Why Do I Keep Pulling My Hair Out? (Understanding Trichotillomania) | Ep. 412

Ever wonder, ‘Why do I keep pulling my hair out?’ In this episode, we break down the reasons behind Trichotillomania, including stress, boredom, genetics, and more. We also cover strategies like Cognitive-Behavioral Therapy (CBT) and Habit Reversal Training (HRT) to help you manage hair-pulling urges and stop the cycle.

Ever wonder, ‘Why do I keep pulling my hair out?’ In this episode, we break down the reasons behind Trichotillomania, including stress, boredom, genetics, and more. We also cover strategies like Cognitive-Behavioral Therapy (CBT) and Habit Reversal Training (HRT) to help you manage hair-pulling urges and stop the cycle. 

What you will learn: 

• Discover how stress and anxiety play a major role in triggering hair pulling.
• Learn why hormonal changes and genetics might make you more prone to this behavior.
• Find out how boredom, loneliness, and exhaustion can lead to unconscious hair pulling.
• Understand the role of habit learning and why pulling can feel so automatic.
• Get tips on using CBT, mindfulness, and self-compassion to break the cycle.

 

Why Do I Keep Pulling My Hair Out? Understanding Trichotillomania and How to Manage It

If you’ve ever caught yourself thinking, “Why do I keep pulling my hair out?” you’re not alone. Whether it happens during moments of stress, boredom, or without even realizing it, hair-pulling—known clinically as Trichotillomania—can feel puzzling and frustrating. But here’s the good news: understanding why it happens is the first step to managing it.

In this guide, we’ll break down the reasons behind hair-pulling and share practical tools and strategies to help you take control.

What Is Trichotillomania?

Trichotillomania is a body-focused repetitive behavior (BFRB) where individuals feel compelled to pull out their hair. It might involve hair from the scalp, eyebrows, eyelashes, or other areas. Often, it’s not just the pulling itself but the feelings of shame or confusion that accompany it that make it particularly difficult to manage.

Let’s explore the main reasons people engage in hair-pulling behaviors.

Why Do People Pull Their Hair?

1. Stress or Anxiety

Many people pull their hair as a way to cope with overwhelming emotions. The act of pulling can create a momentary sense of calm, almost like a “trance,” where the stress or tension temporarily fades away. However, the relief is short-lived, and anxiety often returns, making it tempting to pull again.

2. Hormonal Changes

Hormonal fluctuations, such as those during puberty or the menstrual cycle, can increase the likelihood of hair-pulling. Research shows that lower levels of hormones like progesterone can exacerbate symptoms, particularly in women.

3. Genetics

A family history of Trichotillomania or similar behaviors can play a role. If a relative also pulls their hair, you might be genetically predisposed to it. This isn’t about blame—it’s simply how some brains are wired.

4. Boredom

When life feels dull or unstimulating, hair-pulling can fill the void. It’s often a subconscious response to moments of inactivity, such as watching TV or scrolling through your phone.

5. Over-Stimulation

On the other hand, when life feels too much—loud environments, chaotic schedules, or emotional overwhelm—pulling can serve as a way to slow things down and regain a sense of calm.

6. Loneliness or Disconnection

Hair-pulling can act as a source of comfort during moments of isolation. It’s a way to self-soothe when other forms of connection feel out of reach.

7. Fatigue

When you’re exhausted, your brain might default to pulling simply because it takes less energy to resist. This can make hair-pulling feel automatic and harder to control.

8. Physical Sensations

For some, pulling is tied to physical feelings like tingling, itching, or irritation at the root of the hair. The act of pulling provides temporary relief from these sensations.

9. Habit

Over time, hair-pulling can become a deeply ingrained habit. Your brain starts to associate the behavior with a “reward,” making it an automatic response even when you don’t intend it.

Tools & Strategies to Manage Hair-Pulling

Understanding why you pull is only half the battle. The next step is to implement tools and strategies that work for you.

1. Habit Reversal Training (HRT)

HRT is a type of Cognitive Behavioral Therapy (CBT) specifically designed for behaviors like hair-pulling. It helps you:

• Recognize when you’re about to pull.
• Replace the behavior with a healthier action, like squeezing a stress ball or using a fidget tool.

2. Mindfulness

Mindfulness involves bringing awareness to your urges and emotions without judgment. By noticing the moment the urge to pull arises, you can pause, reflect, and choose a different response.

3. Self-Compassion

Change takes time. It’s easy to feel frustrated after pulling, but kindness toward yourself is key. Remind yourself: This is something I’m working on. Progress, not perfection.

Reassurance & Empowerment

If you’ve ever thought, “Why can’t I stop pulling my hair?” know this: there are real, understandable reasons for your behavior. More importantly, there are evidence-based strategies to help you manage it.

Each time you practice awareness or try a new tool instead of pulling, you’re taking a step toward breaking the cycle. And every small step counts.

Take the Next Step

For additional support, explore the online course BFRB School at CBTschool.com. This resource helps you identify your triggers and customize a plan to address them. It’s a wonderful starting point for anyone ready to take control of hair-pulling behaviors.

Final Words

You are not defined by your hair-pulling. With understanding, the right tools, and a lot of self-compassion, you can make meaningful progress.

And remember: today is a beautiful day to do hard things. 

Transcription: Why Do I Keep Pulling My Hair Out? (Understanding Trichotillomania)

Do you have ever find yourself thinking, ‘Why do I keep pulling my hair out?’ 

Whether it’s during moments of boredom, stress, or sometimes you don’t even realize until after it’s done, this behavior of pulling your hair can feel puzzling and out of control. 

Today, we’re going to break down exactly why people with Trichotillomania (the clinical term for a condition that involves pull out ones hair) and, most importantly, what you can do about it.”

Hello! Welcome back to Your Anxiety Toolkit. I’m Kimberley Quinlan, and as always, I’m here to educate you and help you manage the anxiety disorders and obsessive-compulsive-related disorders that we all struggle with from time to time. 

Today, we’re talking specifically about Trichotillomania—or hair pulling—and why it happens. 

If you’ve ever caught yourself pulling your hair and wondered, ‘Why?’, we’re going to get to the bottom of it together.

“Let me first say, though—please be gentle with yourself as we discuss this. You are not alone in this struggle. 

Trichotillomania can feel really confusing, especially when you don’t even realize you’re doing it sometimes. Many people find that they pull their hair without even realizing they are engaging in these behaviors. 

But here’s the thing—there are specific reasons why people pull their hair, and once we understand what’s behind it, we can start working on changing it. 

We have an online course called BFRB School you do a thorough inventory of all the triggers that cause you to pull your hair and then you customize a plan to target these behaviors.  If you are interested, got to CBTschool.com to learn more.  We have online courses for people who suffer from anxiety, OCD, hair pulling, and skin picking and also for clinicians who want to learn how to use these evidence-based skills in their practices.  Again, that is cbtschool.com to learn more. 

So, let’s get to it and examine the main reasons people pull their hair.” Please note that these are not in any particular order.  

My hope is that you listen to each and every reason and then decide for yourself which ones apply to your specific hair-pulling symptoms. 

There is no one way to have Trichotillomania, so please be as gentle and kind as you can as we explore why you pull out your hair. 

The Number one reason people pull out their hair is because of Stress or Anxiety: 

This is a big one. A lot of people pull their hair when they’re feeling overwhelmed. 

Pulling hair might be a way to calm down, feel in control,  or deal with all that anxiety & tension you’re carrying. 

In the moment, pulling your hair, or even inspecting their hair aids in reducing or distracting someone from thier anxiety.  

As you pull, you may experience moments of deep calm, or what we call a “trance-like” moment, in which your anxiety, panic, and discomforts go away.   

But unfortunately, as you probably already know, the relief doesn’t last. 

While pulling can give you some temporary relief from the stress and anxiety, you will likely feel worse afterward. 

And, your anxiety is right there once you stop pulling.  In this case, the only way to get ongoing relief is just to keep pulling, and my guess is that you are listening to this because you’d like to one day be able to stop pulling. 

The good news is that some strategies and skills will help you manage both anxiety and the pulling. I will share more on specific tools you can use a little later in this episode. 

The second reason people might engage in pulling behaviors is because of Hormonal Changes: 

We have research to show that times like puberty or around your menstrual cycle can make hair-pulling more likely because your body and emotions are going through so many changes. 

Statistics show that Trichotillomania is several times more common in women and has peak onset around puberty. 

From what scientists and researchers understand, lower levels of progesterone (in specific) were associated with more severe symptoms, and lower levels of all hormones were associated with worse overall functioning. 

Understanding this can be super helpful to those who are noticing changes at this stage of life.  

When it feels like everything’s out of balance, pulling becomes a way to cope.

The third reason people with hair-pulling pull is Genetics. 

There is a strong genetic factor when it comes to this condition. 

If you have family members who pull their hair or engage in similar behaviors, you might be more likely to experience it yourself. 

It’s important to remember that it is not your fault (whether you are the child or parent of someone who pulls their hair); it is just how some people’s brains are wired.

Now, one of the most common reasons my clients with trichotillomania pull their hair is number 4, boredom. 

Maybe its one of those moments when you’re just sitting around with nothing to do. 

Maybe you’re watching TV, scrolling through your phone, or waiting for something, and before you know it, you’ve raised your hand up to those hairs, and you are fiddling with the hairs or pulling your hair. 

For many people, pulling becomes a way to fill the empty space

Your brain is looking for stimulation, and pulling offers something to focus on, even if it’s just for a few seconds. It’s almost like your brain is saying, ‘I need something to do,’ and hair-pulling becomes that ‘something.’

It might be the sensation, the texture, or the “just right feeling” that hair gives you. 

The 5th reason people pull their hair is the complete opposite situation to boredom and that is over-stimulation.  

When people feel overstimulated, they may turn to hair-pulling to help calm themselves down. In fact, this is another situation where people fall into the “trance-like” action of hair pulling. Once they start pulling, they might experience an overall feeling of calm. Their heart rate might slow down, and they feel like everything slows down. 

 The 6th reason people pull their hair is Loneliness or feelings of disconnection. 

In moments when you’re by yourself or feeling isolated, pulling can act as a way to self-soothe or create a sense of comfort. It can provide a brief distraction from the emotional discomfort of loneliness, giving you a sense of control over how you’re feeling.

The 7th reason people pull their hair is Feeling Really Tired.

Sometimes, when you’re exhausted, your brain is just running on autopilot. You’re too tired to focus, so pulling your hair becomes a default behavior. 

It’s like your brain is saying, ‘I don’t have the energy to deal with this right now,’ and pulling becomes a mindless way to cope with that fatigue. 

The tiredness makes you less aware of your actions, so pulling feels almost automatic.

The 8th reason you might engage in hair pulling is the experience of Tingling or Itching Sensations.

For some people, hair pulling is tied to a physical sensation—a tingle or itch at the root of the hair or even at the tips of your fingers. 

You might notice a slight irritation or an urge to ‘fix’ the feeling, and pulling the hair gives temporary relief from that sensation. 

It can feel like pulling is the only way to get rid of that discomfort, which makes the behavior hard to resist. Even though the relief is temporary, it’s enough to keep the cycle going.

And lastly we will address a very common reason people pull their hair is that is simply Habit. 

Over time and repetition, hair-pulling can actually become a habit. 

When you pull, your brain releases these feel-good chemicals, and after a while, your brain starts to expect that little reward. So, pulling becomes something you do automatically without even thinking about it.

[Tools & Strategies to Manage Hair Pulling]

“Okay, so now that we know why you pull your hair, let’s talk about what you can do to manage it. Here are a few strategies that have been shown to help:

The gold-standard treatment for hair pulling is Cognitive-Behavioral Therapy (CBT). 

Specifically, there is a type of CBT called Habit Reversal Training (HRT).  Habit reversal Training is super effective for hair pulling. 

HRT involves strategies that help you become more aware of when you’re about to pull and teaches you other ways to respond. 

So instead of pulling, you might find actions such as squeezing a stress ball or playing with a fidget tool to keep your hands busy.

Another practical skill that will accompany your habit reversal traing is Mindfulness: 

Mindfulness is all about noticing what’s happening in the moment. When you feel the urge to pull, you can use mindfulness to bring awareness to those moment. Bringing awareness to the moment can help you identify why you are feeling to urge to pull and help you to stop the pulling before it starts.

As always, recovery for trichotillomania must involve Self-Compassion:

It is so important that you are kind to yourself. It’s so easy to beat yourself up after pulling, but you must Remind yourself that this is a behavior you’re working on, and that change takes time. 

You are learning and doing your best, and that’s an amazing start.”

[Reassurance & Empowerment]

“So, there you have it.  If you are thinking, ‘Why do I keep pulling my hair out?’—remember, there are real reasons for it, and understanding those reasons is the first step toward making changes. 

Whether it’s stress, boredom, or even hormones, you are not alone in this. 

You are not defined by this behavior, and with the right tools, you can manage it.”

Each time you practice awareness or use a different strategy instead of pulling, you’re moving one step closer to breaking the cycle. And that’s something to celebrate.”

“Thank you so much for spending time with me today!  I know how valuable your time is, so thank you. 

Once again, if you are interested in our online course for hair pulling, head on over to CBTschool.com and check it out.

And remember, today is a beautiful day to do hard things.