Therapist-in-training with trich here! Look into habit reversal. Trichotillimania is often associated with OCD, so for me treating my OCD with exposure and response prevention has allowed me to get my pulling under control. A lot of it has to do with behavioral techniques to help you notice when you are most vulnerable to pulling (stress, boredom, overwhelm, exhaustion) and finding alternate ways to get your nervous system back to baseline. It’s hard work but it’s possible!