These tensions can play out in adults, too.

For example, many people with BFRBs say that complete abstinence from picking or pulling is an unhelpful goal that may magnify self-criticism and frustration. Yet, one woman spoke positively about her experiences in Hair Pullers Anonymous, based on Alcoholics Anonymous. “We celebrate abstinence. Just think of any AA program,” she says. They use the same literature and spiritual tools. She joined the support group in January and says in the three months since that “my hair pulling is down so much—you wouldn’t even believe it.” She has a sponsor she can call if she feels like she wants to pull her hair. And she’s also working on self-care, a big emphasis of TLC. “Maybe that’s why I’m having success,” she speculates, “because I’m hitting all these things.”

At the conference, the last session I go to is “Standing Tall in Our Awesomeness.” It’s led by Christina Pearson, who left TLC in 2013 and founded the Heart and Soul Academy in 2014. Roughly 20 kids are sitting in chairs in a horseshoe shape. I take a seat next to the girl with the Maple Leafs sweatshirt. She’s here, along with the rest of the kids from the charcoal drawing session and others up to the age of 14.

Pearson comes in with a pink fascinator atop her head, holding feathery string puppets. “I’m the lady who grew up just like you, and I started TLC,” she says. She greets each child individually.

Then she asks each kid what they liked most about the conference. Among the most common answers: making friends, everything, all of it. To one girl, whom Pearson seems to have spoken with before, she says, “You have a huge heart and a sensitive nervous system.” The girl appears to be holding back tears.

Next, Pearson pulls out a ribbon, gives the end to a child at the front of the horseshoe, then asks her to hold it and pass the rest around.

“Feel the ribbon in your hands. It is connected to each one of you.” I close my eyes. The ribbon is smooth. I’m thinking of the girl in the Maple Leafs sweatshirt, just a bit older than I was when I started pulling. Unexpectedly, I find myself holding back tears.

Pearson leads us up out of our chairs, toward the door: “This is your world,” she says, as we leave the conference room. I’m walking, holding onto the ribbon, surrounded on either side by kids who are three-quarters my height. Surrounded by kids in hats, with bald heads, kids who pick their skin. We walk out through the hotel lobby, past the people dining and reading. And outside the hotel, to a startling view of the San Francisco Bay.

Pearson turns her back to the water to face us. The sun is slowly climbing. Planes are taking off from the nearby airport. She asks us to stand on the earth. Then she asks us to wiggle our bodies. “Close your eyes. What do you smell?” Then we do a wiggle again: “What do you hear?” We can do this any time, she tells us. Baby steps toward mindfulness.