Trichotillomania: behavioral symptom or clinical syndrome? [clinical conference]

Ms A. was a 27-yr-old single white woman who presented for treatment for her chronic hair pulling. It had begun at about age 14 yrs and led to complete hair loss. She had been evaluated by a pediatrician at 14 yrs and a monitoring approach was used. About 10 years' of various treatments followed, including hypnotherapy, weekly psychodynamic psychotherapy, behavior therapy and drug therapy, all of which failed to make any impact. Treatment now was a combination of drug therapy and behavioral therapy, along with a selfhelp group with other women with this problem. Good progress was made. The discussion considers both the condition and the treatment.