Can Hair Pulling Affect My Child? Understanding Trichotillomania and Parenting

Over the years of working at TrichStop, I have encountered many clients who begin therapy for hair pulling because they want to change their behaviour and avoid modelling it for their children. When I summarise their experiences, their main concern is this: that their children will almost automatically develop the same problem.

How grounded is this concern in research? And how concerning is it when children see a parent pulling their hair?

What Does Research Tell Us?

Trichotillomania, or hair pulling disorder, is now understood as a multifactorial condition rather than the result of a single cause. Research suggests that it develops through an interaction between biological vulnerability, emotional regulation difficulties, and learned behavioural patterns.

Twin and family studies indicate a genetic component, with heritability estimates around 30 to 40 percent. Neurobiological findings point to differences in brain systems involved in habit formation and impulse control, particularly cortico-striatal circuits.

At the psychological level, hair pulling often functions as a way to regulate internal states. This can include reducing tension, anxiety, or boredom, or even enhancing focus. Over time, this relief reinforces the behaviour, making it more automatic and harder to stop.

Environmental factors such as stress, life transitions, or limited coping strategies can also play a role in maintaining the cycle. Importantly, research does not support the idea that trichotillomania is caused by trauma, poor parenting, or lack of willpower. It reflects a complex interaction of vulnerability and learning processes.

What Does Parental Fear Tell Us?

Although I often share these findings, they are not always enough to soothe parental concerns. This makes sense when we consider something very familiar to many parents: anxiety.

Parental anxiety is that quiet voice that can appear even when things seem fine, asking, “What if something is wrong?”

This concern reflects care and responsibility. It often increases during periods of stress, family challenges, or personal difficulty. In these moments, when a parent feels overwhelmed and uses coping strategies such as hair pulling, an additional fear can emerge: that their child will learn this behaviour as a way of coping.

Even though research does not support a simple cause-and-effect relationship, anxiety does not always respond to logic.

And Then Comes Guilt

After anxiety raises concerns about possible consequences, guilt often follows.

Guilt can go one step further. It suggests that not only might something go wrong, but that the parent would be responsible for it.

Many clients begin therapy with the intention of helping themselves and being positive role models. However, when the perceived cost of “getting it wrong” becomes too high, it can begin to interfere with progress. Setbacks or relapses may start to feel like complete failure.

From a therapeutic perspective, this pressure is often the real challenge. It is not just the behaviour itself, but the belief that one is responsible for shaping a child’s future in a harmful way.

Breaking the Cycle

So what can help?

Although it may feel difficult, part of the process involves loosening the hold of guilt and anxiety. Before focusing on changing the behaviour, it is often necessary to address the pressure that surrounds it.

Imagine walking through a dense forest while carrying a fully opened tent, just in case you might need it later. That is what this pressure can feel like. When it is folded and carried more gently, the journey becomes more manageable.

Change Is Not a Lonely Path

If you feel ready to make changes and would like support, you do not have to do this alone. With the right guidance and evidence-based approaches, it is possible to better understand your behaviour and build new ways of responding to it.

References

1. Grant, J. E., & Chamberlain, S. R. (2016). Trichotillomania. American Journal of Psychiatry, 173(9), 868–874. 
2. Grant, J. E., Collins, M., & Chamberlain, S. R. (2023). Clinical characteristics of trichotillomania. Annals of Clinical Psychiatry, 35(4), 228–233. 
3. Manassis, K. (2001). Child–parent relations: Attachment and anxiety disorders. Anxiety Disorders in Children and Adolescents, 255.
4. Quintigliano, M., Trentini, C., Fortunato, A., Lauriola, M., & Speranza, A. M. (2021). Role of parental attachment styles in moderating interaction between parenting stress and perceived infant characteristics. Frontiers in Psychology, 12, 730086.