CBT/HRT for Trichotillomania (Hair‑Pulling)

Educational content only. Body‑focused repetitive behaviors (BFRBs) respond to Habit Reversal Training (HRT) and CBT skills. See our Medical Disclaimer.

Overview

Trichotillomania involves recurrent hair‑pulling with urges triggered by emotions, sensations, or automatic habits. Short‑term relief reinforces the cycle.

Why HRT/CBT helps

Awareness training: map triggers (situations, emotions, sensations) and early warning cues.
Competing response: brief, incompatible actions (e.g., fist clench, stress ball) until urge passes.
Stimulus control: reduce access (hats, fidgets, mirrors/time limits) to disrupt habit loops.

Journaling prompts

Trigger → urge (0–100) → competing response used (seconds) → outcome.
Environment tweaks that lowered risk today were…
One self‑compassionate thought I practiced after a slip was…

Use quick logs; see How to Journal.

Selected readings

Azrin & Nunn; Woods et al. HRT/ComB approaches for BFRBs.

When to seek care

Significant impairment or medical concerns (skin/hair) warrant clinician support and coordinated care.