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  • Megan Begley, LCSW

Recognizing Hoarding or Compulsive Buying and Treating the Problem at the Deepest Level

Updated: Jan 26


Clutter and stress: a problem for almost everyone that's worth addressing


As demonstrated by the development of a ‘’Tiny House’’ culture and numerous TV shows devoted to organization and related home makeovers, most Americans identify with the problem of overspending and accumulation of non-essentials. Many of us had parents or grandparents who lived through wartime or Depression-era scarcity and understandably, passed on habits borne of that insecurity. Additionally, we’re so conditioned by advertising to acquire the latest and greatest, shop in alignment with a commercialized holiday calendar, and generally respond to ''bargains,'' that we now collectively normalize a certain degree of wasteful excess and household clutter.


Even as I struggle against it myself, I feel deeply that the normative level of American consumerism is in fact a tragic cultural problem. At the individual level, it adds unnecessary stress to our homes, mental states, and spirits in addition to our wallets. At the macro level, it wastes environmental resources and drives exploitative industrial labor.


Yet, for most of us, finding time to declutter is a real obstacle no matter how capable or well-intentioned we are. It may feel especially challenging if you don't know where to start or how to go about it. If you're ready to part with things, but lack time or organizational skills, then setting related goals or working with a professional organizer could be one of the most worthwhile investments you can make to lower stress, gain mental clarity, and change your life. Once you build your own inner muscle to quickly identify what can be discarded (and I'm a little bitter about the fact that Marie Kondo made the ''sparking joy,'' concept famous when I figured it out years ago), organizing and decluttering will become a highly constructive way to cope with routine stress or acute emotional overwhelm.



Clutter and mental illness: do you need treatment and not just professional organizing?


What if you suspect that any progress made with an organizer would only be temporary because of a compulsive habit related to shopping, buying, or another form of acquisition? Or what if the prospect of working with a professional organizer is off-putting or terrifying because getting rid of things causes you so much distress? If so, you likely also struggle with depression, one or more forms of anxiety, and/or other mental health disorders. As typically revealed in shows such as ''Hoarders,''--which somehow seem to both illuminate and further stigmatize the condition--people often develop hoarding behavior or a ''shopping addiction'' as an obsessive-compulsive disorder stemming from one or more traumatic experiences. However, it's important to realize that adverse experiences you may not categorize as ''trauma,'' may have been similarly impactful.

If any of this sounds like you, and you identify with the below features of Hoarding Disorder or Compulsive Buying Behavior (otherwise known as a ''shopping addiction'' or oniomania) then read below to learn how EMDR therapy or hypnotherapy could help you.


''How do I know if I'm a hoarder?''

Having been been added to the most recent version of the DSM (the official diagnostic handbook for psychiatrists and licensed therapists), Hoarding Disorder is now a formal diagnosis categorized under a class labeled Obsessive-Compulsive and Related Disorders. The criteria are as follows:

  1. Persistent difficulty discarding or parting with possessions, regardless of their actual value

  2. This difficulty is due to a perceived need to save the items and to distress associated with discarding them

  3. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g. family members, cleaners, authorities)

  4. The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others)

  5. The hoarding is not attributable to another medical condition (e.g., brain injury)

  6. The hoarding is not better explained by the symptoms of another mental disorder (e.g, obsessions in obsessive-compulsive disorder, decreased energy in major depressive disorder, delusions in schizophrenia or another psychotic disorder, cognitive deficits in major neurocognitive disorder, restricted interests in autism spectrum disorder)

Additionally, approximately 80 to 90 percent of individuals with hoarding disorder display the trait of ''excessive acquisition (of items that are unneeded, or for which there is no available space)'' in addition to difficulty discarding existing possessions.


As families of individuals with hoarding behavior know, a person may or may not have insight into the reality or severity of their condition, which for treatment professionals, is another consideration in the diagnostic process and a potential obstacle to treatment.


''How do I know if I have a shopping addiction?''

Unlike Hoarding Disorder, Compulsive Buying Behavior has not been recognized as a distinct diagnosis. For example, it hasn't been classified as an addictive behavior because, while the activation of neurochemical reward pathways has been scientifically established for substance addiction and gambling, the clinical evidence in that regard is lacking for shopping (and certain other behaviors, such as sex and kleptomania).

Compulsive Buying Behavior is sometimes referred to as Compulsive Buying Disorder, which is a little confusing since it does sound like a diagnosis. However, it's actually lumped into a diagnosis called Impulse Control Disorder, Not Otherwise Classified. This mostly reflects a disagreement about how to best categorize the condition, as it combines features of obsessive-compulsive disorder, mood dysregulation, and indeed, addiction.

Regardless of the diagnostic technicalities, the condition is widely regarded as one in need of treatment. You would likely benefit from treatment if you identify with the following characteristics of addictive behavior:

  1. Difficulty resisting the purchase of unneeded items

  2. Preoccupation with shopping for unneeded items

  3. Shopping to improve your mood or getting a ''high'' from the act of buying

  4. Financial difficulties because of uncontrolled shopping

  5. Guilt or remorse about shopping

  6. Spending a great deal of time researching desired items and/or shopping for unneeded items


The most common, standard forms of treatment for hoarding and compulsive buying are limited


The primary standard therapies for both Hoarding Disorder and Compulsive Buying Behavior are Motivational Interviewing and Cognitive Behavioral Therapy, two approaches that work with the reasoning part of the brain. After discussing the pros and cons of each standard form of talk therapy below, I'll describe how mind-body (somatic) therapies like EMDR and hypnotherapy go further by addressing the trauma or emotional wounds commonly underlying hoarding and compulsive buying behavior.


The limitation of Motivational Interviewing for hoarding and compulsive shopping or buying


The goal of Motivational Interviewing (MI) is to help a person move closer to changing their behavior by objectively exploring the pros and cons of the situation. Widely used in all forms of addiction treatment, it's based on the recognition that initially, motivation to stop a behavior may be lacking even if it causes significant external problems (e.g., family conflict, bankruptcy) because they may seem to be outweighed by the short-term rewards (e.g., anxiety relief, euphoria). MI can be an especially valuable aspect of therapy for someone who experiences only judgment and anger about the problem from people close to them, as the pain of being misunderstood and expected ''to just stop'' can actually perpetuate the behavior. However, the main limitation of Motivational Interviewing is that it doesn't attempt to heal the deeper wounds underlying most behavioral problems and addictions.


The limitation of Cognitive Behavioral Therapy for hoarding and compulsive shopping or buying


The goal of Cognitive Behavioral Therapy (CBT) is to 1) increase awareness of the relationship between thoughts, feelings, and behavior, and 2) ideally (this is where it gets tricky), build actual skills to manage the interdependent relationship of the three, with special attention on reframing faulty beliefs and cognitive distortions (inaccurate thoughts).


It's unquestionably important to recognize and harness the influence of your thinking habits on mental health. However, there's at least two reasons why CBT alone may not be fully effective for hoarding or compulsive shopping.


First of all, for CBT to be implemented at a level that actually creates change, repetition of homework (where you track your mood, any triggering situations for that mood, and associated feelings, thoughts, and behaviors) is typically very important. In addition to requiring your focus on the issue outside sessions, it enables you and the therapist to target the core of the problem before the hour ticks away. Otherwise, what's often deemed ''CBT'' is simply a conversation that doesn't translate into actionable steps for progress. (It would kind of be like talking to a professional organizer about your clutter and the problems it causes you, but never actually touching the stuff.) CBT is evidence-based (demonstrated as effective by research) for several mental health issues when applied in a structured way as initially designed, but it's commonly used as a catch-all term for supportive discussion. Most people lack motivation to do the homework involved for CBT to be impactful, and it may not even be required or expected by the therapist.


Secondly, because CBT relies on your reasoning about thoughts, feelings, and behaviors, (like motivational interviewing) it doesn't attempt to heal the deeper wounds underlying most behavioral problems and addictions.



Using EMDR and hypnotherapy as deeper forms of treatment for hoarding and compulsive buying


EMDR and hypnotherapy target mental health problems more deeply by addressing the mind-body (somatic) connection


Most people with hoarding or compulsive buying behavior have history of trauma, tragedy, or emotional wounds that were triggers for the development of the problem, either suddenly or as a later phase of mental health decline. The reasoning-based talk therapy approaches described above have value in the comprehensive treatment of issues, but unlike mind-body (somatic) therapies such as EMDR and hypnotherapy, they bypass an extremely rich level where the core of loss, grief, pain, and fear can actually be reached and begin to heal. Any work attempted to change faulty thinking, develop positive coping skills, or work with physical clutter will be more successful if this level is also addressed.


Mind-body/somatic therapies access the limbic system, which connects the responses of the brain--impressions, feelings, and memories--with the body's physical reactions. The phrase ''mind-body'' continues to have a somewhat woo-woo connotation, but the connection is as literal and factual as the physiology of the nervous, endocrine, digestive, and other systems.


Somatic therapies employ a mindful, relaxed state in order to focus on, or at least include, the experience of the body's sensations in the problem at hand. Although this may not sound impressive, it actually opens the door to an entirely different level of work on an issue than just thinking and talking about it. That's because the role of the limbic system is to record your significant emotional experiences at the physiological level, and prompt you physically to avoid future distress (e.g., shaking with fear) or repeat rewarding behavior (e.g., sexual arousal). Of course, this process is subconscious, but I invite you to now think of that word differently, and consider that your body and your subconscious mind are actually the same thing. When you let that sink in, it seems both mind-blowing and totally obvious.


You can read more about Mind-Body therapy here.



Using EMDR therapy for hoarding or compulsive buying: the approach to use when you can identify your trauma(s)


EMDR (Eye Movement Desensitization and Reprocessing) is a technique that lowers or eliminates the intensity of a disturbing memory by enabling the brain to process it more effectively in present time.


By combining somatic (body-centered) reconnection to the memory with a form of alternating stimuli (hand buzzers can be used in addition to eye movements), EMDR brings the hemispheres of the brain and the broader limbic system back into a state where the memory can be properly time-stamped as ''the past.'' It typically decreases not only physical symptoms of post-traumatic stress or anxiety (e.g., panic), but also the emotional charge of painful feelings related to the experience. As this starts to occur in the session, there's often a change in insight that begins to naturally reframe the faulty beliefs and cognitive distortions associated with the trauma, efficiently accomplishing much of the work that would be done in an ideal application of Cognitive Behavioral Therapy.


EMDR hasn't been deemed an evidence-based treatment for Hoarding Disorder or Compulsive Buying Behavior, as these problems are multi-faceted. However, it's a highly evidence-based treatment for post-traumatic stress disorder (PTSD). Accordingly, for someone who has trauma history--whether they recognize a specific traumatic experience as triggering for the hoarding or buying behavior or not--EMDR is likely to be an important component in overcoming the issue. This article describes how there is in fact now clinical research supporting use of EMDR for post-traumatic Obsessive Compulsive Disorder, which as noted above, is diagnostically related to both hoarding and compulsive buying.


You can read more about why and how EMDR works for trauma here and here.


Using hypnotherapy for hoarding or compulsive buying: the approach to use for gaining awareness when you don't think you have trauma history


Most people are most familiar with the use of hypnosis to rapidly break a habit (e.g., smoking cessation) or overcome a particular phobia, which usually involves an emphasis on suggestion and ''anchoring,'' (associations between emotional states and cues such as words or sounds). However, unlike hypnosis used for a ''reprogramming'' type of outcome, the Center for Holistic Behavioral Health uses hypnotherapy as a psychodynamic approach, meaning that the purpose is to explore the subconscious or unconscious developmental roots of current problems. The primary focus is memory regression instead of suggestion.


Although the risk of ''false memories'' is a common criticism of using hypnotherapy for memory regression, it's highly unlikely to occur with the approach used by the Center for HBH. Because people differ considerably in their ability to reach a deep trance state, mindful relaxation is all that's expected and needed for benefit. Nothing is forced. So how does it work? Although we're not conditioned to believe this is the case, the material within our unconscious is usually readily accessible if we're open to encountering it, and it becomes especially easy to connect with when using a somatic approach as described above. In other words, the body's sensory link to your conscious emotions can be thought of as a subconscious bridge to even deeper material.


If you have a problem with hoarding or compulsive buying behavior but you don't understand why, hypnotherapy can be used to explore the early life (or more recent) experiences that unknowingly set up an emotional and behavioral pattern behind the issue. For example, while a primary goal of Cognitive Behavioral Therapy for compulsive buying would be to change your thoughts about low self-worth that lead to shopping, the goal of hypnotherapy is to uncover the pattern of wounds that caused you to have low self-worth in the first place. Like EMDR, the hypnotherapy process usually creates new insight that begins to naturally reframe the faulty beliefs and cognitive distortions associated with the issue, efficiently accomplishing much of the work that would be done in an ideal application of Cognitive Behavioral Therapy.


You can read more about the type of hypnotherapy used by the Center for Holistic Behavioral Health here and here.


If you're ready to comprehensively approach a problem with hoarding or compulsive buying by doing therapy and working with a professional organizer, I recommend Tara Stewart at www.taramstewart.com. or Emily Evans at https://www.eliminatewithemily.com/








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