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Impulse Control Disorders - Trichotillomania

Updated on July 16, 2017

Motive is best defined as the reason or the rationale behind an act and while traditionally criminal law adheres to the principal that a crime consists of only two components i.e. the physical element (the act of committing the crime) and the mental element (a person’s awareness that he or she has or is about to commit a crime) motive nonetheless plays an important role. It is a key component in several defenses and is taken into account during sentencing.

Motive can be a mitigating factor and can lessen the gravity or the impact of a crime. The person who knowingly steals a loaf of bread and the person who knowingly robs a bank both satisfy the physical and mental element required to establish guilt but to treat both in the same manner would be a generalization. Let’s take it a step further. Let’s say that the hypothetical person who stole the loaf of bread did so to feed his hungry family and wouldn’t have committed the act otherwise. Is he or she to be treated in the same manner as the bank robber? Motive is relevant to ensure that perpetrators receive fair treatment especially when it comes to public perceptions.

When we are dealing with the mental element the assumption is that we are dealing with a person of normal fortitude and likewise motive, which is an intangible element, is also based on the notion that the person who committed the act is a person of normal strength and firmness of mind.

On that note it is also important or relevant to mention that there is nothing to indicate or suggest that people who suffer from psychosomatic illnesses have a higher propensity to commit crimes when compared to a normal person unless of course the illness itself compels the person to commit a crime (Impulse Control Disorder) for example kleptomania or the recurring urge to steal. In Australia for example only 4.4% of Australian homicide offenders are recorded as suffering from mental disorders.

Impulse Control Disorders

Under normal circumstances most people can control their urges and impulses. With people who suffer from impulse control disorders however the situation is more complex and they act on impulse i.e. they cannot resist the urge to do something that is often harmful to themselves or others. There are six categories of impulsive control disorders – trichotillomania, intermittent explosive disorder, pathological gambling, kleptomania, pyromania and impulsive sexual behavior. Impulse control disorders present unique issues for the criminal justice system and presents it with the challenge of distinguishing between a controllable act and an uncontrollable act.

Impulse control disorders become relevant during sentencing and the inability of the perpetrator to refrain from committing the act despite knowing that it is wrong complicates the process. While on the subject we must also consider the implications of Parkinson’s Disease (a progressive and chronic movement disorder that worsens over time). Recent research on the subject suggests that all six categories of impulse control disorders can occur in individuals with Parkinson’s Disease and it occurs in 3 – 5% of patients suffering from Parkinson’s Disease. Ultimately it should be doctors and phycologists who determine if an accused or a perpetrator suffers from an impulse control disorder.

When dealing with a person who is afflicted by an impulse control disorder the question of motive does not arise. Impulse control disorders are classed as repeated acts that have no clear rational motivation. Pyromania for example is categorized as multiple acts of, or attempts at, setting fire to property or other objects without an apparent motive and by a persistent preoccupation with subjects related to fire and burning.

Despite the improbability of being able to establish a clear and discernable motive it is worth looking at the six categories of impulse control disorders because it is an illness that most of us will stumble across at some point in time or other. Let’s start with Trichotillomania which is characterized by the repeated pulling of one’s hair. It may be hair from the scalp, the eyebrows or any other part of the body that the victim feels compelled to aggrieve.

There is a period of tenseness prior to committing the act and a sense of relief once the act is completed. Some researchers compare it to an unexplainable addiction or a compulsion that continues for the afflicted person’s lifetime. Often, a common symptom with those who suffer from Trichotillomania is self-imposed isolation because despite getting some measure of relief or satisfaction from committing the act they are ashamed of their actions and have difficulty in explaining it to others.

Other symptoms associated with Trichotillomania are repeated self-grooming, nail biting and lip or cheek biting. Many Trichotillomania sufferers commit the act without realizing it and the act is normally done during sedentary activities i.e. while they are seated at a desk, reading, watching television etc. An average person blinks 15 – 20 times per minute and up to 1,200 times per hour and he or she does so without realizing it. A similar comparison may be made to understand the nature of Trichotillomania where the actions are sometimes done without conscious thought.

With some Trichotillomania sufferers, there is an impulse to reach over to certain areas of their body and to start picking and pulling at the relevant areas especially when they experience an itching sensation. It is akin to an automated response.

It is important to recognize the symptoms and to try and be as understanding and as accommodating as possible. The inclusion of Trichotillomania here doesn’t mean that those with Trichotillomania have any sort of criminal tendencies or that Trichotillomania precipitates criminal behavior. It is to give us some insights on the challenges that those with Trichotillomania face on a daily basis.

© 2016 Kathiresan Ramachanderam and Dyarne Jessica Ward


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