PhronesisWe apply the Displacement Framework to Trichotillomania (TTM, Hair-Pulling Disorder), providing a deep analysis of the most studied body-focused repetitive behavior that extends the general BFRB analysis in this series. TTM's distinctive features — tactile specificity of the hair root, trichophagia escalation pathway, visible alopecia burden, and the shame-concealment loop — warrant dedicated formalization.
The W_pull wrong attractor operates in three phases: Phase 1 (mounting D(ξ_tension) driving hair-seeking), Phase 2 (pulling act providing compound negative reinforcement through tension relief and positive reinforcement through tactile reward), Phase 3 (post-pull D(ξ_shame) creating new tension that re-enters Phase 1). Nine formal propositions are derived covering: S⁰_affect as the tension-regulation ground state (P1), W_pull three-phase structure (P2), tactile specificity of hair root resistance and follicular pop as sensory reward components (P3), automatic vs. focused pulling as distinct subtypes with different treatment implications (P4), trichophagia as nested wrong attractor W_trichophagia with trichobezoar as physical escalation endpoint (P5), D(ξ_alopecia) as persistent between-episode cost (P6), the shame-concealment deepening loop in which alopecia → shame → concealment → isolation → tension → more pulling (P7), N-acetylcysteine as the strongest pharmacological evidence through glutamate modulation reducing basin depth (P8), and the concealment trap as required treatment target alongside pulling behavior (P9).
The paper formally distinguishes TTM from OCD, addresses the male underdiagnosis problem, and analyzes pediatric TTM's distinct shallow-basin course.