Even if a tulpa can communicate through vocality just fine, they may want to use other methods on occasion to connect on a deeper level and to make their feelings heard. Sometimes, stress can cause a tulpa to be unable to use vocality for some systems, and tulpish may be used.

There’s no shame in using tulpish, head pressures, or emotional responses. You’re doing just fine with what you can do.

I dunno man, as someone who took a several years break from tulpamancy, returned to it with zero recollection of headpressures and headaches existing in the process of making a tulpa, and gotten them once again while not expecting them AT ALL - for me they're pretty real. I never get them otherwise. I daydream a lot, no headaches no pressures. Work can be frustrating and hard - no headaches no pressures. If I spend even 20 minutes on tulpamancy, I get them.

Not that it's a requirement to have them. But this is a side-effect that I very much believe is common.