As with all disorders, or any kind of problem, it seems, my struggle  with trich is multi-faceted.  There is the definitive explanation: the  urge to/action of pulling out hair.  Then there is the shame.  The  embarrassment.  The exclusion.  The feeling of powerlessness,  worthlessness, and absolute lack of control.  I have vascilated between  two extremes: The first is the belief that it's not my fault, there's  nothing I can do; I may as well just accept it, stop worrying about it,  and live with it.  The second is that I only have this problem because I  am a weak, out-of-control person who isn't trying hard enough to lick  it.  I wish I knew what the reality of it is.  I go through phases where  I just pull and don't really think about it, which is usually followed  by a period of time when I decide I'm really going to 'get it this  time'.  I have seen multiple counselors.  I have taken different  prescriptions usually prescribed for ADD, OCD, Depression, that are  suppose to help.  I have tried alternative "energy healing" therapies,  and Cognitive Behavioral Techniques.  I put gloves on my hands when I  read, glasses on my face, hats or scarves on my head.  I have covered  all the mirrors in the house but one.  Yet here I am, still frustrated,  not exactly sure what my next tactic will be.  Someone talked to a  psychologist who said there has been a lot of success with a supplement  that can be bought at a health food store.  It's an amino acid.  I don't  know much about it, but it's certainly worth a try.
Just the other night I got carried away lying in bed.  The Mr. had  already drifted off to dreamland.  Bedtime is one of the worst times for  me.  I only pulled out four or five eyelashes, but when they're already  thin, and you pull them all out in the same concentrated area (which I  tend to do a lot), a few eyelashes can be the difference between some  sparcity and a gaping, 1/2" space.
It is really hard for my husband to watch me when I'm pulling out my  hair.   He feels like I become someone else when I do it.  Together we have  tried to figure out the best response.  Bless his heart that man has  tried everything.  He has tried subtly trying to divert my attention.   For some reason this makes me angry in my 'altered' state.  So does  handing me a pair of gloves, but 
asking  if I would like him to 
bring  me some gloves works.  Usually I need him to put them on me, too.   Telling me that it hurts him to see me pulling is helpful.  I will  usually ask him why and he is able to explain that he doesn't like  seeing me hurt myself; that he feels like that's not me, etc.  For some  reason when I can tell he is bothered but doesn't say anything, I get  upset.  Somehow I have convinced myself that it is for selfish reasons  that he hates it.  Of course this makes no sense, and of course I know  that he is concerned because he loves me, but when I am pulling, or feel  a strong urge to pull, rationality seems to go out the window.  I  really, really hate that.  I don't know if this whole issue has been  harder on him or on me.  He told me one day that he would spend all our  money if he knew that it would fix this.  I love that man.
A few months ago I started searching on the internet.  I actually found  several videos of (mostly teen-age) girls talking about their struggle  with trich.  I was absolutely blown away.  First of all, I thought I was  an anomaly.  I had only ever heard of one other person who experienced  this problem.  Some doctors and counselors knew what it was, but most  had very little experience with it.  I think part of this is because  people are so embarrassed about it.  They think they will be rejected by  society (especially one that is so aesthetically based, and projects  perfection as the 'norm'), and so they just hide it.  I don't exactly  plan to shout it from the rooftops, but part of the reason I'm sharing  this is the hope that someone else who is struggling with these same  issues will be able to find some sort of hope or help in something I  say, or at the very least realize they are not alone.  Second, I was  humbled and incredibly grateful to learn that I seem to have a milder  case of trich.  A lot of the girls I learned about shave their heads and  wear wigs because they have pulled out so much hair in concentrated  areas.  Once again I am reminded that no matter how bad things feel,  there is always someone who has it worse.
Through all of this I  am so grateful for faith in a higher power.  I am grateful for the  reminders that this life is temporary, and even if I struggle with trich  until the day I die, one day I will not.  One day I will be whole and  beautiful and confident.  I am also grateful to know that everything  happens for a reason.  This life is a test.  There are things I can  learn from this.  Compassion, patience, perspective.  I have felt that  in part dealing with Trich will one day enable me to somehow help other  people.  I don't know exactly how that will play out, but I have felt  it.  Sometimes i wish I could just see a few steps ahead, but I think  the learning and growing in life happen because we 
can't.  Above all I am grateful for a  Savior, who has suffered not only for the sins of all mankind, but  their sorrows and pain and grief.  I know that we are given trials so  that we learn to turn to Him.  When I feel so totally and utterly alone,  that no one could possibly understand me, I know there is one who can.
Love to all
SBB