ABSTRACT
Through the lens of family systems therapy, an adolescent’s BFRBD symptoms can be understood as a signal of unresolved issues within the family system. Including the parents in treatment be empowering, as they can make changes to the teen’s environment to reduce the triggers that lead to picking, pulling and biting. In this chapter, readers will meet Ivy, whose hair-pulling crisis prompted necessary communication with her mother. Her participation in the session improved their relationship and helped Ivy to find new coping skills. Readers are also introduced to 11-year-old Colt, who underwent several major surgeries before the age of 6 and struggled with a variety of body-focused repetitive behaviors before beginning to pull out his hair. He entered therapy for trichotillomania almost bald. A combination of individual and family therapy with the author for 15 months helped the family process their traumatic experiences and led to the full resolution of Colt’s hair pulling.
