Please help us providing you more information
regarding hair pulling to help you break
Gender: ( )Male ( ) Female
activities are you engaged at
4) a)Identify your emotions, thoughts and feelings just BEFORE you pull: , during and after pulling (angry, anxious, worried, frustrated, bored, etc.):
b) Identify your emotions, thoughts and feelings DURING hair pulling:
c) Identify your emotions, thoughts and feelings AFTER pulling:
5) How long have you been pulling (months/years)?
How did hair pulling begin?
6) How long do you pull once you begin?
what point of hair pulling, do become aware you have been pulling (before I
start pulling, in
Who lets you know that you are pulling?
8) Do you pull strand by strand or do you pull in chunks?
9) Do you eat hair after pulling?
10) Have you or are you diagnosed with a clinical disorder?
a. If yes what and by whom?
11) Do you pull specific types of hair (e.g. curly, wavy, discolored, etc)?
a. If yes please specify
12) Do o
b. If yes please specify who?
13) What have you done in
14) Please share what you have figured out regarding why you pull hair?
15) Do you or have you had any o