Trichotillomania Therapy · Marin County, CA
Trichotillomania (Hair Pulling) Therapy in Marin County
Trichotillomania — the compulsive urge to pull hair — is a Body-Focused Repetitive Behavior (BFRB) that affects roughly 1–2% of the population. Reframe CBT specializes in ComB (Comprehensive Behavioral Model) treatment for trichotillomania in Marin County.
Understanding Trichotillomania
Trichotillomania is not a habit or a choice — it's a recognized mental health condition that responds to specialized behavioral treatment. Many people with trichotillomania feel intense shame and hide their hair pulling from family, friends, and even their doctors.
- Recurrent pulling of hair from the scalp, eyebrows, eyelashes, or body
- Pulling triggered by specific sensory experiences, emotions, or situations
- Automatic pulling (without awareness) and focused pulling (with full awareness)
- Significant distress and shame about hair loss or bald patches
- Rituals around the pulled hair — examining, rolling, or swallowing
- Co-occurring anxiety, OCD, or skin picking (excoriation disorder)
ComB Treatment for Trichotillomania
The ComB (Comprehensive Behavioral Model) is the most effective treatment for trichotillomania. Unlike generic CBT, ComB targets the specific sensory, cognitive, emotional, motor, and environmental factors that maintain hair pulling for each individual.
BFRB Assessment
We assess the five ComB domains — sensory, cognitive, emotional, motor, and environmental — to understand what drives your hair pulling.
Awareness Training
Many people pull automatically without awareness. We build moment-to-moment awareness of pulling urges and behaviors.
Competing Responses
We develop personalized competing responses — alternative behaviors that are incompatible with hair pulling and address the same sensory or emotional need.
Sensory Substitutes
For sensory-driven pulling, we identify substitute textures, sensations, or fidget tools that satisfy the sensory need without pulling.
Environmental Modifications
We modify the environments where pulling most often occurs — lighting, seating, mirror access, and other contextual factors.
Emotional Regulation
For emotionally-driven pulling, we build CBT skills for managing the emotions that trigger pulling — anxiety, boredom, frustration, and dissociation.
Meet Your Therapists
Julie Hingsbergen, LMFT
Julie is a Licensed Marriage and Family Therapist and the founder of Reframe CBT. She specializes in CBT and ERP for OCD, anxiety disorders, phobias, and BFRBs, and holds specialized credentials including IOCDF Clinical Member and Certified ADHD Professional (ADHD-CCSP).
- Licensed Marriage & Family Therapist (LMFT)
- IOCDF Clinical Member
- Certified ADHD Professional (ADHD-CCSP)
- Fear of Flying Clinic (FOFC) Affiliate
- 15+ years clinical experience
Nicole Springer, Registered AMFT
Nicole is a Registered Associate Marriage and Family Therapist at Reframe CBT, supervised by Julie Hingsbergen, LMFT. She specializes in CBT and ERP for OCD, anxiety, phobias, and BFRBs, and works with children, teens, college students, and adults.
- Registered Associate Marriage & Family Therapist
- Supervised by Julie Hingsbergen, LMFT
- IOCDF Member
- Specializes in CBT & ERP
- Works with children, teens, college students & adults
Frequently Asked Questions
Trichotillomania Therapy in Marin County
Book a free 20-minute consultation to discuss your trichotillomania. You don't have to hide it or manage it alone — specialized treatment works.