, lyncin, that's actually a really great memory
recall strategy for the criteriafor trichotomania.
You've compared it to awell-established theory, like
you were talking about, withthis cycle of abuse, and I think
that analogy reallycrystallizes the repetitive and
compulsive nature of thehair-pulling urge.
LINTON (04:29):
So very true, Stacey, and it demonstrates how the
gratification from giving intodestructive urges, whether
lashing out in violence orpulling one's hair, it is always
short-lived.
This cycle will continue topersist without intervention.
STACY (04:48):
Exactly so.
Some other features that mayaccompany hair-pulling include
rituals like pulling hair with aspecific texture, pulling the
hair out in a certain way, orexamining or playing with the
hairs, and some clients eveningest the hairs, which can
accumulate into dense massescalled trichobizors.
LINTON (05:06):
Wow, that sounds like something out of Harry Potter.
STACY (05:10):
Yes, that the goat bazaar that Harry used as an antidote
to save Ron when he drank thepoison weed.
Well, this is a little bitdifferent.
You know how cats get hairballswhen they groom themselves.
LINTON (05:22):
Yeah, not from personal experience, but yes, you know, I
know what you're talking about.
STACY (05:27):
Yes, well, a tricobozare is a human hairball.
LINTON (05:31):
That's quite the image, Stacey.
Thanks for sharing.
STACY (05:35):
Yes, and you can imagine the gastrointestinal
complications that can arisefrom that.
LINTON (05:40):
No kidding, what about common comorbidities for
tricotomanias?
STACY (05:45):
Well, major depressive disorder and excreation or skin
picking disorder are the mostcommon, and many clients with
tricotillomania also engage inother repetitive body-focused
behaviors like nail biting andlip chewing, for example.
All right, Linton.
So what kinds of evidence-basedtreatment options are available
(06:06):
for clients withtricotillomania?
LINTON (06:09):
Well, habit reversal training, or HRT, is considered
the forerunner in treatingtricotillomania.
Hrt helps clients become moreaware of hair-pulling urges and
replaces the habit with analternative, competing behavior.
Hrt operates on the premisethat tricotillomania is a
(06:33):
learned, automatic behavior thatcan be unlearned and replaced
through awareness training andcompeting response practice.
STACY (06:44):
Okay, makes sense so far.
So how exactly does HRT work?
What does that look like?
LINTON (06:50):
Well with HRT.
The first goal is helping theclient to recognize the stimuli
and situations triggering theirhair-pulling urge.
This makes the habit moreconscious rather than automatic
Very important.
The next step is to teach theclient to implement a competing
response, a behavior that makespulling hair impossible as soon
(07:14):
as the urge strikes.
STACY (07:16):
Okay, so can you give some examples of these competing
responses?
LINTON (07:21):
Yeah sure.
Simple responses like sittingon your hands wearing gloves or
bandages or squeezing a stressball prove physical barriers
making hair-pulling impossibleat the moment.
Another one is combing yourhair instead of pulling it out.
STACY (07:40):
Okay, I see.
So it literally provides acompeting or basically like a
substitute behavior to disruptthe hair-pulling sequence.
LINTON (07:48):
Exactly.
The key is making the competingresponse as ingrained habit by
repetition, so that it replaceshair-pulling as the automatic
go-to behavior when the urgesarrive.
STACY (08:02):
Okay.
Well, replacing hair-pullingwith a competing response seems
like it would be unsuccessful ifyou're just doing a like a
one-off therapy session with theclient.
So I imagine that clientsreally need to practice that
competing response for quite awhile before it becomes
automatic.
LINTON (08:17):
That is correct, though there isn't a set time frame.
As you know, every client isdifferent.
It typically takes two to fourmonths to build up the client's
skills through repeatedrehearsal until the competing
response becomes automatic andnaturally interrupts their
pulling sequence.
Overlearning is vital.
(08:40):
Clients must repeat competingresponse practice across
multiple setting until the newhabit displaces hair-pulling.
The first few weeks aretypically the most difficult for
a client, but small milestoneslike 30, 60, 90 days will give
the client and you a goodindication that the new behavior
(09:03):
is likely on track to becomewell-established and long-term.
Consistency is the keythroughout the whole process.
STACY (09:13):
Yes, and then social support training, also called
contingency management, iseventually added into the mix
also, right?
LINTON (09:22):
Right.
The social support, training orcontingency management
component engages someone in theclient's environment to bolster
their habit of reversaltraining.
This support person is coachedto provide positive
reinforcement every time theclient successfully utilizes
(09:42):
their practiced competingresponse to interrupt the
hair-pulling.
Additionally, the supportperson generally draws attention
to early cues or warning signsthat indicate that escalation is
building so the client candeploy their competing responses
.
STACY (10:02):
Oh, I got you Okay.
So this could be like a spouseor someone that lives in the
same household or something,someone that could be the person
to help reinforce the client.
You know what they're doingcorrectly and then also kind of
let them know when there's alittle red flag they need to be
aware of.
LINTON (10:16):
Right, right.
STACY (10:17):
Okay.
So another behavioralintervention that can be added
to the mix is something calledstimulus control strategies,
which are used to reduceexposure to triggering cues and
make engaging the actual hairpulling behavior more difficult.
This is where you're going towork with the client to minimize
their exposure to environmentaland situational triggers that
(10:38):
are contributing to the hairpulling compulsions.
A common example is you know,if watching TV is identified as
a trigger that precedes hairpulling urges, because it's kind
of a mindless activity, havethe client remove TV access
during high risk times.
Eliminating triggers disruptsconditioned cues associated with
the hair pulling habit.
Another strategy is to make thehair pulling more difficult to
(11:01):
perform.
So how about having the clientwear fake long nails, for
example, linton?
LINTON (11:06):
Well, you know you would think that would help.
But I saw a lady at Publix withtwo inch long nails who didn't
see any trouble with fine motorskills.
She was typing on her phone andgrabbing items off the shelves
like she spent a lot of timethere.
STACY (11:23):
Ah yes, like someone we know, linton Well, that is a
good point.
Maybe some thick gloves ormittens might be a better option
.
I personally can't even put onmy hat when I've got my winter
gloves on.
So a few other enhancedbehavior therapy protocols that
you can use along with HRT toaddress the urges or negative
emotions that underlietricotillomania include
(11:47):
cognitive therapy to identifyand change dysfunctional beliefs
like I can't have any grayhairs, or I'll just pull one
hair and then I'll stop.
Dialectical behavioral therapy,which utilizes mindfulness,
distress tolerance and emotionalregulation skills training to
help clients better manageoverwhelming urges without
(12:08):
self-judgment, acceptance andcommitment therapy to increase
willingness to enduredistressing thoughts, feelings
or sensations related to hairpulling urges without reacting
by automatically pulling hairs aform of experiential escape or
emotional regulation.
Then there's motivationalenhancement therapy, which can
(12:28):
be used to increase the client'smotivation to stop the behavior
.
And then we've got relaxationtechniques like progressive
muscle relaxation to reducestress and finally relapse
prevention strategies.
LINTON (12:42):
Wow.
Well, there's a lot of optionsavailable, aren't there, Stacey?
Yes, there certainly are.
So how about we just do asummary at this point?
STACY (12:51):
Sure thing, all right.
So taking it from the top,tricotillomania is a body
focused, repetitive behaviordisorder that's characterized by
recurrent urges to pull outone's hair, despite trying to
resist.
Onset is typically duringadolescence.
Diagnostic criteria includesrecurrent pulling out of one's
(13:12):
hair, resulting in hair loss,and repeated attempts to
decrease or stop the hairpulling.
Hair pulling can be accompaniedby different emotional states,
for example anxiety or boredom,a sense of tension before
pulling out the hair or tryingto resist the urge to pull out
the hair, a sense of pleasure orrelief after the hair is pulled
(13:33):
out, and potentially ritualslike examining pulled hairs or
ingesting them.
Tricotillomania has a very highcomorbidity, with depression,
excreation disorder and otherbody focused and in terms of
treatment.
LINTON (13:49):
Habit reversal training uses awareness of triggers and
competing responses to replacetheir pulling habit.
Contingency management fortricotillomania, also called
social support training,involves training as support
person to reinforce the client'scompeting responses and point
(14:09):
out warning signs when theclient is in a triggered kind of
situation.
Stimulus control minimizesexposure to triggers, and
additional interventions likeCBT, dbt and ACT address
underlying cognitive andemotional factors that
(14:30):
contribute to the pulling ofhair.
Well, it was great getting youall up to date on
tricotillomania for your exam.
Thanks for all of your serviceand dedication, making the world
a happier and healthier place.
STACY (14:47):
And as we always say, it's in there.
Welcome therapists to our Licensure Exams podcast.
I'm Stacy.
LINTON (00:05):
And I'm Linton, and today we'll be demystifying a
disorder called trichotillomania, which is a body-focused
repetitive behavior disordercharacterized by the recurrent
urge to pull out one's hair,despite trying to resist the
urge.
STACY (00:23):
You know, linton, for some reason trichotillomania
that's a word that rolls off mytongue like serendipity or
lexadazical.
LINTON (00:31):
Well, here's a fun fact the word trichotillomania is
derived from the Greek roots oftricot, which means hair, tylo,
which means to pull, and mania,which means madness.
So you see, the Greek rootsaptly describe the critical
components of constantly feelingcompelled to pull out one's
(00:54):
hair.
STACY (00:55):
Well, that certainly makes it easier to remember.
So let's start by going overthe diagnostic criteria in the
DSM-5TR or trichotillomania, allright.
All right, starting withrecurrence pulling out of one's
hair, resulting in hair loss,repeated attempts to decrease or
stop hair pulling.
The hair pulling causesclinically significant distress
(01:17):
or impairment in relational,occupational, social or
educational functioning.
And there's that rose memorydevice of yours, linton, to
remember the areas offunctioning.
The hair pulling or hair lossis not caused by a medical
condition, and the symptoms ofanother mental disorder, such as
an attempt to rectify aperceived physical defect that
(01:39):
you might see with bodydysmorphic disorder, do not
better explain the hair pulling.
LINTON (01:45):
Right, and those are basically the key features that
you'll find in the DSM-5TR.
Trichotillomania tends todevelop when.
STACY (01:57):
So it often starts during early adolescence, when an
individual is going throughpuberty, and there's some
hypotheses that suggest hormonalchanges during puberty might
trigger trichotillomania inbiologically vulnerable
individuals, and the conditioncan persist for months or years
if it's not treated.
Periods of remission may occur,but relapse is pretty common.
LINTON (02:20):
Exactly.
Stress, anxiety, boredom anddepression tend to worsen
symptoms.
Let's go over some of thefeatures that may accompany
trichotillomania.
STACY (02:32):
Of course.
So individuals typically feelrising tension immediately
before pulling hair or whentrying to resist the urge to
pull hair.
The hair pulling may bepreceded by an itchy or a
tingling sensation in the scalp.
Hair pulling then leads to animmediate sense of gratification
, pleasure or relief.
However, those feelings quicklygive way to disappointment or
(02:56):
frustration.
LINTON (02:58):
That description reminds me of Lenore Walker's cycle of
abuse theory, which has threestages.
So the person starts with atension-building phase In the
cycle of abuse.
Tension builds as stressorsaccumulate and the abuser feels
(03:19):
frustrated and angry.
Similarly, with trichotomania,the tension and anxiety build
before it urged to pull at thehair intensifies.
Next comes the explosive phase,or hair-pulling episode.
The abuser explodes in angerand violence to release tension,
(03:42):
taking out their emotions onthe victim.
With trichotomania, the clientpulls out their hair for
emotional relief andgratification.
And finally, then there's thehoneymoon phase.
The abuser apologizes and healso makes promises to change.
The client with trichotomaniafeels regret, self-loathing over
(04:07):
hair-pulling and vows to stoppulling at their hair.
STACY (04:12):
You know, lyncin, that's actually a really great memory
recall strategy for the criteriafor trichotomania.
You've compared it to awell-established theory, like
you were talking about, withthis cycle of abuse, and I think
that analogy reallycrystallizes the repetitive and
compulsive nature of thehair-pulling urge.
LINTON (04:29):
So very true, Stacey, and it demonstrates how the
gratification from giving intodestructive urges, whether
lashing out in violence orpulling one's hair, it is always
short-lived.
This cycle will continue topersist without intervention.
STACY (04:48):
Exactly so.
Some other features that mayaccompany hair-pulling include
rituals like pulling hair with aspecific texture, pulling the
hair out in a certain way, orexamining or playing with the
hairs, and some clients eveningest the hairs, which can
accumulate into dense massescalled trichobizors.
LINTON (05:06):
Wow, that sounds like something out of Harry Potter.
STACY (05:10):
Yes, that the goat bazaar that Harry used as an antidote
to save Ron when he drank thepoison weed.
Well, this is a little bitdifferent.
You know how cats get hairballswhen they groom themselves.
LINTON (05:22):
Yeah, not from personal experience, but yes, you know, I
know what you're talking about.
STACY (05:27):
Yes, well, a tricobozare is a human hairball.
LINTON (05:31):
That's quite the image, Stacey.
Thanks for sharing.
STACY (05:35):
Yes, and you can imagine the gastrointestinal
complications that can arisefrom that.
LINTON (05:40):
No kidding, what about common comorbidities for
tricotomanias?
STACY (05:45):
Well, major depressive disorder and excreation or skin
picking disorder are the mostcommon, and many clients with
tricotillomania also engage inother repetitive body-focused
behaviors like nail biting andlip chewing, for example.
All right, Linton.
So what kinds of evidence-basedtreatment options are available
(06:06):
for clients withtricotillomania?
LINTON (06:09):
Well, habit reversal training, or HRT, is considered
the forerunner in treatingtricotillomania.
Hrt helps clients become moreaware of hair-pulling urges and
replaces the habit with analternative, competing behavior.
Hrt operates on the premisethat tricotillomania is a
(06:33):
learned, automatic behavior thatcan be unlearned and replaced
through awareness training andcompeting response practice.
STACY (06:44):
Okay, makes sense so far.
So how exactly does HRT work?
What does that look like?
LINTON (06:50):
Well with HRT.
The first goal is helping theclient to recognize the stimuli
and situations triggering theirhair-pulling urge.
This makes the habit moreconscious rather than automatic
Very important.
The next step is to teach theclient to implement a competing
response, a behavior that makespulling hair impossible as soon
(07:14):
as the urge strikes.
STACY (07:16):
Okay, so can you give some examples of these competing
responses?
LINTON (07:21):
Yeah sure.
Simple responses like sittingon your hands wearing gloves or
bandages or squeezing a stressball prove physical barriers
making hair-pulling impossibleat the moment.
Another one is combing yourhair instead of pulling it out.
STACY (07:40):
Okay, I see.
So it literally provides acompeting or basically like a
substitute behavior to disruptthe hair-pulling sequence.
LINTON (07:48):
Exactly.
The key is making the competingresponse as ingrained habit by
repetition, so that it replaceshair-pulling as the automatic
go-to behavior when the urgesarrive.
STACY (08:02):
Okay.
Well, replacing hair-pullingwith a competing response seems
like it would be unsuccessful ifyou're just doing a like a
one-off therapy session with theclient.
So I imagine that clientsreally need to practice that
competing response for quite awhile before it becomes
automatic.
LINTON (08:17):
That is correct, though there isn't a set time frame.
As you know, every client isdifferent.
It typically takes two to fourmonths to build up the client's
skills through repeatedrehearsal until the competing
response becomes automatic andnaturally interrupts their
pulling sequence.
Overlearning is vital.
(08:40):
Clients must repeat competingresponse practice across
multiple setting until the newhabit displaces hair-pulling.
The first few weeks aretypically the most difficult for
a client, but small milestoneslike 30, 60, 90 days will give
the client and you a goodindication that the new behavior
(09:03):
is likely on track to becomewell-established and long-term.
Consistency is the keythroughout the whole process.
STACY (09:13):
Yes, and then social support training, also called
contingency management, iseventually added into the mix
also, right?
LINTON (09:22):
Right.
The social support, training orcontingency management
component engages someone in theclient's environment to bolster
their habit of reversaltraining.
This support person is coachedto provide positive
reinforcement every time theclient successfully utilizes
(09:42):
their practiced competingresponse to interrupt the
hair-pulling.
Additionally, the supportperson generally draws attention
to early cues or warning signsthat indicate that escalation is
building so the client candeploy their competing responses
.
STACY (10:02):
Oh, I got you Okay.
So this could be like a spouseor someone that lives in the
same household or something,someone that could be the person
to help reinforce the client.
You know what they're doingcorrectly and then also kind of
let them know when there's alittle red flag they need to be
aware of.
LINTON (10:16):
Right, right.
STACY (10:17):
Okay.
So another behavioralintervention that can be added
to the mix is something calledstimulus control strategies,
which are used to reduceexposure to triggering cues and
make engaging the actual hairpulling behavior more difficult.
This is where you're going towork with the client to minimize
their exposure to environmentaland situational triggers that
(10:38):
are contributing to the hairpulling compulsions.
A common example is you know,if watching TV is identified as
a trigger that precedes hairpulling urges, because it's kind
of a mindless activity, havethe client remove TV access
during high risk times.
Eliminating triggers disruptsconditioned cues associated with
the hair pulling habit.
Another strategy is to make thehair pulling more difficult to
(11:01):
perform.
So how about having the clientwear fake long nails, for
example, linton?
LINTON (11:06):
Well, you know you would think that would help.
But I saw a lady at Publix withtwo inch long nails who didn't
see any trouble with fine motorskills.
She was typing on her phone andgrabbing items off the shelves
like she spent a lot of timethere.
STACY (11:23):
Ah yes, like someone we know, linton Well, that is a
good point.
Maybe some thick gloves ormittens might be a better option
.
I personally can't even put onmy hat when I've got my winter
gloves on.
So a few other enhancedbehavior therapy protocols that
you can use along with HRT toaddress the urges or negative
emotions that underlietricotillomania include
(11:47):
cognitive therapy to identifyand change dysfunctional beliefs
like I can't have any grayhairs, or I'll just pull one
hair and then I'll stop.
Dialectical behavioral therapy,which utilizes mindfulness,
distress tolerance and emotionalregulation skills training to
help clients better manageoverwhelming urges without
(12:08):
self-judgment, acceptance andcommitment therapy to increase
willingness to enduredistressing thoughts, feelings
or sensations related to hairpulling urges without reacting
by automatically pulling hairs aform of experiential escape or
emotional regulation.
Then there's motivationalenhancement therapy, which can
(12:28):
be used to increase the client'smotivation to stop the behavior
.
And then we've got relaxationtechniques like progressive
muscle relaxation to reducestress and finally relapse
prevention strategies.
LINTON (12:42):
Wow.
Well, there's a lot of optionsavailable, aren't there, Stacey?
Yes, there certainly are.
So how about we just do asummary at this point?
STACY (12:51):
Sure thing, all right.
So taking it from the top,tricotillomania is a body
focused, repetitive behaviordisorder that's characterized by
recurrent urges to pull outone's hair, despite trying to
resist.
Onset is typically duringadolescence.
Diagnostic criteria includesrecurrent pulling out of one's
(13:12):
hair, resulting in hair loss,and repeated attempts to
decrease or stop the hairpulling.
Hair pulling can be accompaniedby different emotional states,
for example anxiety or boredom,a sense of tension before
pulling out the hair or tryingto resist the urge to pull out
the hair, a sense of pleasure orrelief after the hair is pulled
(13:33):
out, and potentially ritualslike examining pulled hairs or
ingesting them.
Tricotillomania has a very highcomorbidity, with depression,
excreation disorder and otherbody focused and in terms of
treatment.
LINTON (13:49):
Habit reversal training uses awareness of triggers and
competing responses to replacetheir pulling habit.
Contingency management fortricotillomania, also called
social support training,involves training as support
person to reinforce the client'scompeting responses and point
(14:09):
out warning signs when theclient is in a triggered kind of
situation.
Stimulus control minimizesexposure to triggers, and
additional interventions likeCBT, dbt and ACT address
underlying cognitive andemotional factors that
(14:30):
contribute to the pulling ofhair.
Well, it was great getting youall up to date on
tricotillomania for your exam.
Thanks for all of your serviceand dedication, making the world
a happier and healthier place.
STACY (14:47):
And as we always say, it's in there.
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Therapy Gecko
An unlicensed lizard psychologist travels the universe talking to strangers about absolutely nothing. TO CALL THE GECKO: follow me on https://www.twitch.tv/lyleforever to get a notification for when I am taking calls. I am usually live Mondays, Wednesdays, and Fridays but lately a lot of other times too. I am a gecko.