Do you find yourself pulling your hair and feeling confused, frustrated, or even ashamed — especially if you’ve tried to stop and haven’t been able to?
You might wonder why it keeps happening or worry that you should be able to control it. Trichotillomania, also known as hair‑pulling disorder, is a body‑focused repetitive behavior (BFRB), and it’s far more common than most people realize. It is not a lack of willpower, and it does not define who you are!
How I Work With Trichotillomania
In therapy, you’ll find a compassionate, non‑judgmental space where we look at hair pulling with curiosity instead of shame. I use an integrative, evidence‑based approach that draws from:
Habit Reversal Training (HRT) to increase awareness of pulling patterns and develop alternative responses to urges
Dialectical Behavior Therapy (DBT) skills to support emotional regulation, distress tolerance, and nervous system balance
Acceptance and Commitment Therapy (ACT) to help you change your relationship with urges, thoughts, and self‑criticism — without relying on force or suppression
Together, we explore what your pulling may be doing for you, what triggers or maintains it, and how to build skills that help you feel more in control and supported. Our goal isn’t perfection or “never pulling again,” but meaningful reduction, greater awareness, and long‑term relief — including planning for slips without shame or giving up.
Focused vs. Automatic Pulling
One of the first things we work on in therapy is understanding how your pulling happens. Many people experience more than one pattern:
Focused pulling often feels intentional and emotionally driven. You may notice urges increase with anxiety, overwhelm, frustration, boredom, or strong internal tension.
Automatic pulling tends to happen outside of awareness — during activities like watching TV, scrolling on your phone, working, or driving.
Learning the difference between focused and automatic pulling helps reduce self‑blame and allows us to choose tools that actually fit your experience, rather than using a one‑size‑fits‑all approach.
Other Body‑Focused Repetitive Behaviors (BFRBs)
If you struggle with hair pulling, you may also notice other repetitive behaviors. I also work with people experiencing:
Skin picking (excoriation disorder)
Nail biting
Lip, cheek, or tongue biting
These behaviors often share underlying themes related to anxiety, emotional regulation, sensory needs, and the nervous system. In therapy, we focus on understanding what the behavior provides and finding healthier, more supportive ways to meet those needs.
You Don’t Have to Do This Alone
Many people with trichotillomania have spent years feeling misunderstood or trying to manage on their own. Therapy can be a space where you don’t have to explain or hide — where the behavior is understood in context and addressed with care.
If you’re living with hair pulling or another body‑focused repetitive behavior and are looking for thoughtful, evidence‑based support, I’d be glad to talk with you about how therapy might help.