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Transcripts of Selected Group Discussions on CYC-Net

Since it's founding in 1997, the CYC-Net discussion group has been asked thousands of questions. These questions often generate many replies from people in all spheres of the Child and Youth Care profession and contain personal experiences, viewpoints, as well as recommended resources.

Below are some of the threads of discussions on varying Child and Youth Care related topics.

Questions and Responses have been reproduced verbatim.

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Hair pulling

I am currently working with a girl in my group home who has a disorder but we are unable to pinpoint it. The girl constantly pulls out her hair, all the time, it's almost a compulsion. Does anyone know of a disorder like that? I seem to recall one, but cannot remember the name, and therefore am having difficulty finding info on it. If so please let me know.


It's called trichotillomania. It's thought to be related to anxiety/stress/tension. It is a compulsive disorder. It's in the DSM IV. Your local mental health unit should have some info re: therapeutic interventions.

Leona Doig
The name is called "Trichillotomia", often associated with Obsessive Compulsive Disorder, and other disorders, including Tourette Syndrome, Rage disorder and more. She needs to see a specialist, probably a neurologist, or psychiatrist, to deal with this...often medications are in order. If it's Tourettes Associated, and seeing you're from Canada, contact The Tourette Syndrome clinic in Toronto, Ontario, at Western Hospital... Dr. Paul Sandor and associates, at the very least, they can direct to local assistance. They're on the web, as well, but I don't have the address handy.

Tammbrey Fysh

It could be Trichotillomania. This is a form of self-harm, but is, as you said, more of a compulsion. I'm unsure of any books specifically dealing with this, but maybe someone else will know.


Hi Kara
This is a disorder and you can find details on it at

Corinne MacMullin

I am also working with a youth like this, and she does it as a form of self-mutilation, because she has no access to sharp objects.

April Ward CYCW

What does the child do with the hair once it is pulled? Does she eat it, hide it, share it? when does she do it? why does she say she pulls her hair? Please send more information. Hair pulling can be associated with several conditions (ocd, anxiety). And, most importantly what kind of service is she getting now for the issue?

Jane Zicarelli-Knaub

The disorder is called trichotillomania. Check out this web site for more information.

Julie Gerber

Yes there is a disorder regarding compulsive or repetitive hair pulling and it is called Trichotillomania. According to this disorder there is an increased sense of tension immediately before pulling out the hair or when a person resists pulling it, and after pulling there is increased pleasure and gratification. You can find quite a bit of information regarding this online and I am sure in medical/psychological journals. I have included a website that may be helpful. Good luck!


This is the first time I have posted a message – hope it arrives OK. My name is Jan Sutton and I am a counsellor and author from the UK. It sounds as if the girl in your group home could well be suffering from "Trichotillomania".

I run two websites dedicated to self-injury: Self-Injury & Related Issues, & Self-Injury, Abuse and Trauma Resource Directory. On the latter there is a page of links and books on this subject.
The URL is: illomania-Links_and_Books.htm

Hope this is of some help.

*Thank you to the many others who replied to this query. We have left out several which repeated information contained in the replies above – Editors.
Michelle Woolsey reminded us of a reply to a similar query earlier this year about eyelash pulling – here it is, together with some other helpful contributions:

First of all I don't have a great deal of experience with this disorder, but I also had a nine year old client who pulled out eyelashes. I read everything I could find on the subject known as tricholtillomania, which I found is a form of anxiety disorder and sometimes OCD, and is also a type of self-injurious behaviour. What we know about self-injurious behaviour is that it is a way the client has of coping with the emotional pain or anxiety they are experiencing. Our consulting Psychologist confirmed my findings and supported my strategies for working with the client.

This is what I did... I started out just building the relationship with the client because the client initially blocked anything that had to do with her presenting problem, so I felt, as always, that I needed to develop that relationship and sense of trust if we were to move forward. We did a great deal of get to know you exercises, reading therapeutic stories, arts and crafts related to feelings etc. When our relationship had reached the point where the client was willing to explore her issues, I began to work on the underlying causes of the anxiety (effects of witnessing family violence, on-going issues with step-family, attachment issues with mom, self-esteem issues). I also introduced an appropriate soothing behaviour to substitute for the eyelash pulling. I gave my client 2 smooth shiny stones (pinkish in colour because pink was my client's favourite colour) and suggested that my client keep them by her bed (charting revealed this is where she seemed to do the pulling most often) and keep them in her hands, run them over her face and eyes whenever she felt the urge to pull out her lashes. The rocks were very cool and smooth feeling on my client's skin and seemed to be a soothing experience. This seemed to work; however there were some set-backs when the rocks were misplaced for a few days. The one thing I will stress is that scolding or reprimanding the child for this behaviour, will only increase the anxiety the child feels and will likely increase the behaviour. Therefore, it is crucial that parents who are frustrated and worried by this behaviour are aware of the detrimental effects of scolding. Parents need to find other ways of addressing the behaviour such as charting it, not to reprimand the child, but rather to determine the situations or thoughts that trigger the behaviour, which will assist the CYW in helping the client. It is also important to recognize that the parent/s may need support for family issues too and that they get the help they need. this in turn will enable them to be more supportive to their child.

I used charting with my client and it was very revealing and helpful in the treatment process. The client brought the chart to each sessions and was rewarded with a sticker in a special book the client had chosen from out "treasure box" and a new chart was sent home. I would recommend explaining thoroughly to the client the function of the chart as a treatment tool and not a way of pointing out "failures" so that the client does not carry a sense of guilt about recording the incidents of eyelash pulling. Please feel free to email me if you have any more questions and it may be wise to consult a Psychologist regarding your client. It is good to have that back-up support. Hope this helps a little.

I'm not sure what the actual reason behind this behaviour is, but I did the same thing around the ages of 7 or 8. Your theory of anxiety fits for me and my situation at that time. It was a passing phase (3-4 months), but I am not sure whether I stopped because the anxiety went down or if it was out of embarrassment from other children noticing the gaps in my eyelashes. Hope this at least helps you, and this child, know that they aren't the only ones to do this.

Andrea Paine

I have been working in Ontario as a Child and Youth Care for the past 17.5 years. In the last 5 years have specialized in working with adolescents who have eating disorders and their families. 5 years ago I came across my first case of this behavior with one of my anorexic clients. As you know, eating disordered kids often have many co-morbid disorders, and as I found out, this was one. It is called trichotillimania. It is quite possible that this young girl is unaware that she is doing it. Many sufferers describe going into "trance like" states or "zoning" out when they are doing it. Often they have no memory of doing it at all. There are many ideas about what causes it and how to treat it. There is some thinking that it is related to childhood chicken pox, as well as another school that is researching the disorder to levels of serotonin in the brain. It is often categorized as an anxiety disorder, or impulse-control disorder or as in the experience I have had with my client as a co-morbidity to her anorexia. Some people have been moderately treated with cycles of medications like prozac or paxil, but many have not found medication helpful. I have found relaxation exercises combined with cognitive behavioral approaches (modified for kids and teens) to be helpful. I would also be wondering about past trauma for this girl as well as querying what is going on in the family. There are some websites that have articles and links to support groups and other resources. Just search under trichotillimania. Because of my specialization in the past 5 years, I am curious about this little girls relationship with food and sense of body image/esteem. What is the family's attitude to food, appearance and body image?

Lyn Lavigne

I am not sure of the name, but I too know a little girl, about age 5 that is pulling her hair out and sometimes she will eat it. The mother took her to see a doctor and the doctor said it was psychological, and that her reasons for doing this was something that was occurring in the home. Pulling her hair was her way of coping with something she did not like. The doctor asked the girl if there was something going on at home that she didn't like and she said her mommy spanks her a lot.

I am not sure if this helps you, but it is a psychological disorder for sure.

Amy Rafuse

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