Awareness Training: The First Step Toward Change That Feels Scary

Awareness Training is often the very first step in Habit Reversal Training (HRT), a well-established and effective approach for treating hair pulling in Trichotillomania. Rather than focusing on “just stopping,” this step gently helps you begin noticing when, where, and how pulling happens often in moments that previously felt automatic or outside your control.

HRT has been shown to be one of the most effective treatments for reducing hair-pulling behaviours, offering practical tools and a hopeful path toward change one small, manageable step at a time.

But what does Awareness Training actually look like in the beginning—and why can it feel so difficult?

How Can Awareness Training Feel at the Start?

In my clinical work, when individuals begin Awareness Training, I often see feelings of overwhelm or fear arise. For many, this step feels surprisingly difficult. Tracking urges and noting the context around pulling can bring up resistance. 

Some people worry their hair pulling has “gotten worse” simply because they’re thinking about it more. Others find themselves forgetting to track urges or avoiding the Self-Monitoring Tool altogether.

And here’s something important: forgetfulness in therapy is rarely laziness or sabotage. Often, it’s a sign that something feels big. Heavy. Overwhelming. 

Many clients genuinely want to do their best, and at the same time, Awareness Training can feel like shining a bright light on something they’ve spent years trying not to look at. 

For many, it is overwhelming at first.

But this doesn’t mean therapy is not working. In fact, it often means something important is happening. These reactions give us valuable information about what feels scary, what feels exposed, and where support is most needed. When we talk openly in therapy, these moments become part of the healing process.

That’s one of the reasons communication matters so much.

What Am I Really Afraid Of?

Over time, I’ve noticed that the challenges with Awareness Training are deeply personal. Still, certain fears come up again and again.

“If I Think About Hair Pulling More, I’ll Have More Urges.”

Some people worry that focusing on their pulling will increase urges. And sometimes, especially at the beginning, it can feel that way. And in sometimes—especially at the beginning—it can feel that way.

But this isn’t failure. It’s often a sign that avoidance is softening. When we stop pushing something away, we notice it more clearly. And meaningful change requires that gentle shift: learning to stay present with what once felt too uncomfortable to face.

“What If I Realize It’s Worse Than I Thought?”

For some, the first few days of tracking can be shocking. Seeing the frequency of urges in numbers can feel frightening or discouraging. 

If that happens, please know this: your reaction makes sense. 

It’s hard to look closely at something that has caused shame or frustration. Wanting to avoid it is human. But awareness doesn’t create the problem, it simply reveals what has already been there. 

And once something can be seen clearly, it can be understood. And once understood, it can begin to change. 

What Does Awareness Training Give Me?

Awareness Training gently invites you to look at something that feels scary—and to discover that you can handle it.

Over time, individuals may notice that the fear in their minds is often bigger than the reality. With support, curiosity begins to replace panic. Instead of reacting automatically, individuals start asking:

• What’s happening inside me when this urge appears?
• What emotions are present?
• What does this urge need?
• What part of me is trying to cope?

When clients learn to look at their urges through this lens, the behaviour itself becomes less terrifying. Hair pulling shifts from feeling like an uncontrollable force to something that can be observed, understood, and gradually changed.

It becomes less mysterious. Less powerful.

What’s Important to Know When Starting Awareness Training?

When individuals ask, “What will happen if I become more aware?” I hear the fear underneath:

“I know how it feels to avoid my urges. I’m afraid of what will happen if I stop avoiding them.”

That fear is valid. It is real. And it is important.

Change almost always involves stepping into something unfamiliar. It’s healthy to feel cautious. It’s healthy to need support.

That’s why therapy exists, and this is the role of the therapist—not to predict everything that will happen or not to promise that it will be easy, but to ensure you don’t have to navigate this alone. Sometimes, when it’s hard to believe in yourself, your therapist holds that belief for you- until you can hold it on our own.

Change becomes easier with therapy—and with evidence-based treatments for trichotillomania, including Habit Reversal Training and acceptance-based approaches.

Awareness is not punishment. It’s not judgement.

Awareness is the beginning of choice.

And choice is where freedom starts.

You Don’t Have to Do This Alone

At TrichStop, we guide you step by step through Awareness Training and beyond, with specialist therapists who understand trichotillomania. Change is possible — and it starts with support.

References: 

1. Banafshi, Z., & Khatony, A. (2025). Exploring the lived experiences of individuals with trichotillomania: a descriptive phenomenological study. BMC psychology, 13(1), 1040. https://link.springer.com/article/10.1186/s40359-025-03427-z 

2.Hamid, N., Bordbar, M., & Marashi, S. A. (2021). Effectiveness of Habit Reversal Training (HRT) on anxiety and trichotillomania (TTM). https://www.sid.ir/paper/1013813/en 

3.Woods, D. W., Wetterneck, C. T., & Flessner, C. A. (2006). A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania. Behaviour research and therapy, 44(5), 639-656. https://www.sciencedirect.com/science/article/abs/pii/S0005796705001269 

4. https://www.trichstop.com/self-monitoring-hair-pulling-trich

5.https://www.reddit.com/r/trichotillomania/comments/1huiw07/how_do_you_raise_awareness_on_the_subject_without/

6. https://www.trichstop.com/treatment/pro/cbt

7. https://www.trichstop.com/program