Trichotillomania (Hair Pulling)

What is Trichotillomania?

Trichotillomania is a condition that involves pulling out your own hair leading to noticeable hair loss. This pulling can occur from any site where hair grows including:

  • Scalp
  • Eyelashes
  • Eyebrows
  • Arms
  • Pubic area

Many children also engage in post pulling rituals such as:

  • Examining hair
  • Rubbing hair between fingers or across lips
  • Eating, chewing or swallowing hair

Most children who pull experience significant distress and shame about their pulling, resulting in them hiding their pulling or resultant hair loss and being reluctant to speak to family or friends about their struggles.


The greatest IMPACT on a child who pulls

is not the effect it has on their hair but on their SELF-ESTEEM


What causes Trichotillomania?

At this stage the exact cause of hair pulling is unknown. It can be triggered by simple sensory experiences such as getting sand in your hair at the beach, or by stressful life events. Hair pulling can be a way that children soothe themselves when experiencing a range of different emotions, just like a younger child might hug a favourite toy or blanket or suck their thumb (a behaviour often associated with hair pulling in very young children). Hair pulling usually starts around 11 years of age but can also occur in very young children (often referred to as Baby Trich).

There are two types of pulling behaviours:

AUTOMATIC: this kind of pulling occurs without awareness and often occurs during sedentary activities such as watching television or using the computer

FOCUSSED: this type of pulling occurs in response to specific uncomfortable physical sensations such as itchiness or pain and usually results in a feeling of relief after pulling


One of the most important things for parents to know is that

IT IS NOT YOUR FAULT.

You have not failed as a parent or caused your child to develop this behaviour
You are a key resource in helping your child to recover from hair pulling

Try to remember that IT IS NOT YOUR CHILD’S FAULT EITHER. Getting angry and frustrated or punishing your child for their pulling behaviour will not help to reduce their pulling and will just result in both you and your child becoming stressed and upset.

How can therapy help?

Therapy can assist your child in a number of ways, including

  • teaching strategies to reduce hair pulling behaviour
  • educating your child, family, peers and school about trichotillomania
  • making environmental adjustments to reduce pulling behaviour
  • assisting your child to understand that they are not crazy or weird
  • improving self esteem
  • managing co-occurring conditions such as anxiety and depression

Therapy can also assist parents to:

  • understand more about hair pulling
  • understand helpful and unhelpful responses to hair pulling
  • provide helpful support to their child
  • remain focused on developing a relationship with your child that is not solely focused on hair and hair pulling
  • address concerns and fears about the long term impact of hair pulling on your child

What does therapy involve?

Habit Reversal Therapy: The aim of habit reversal therapy is to increase awareness of the triggers for and occurrence of unwanted behaviours such as hair pulling and to reduce the likelihood of these behaviours occurring by teaching alternative behavioural responses that your child can implement when they experience an urge to pull.  

Stimulus Control: This involves altering the environment in which pulling behaviours occur to make pulling more difficult and this less likely to occur. A problem solving approach is taken that assists families to identify particular environmental cues that may be associated with the pulling and to develop strategies that reduce the impact of these factors.

Support and Rewards: Parental support (and sometimes teacher support) is important in helping the child to be consistent in applying the new strategies that they have learnt. The support person might assist the child to notice when hair pulling occurs and gently remind them to implement the agreed upon response. The support person may also provide praise and/or other rewards to increase the child’s motivation to use the substitute behaviour(s).

Narrative Therapy: Strategies from narrative therapy are helpful in assisting young children to develop an understanding of their pulling as separate from themselves and in identifying strengths and supports that can be used to assist in beating the pulling behaviour. These strategies can also be helpful in assisting your child to speak about topics that are uncomfortable or bring up feelings of shame. 

Cognitive Behavioural Therapy: This skills based therapy is effective in developing skills to manage unhelpful thoughts and feelings that may trigger pulling behaviour. It is also effective in addressing any co-occurring psychological issues that may be causing additional suffering for you child e.g., social anxiety or depressed mood.

A psychologist experienced at working with children and families impacted by hair pulling can work together with you to develop an appropriate treatment plan and provide ongoing support as you implement the treatment plan together.

How do I make an appointment or access more information about Trichotillomania?

If you would like to find out more information about treatment for trichotillomania or would like to book an appointment please contact us on 02 8814 5703 or reception@talbotpsychology.com.au You can also get more information about trichotillomania from the Trichotillomania Learning Centre.

Trichotillomania (Hair Pulling)

What is Trichotillomania?

Trichotillomania is a condition that involves pulling out your own hair leading to noticeable hair loss. This pulling can occur from any site where hair grows including:

  • Scalp
  • Eyelashes
  • Eyebrows
  • Arms
  • Pubic area

Many children also engage in post pulling rituals such as:

  • Examining hair
  • Rubbing hair between fingers or across lips
  • Eating, chewing or swallowing hair

Most children who pull experience significant distress and shame about their pulling, resulting in them hiding their pulling or resultant hair loss and being reluctant to speak to family or friends about their struggles.


The greatest IMPACT on a child who pulls

is not the effect it has on their hair but on their SELF-ESTEEM


What causes Trichotillomania?

At this stage the exact cause of hair pulling is unknown. It can be triggered by simple sensory experiences such as getting sand in your hair at the beach, or by stressful life events. Hair pulling can be a way that children soothe themselves when experiencing a range of different emotions, just like a younger child might hug a favourite toy or blanket or suck their thumb (a behaviour often associated with hair pulling in very young children). Hair pulling usually starts around 11 years of age but can also occur in very young children (often referred to as Baby Trich).

There are two types of pulling behaviours:

AUTOMATIC: this kind of pulling occurs without awareness and often occurs during sedentary activities such as watching television or using the computer

FOCUSSED: this type of pulling occurs in response to specific uncomfortable physical sensations such as itchiness or pain and usually results in a feeling of relief after pulling


One of the most important things for parents to know is that

IT IS NOT YOUR FAULT.

You have not failed as a parent or caused your child to develop this behaviour
You are a key resource in helping your child to recover from hair pulling

Try to remember that IT IS NOT YOUR CHILD’S FAULT EITHER. Getting angry and frustrated or punishing your child for their pulling behaviour will not help to reduce their pulling and will just result in both you and your child becoming stressed and upset.

How can therapy help?

Therapy can assist your child in a number of ways, including

  • teaching strategies to reduce hair pulling behaviour
  • educating your child, family, peers and school about trichotillomania
  • making environmental adjustments to reduce pulling behaviour
  • assisting your child to understand that they are not crazy or weird
  • improving self esteem
  • managing co-occurring conditions such as anxiety and depression

Therapy can also assist parents to:

  • understand more about hair pulling
  • understand helpful and unhelpful responses to hair pulling
  • provide helpful support to their child
  • remain focused on developing a relationship with your child that is not solely focused on hair and hair pulling
  • address concerns and fears about the long term impact of hair pulling on your child

What does therapy involve?

Habit Reversal Therapy: The aim of habit reversal therapy is to increase awareness of the triggers for and occurrence of unwanted behaviours such as hair pulling and to reduce the likelihood of these behaviours occurring by teaching alternative behavioural responses that your child can implement when they experience an urge to pull.  

Stimulus Control: This involves altering the environment in which pulling behaviours occur to make pulling more difficult and this less likely to occur. A problem solving approach is taken that assists families to identify particular environmental cues that may be associated with the pulling and to develop strategies that reduce the impact of these factors.

Support and Rewards: Parental support (and sometimes teacher support) is important in helping the child to be consistent in applying the new strategies that they have learnt. The support person might assist the child to notice when hair pulling occurs and gently remind them to implement the agreed upon response. The support person may also provide praise and/or other rewards to increase the child’s motivation to use the substitute behaviour(s).

Narrative Therapy: Strategies from narrative therapy are helpful in assisting young children to develop an understanding of their pulling as separate from themselves and in identifying strengths and supports that can be used to assist in beating the pulling behaviour. These strategies can also be helpful in assisting your child to speak about topics that are uncomfortable or bring up feelings of shame. 

Cognitive Behavioural Therapy: This skills based therapy is effective in developing skills to manage unhelpful thoughts and feelings that may trigger pulling behaviour. It is also effective in addressing any co-occurring psychological issues that may be causing additional suffering for you child e.g., social anxiety or depressed mood.

A psychologist experienced at working with children and families impacted by hair pulling can work together with you to develop an appropriate treatment plan and provide ongoing support as you implement the treatment plan together.

How do I make an appointment or access more information about Trichotillomania?

If you would like to find out more information about treatment for trichotillomania or would like to book an appointment please contact us on 02 8814 5703 or reception@talbotpsychology.com.au You can also get more information about trichotillomania from the Trichotillomania Learning Centre.