I don't think anybody knows what's going on with this disorder. I'm not in a trance or stressed out when I pull out my hair like some of the people logging on. Combining medication and a behavioral program produces the best results. After several minutes of general discussion I began to take Tommy's history. He told me that he didn't remember exactly when he started pulling out his hair, but he could remember pulling out his hair and sucking his thumb when he was a toddler.
Some kids pull out their hair in tufts when they tantrum or stressed.
Other kids are bored and when they pull out their hair they seem comforted. Tommy had some stress in his life, but I had a hunch he fell in the latter category. He did not bite his nails or engage in any other obsessive-compulsive behaviors. And he didn't suck his thumb anymore. This disorder is called trichophagia.