At first glance for many, the main struggle presented by compulsive hoarding is the clutter. Overflowing a person’s drawers, closets and storage spaces, limiting living space and making certain aspects of the home inaccessible and non-functioning, clutter is surely the main culprit. However, as many who face compulsive hoarding, as well as their loved ones know, clutter problems almost always occur in conjunction with difficulty throwing items away and for some, problems with collecting or buying more items than one needs (acquisition).
Researchers and therapists believe that difficulty with discarding and problems with acquisition play an important role as behaviors which often create and influence clutter.
In working with individuals dealing with compulsive hoarding, therapists have found that addressing the discarding and acquisition behaviors are a crucial part of treatment. Recently, researchers have been further investigating the processes of discarding and acquisition in those with compulsive hoarding. They have done so through a series of experimental tasks which mimic challenge opportunities presented in treatment. These tasks are designed to elicit thoughts and feelings associated with discarding and acquisition, in order to more fully understand the phenomenon and further inform future treatments.
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In the discarding task, carried out in the individual’s home, the participant is asked to select a personal item with little to no sentimental or financial value and make a decision about whether to keep or throw away the item. Before making the decision, participants are assigned to either list their thoughts about the item or answer a series of questions about the possession on tape. If the decision is made to discard, participant’s distress levels about discarding are then rated every 5 minutes for 15 minutes after listening to their tape three times. Thus far, researchers have learned a great deal about the challenges present in discarding and the benefits of performing the task for those with compulsive hoarding. In the process of selecting an item and anticipating discarding, participants are engaging in an imaginal exposure.
They have often expressed feelings of sadness, anxiety, guilt and anger and thoughts concerning doubt, safety, responsibility and attachment related to items. Numerous participants have found that hearing themselves talk about their thoughts on tape has unexpectedly been one of the hardest parts. For many, it is the first time they may have heard their thoughts voiced aloud and frustration, shame, embarrassment and anger might accompany this. However, it has also often resulted in sense of relief and validation at the same time. It has not been uncommon for individuals to become very emotional. For those participating, most have been surprised to experience the intensity of emotion around discarding reduce as time goes on. The task allows them to try out one of their worst fears and turn to face it head on. For many individuals, the chance to explore their feelings and the thoughts surrounding a possession has been powerful experience both cognitively and emotionally.
The acquisition task is similar to the discarding task, differing in that it is held in a place of acquisition as opposed to the home. The place of acquisition varies across individuals, ranging from a store, to the side of a road, to the internet or home shopping network. So far, investigation into the acquisition task has greatly informed researchers on the process. For some, collecting or buying things is described as being in “another place” or another “zone” which feels “impulsive” or “out of control”, while for others it feels “calculated” and “controlled”. The type of items acquired significantly range from effects such as glass vases to paper pamphlets. Despite differences, in place, process and type of items acquired, participants have expressed similar thoughts and feelings surrounding the acquisition.
Thoughts include doubt about having enough items, responsibility to acquire for others, uniqueness or appreciation for the aesthetics of an item and future planning for use of items. A mix of feelings often surrounds acquisition such as pleasure, anxiety, anger, sadness. Participants have found it helpful to stop for a moment and question their thoughts and feelings surrounding the acquisition instead of following through on it automatically. It is clear from the experimental task that acquisition can be major contributor to clutter and is helpful to address in treatment.
Overall, both of the challenge tasks have been a learning experience for participants and researchers alike. It has been clear that these processes can be similar and yet unique in a number of ways for individuals with compulsive hoarding. It also has become apparent that the two behaviors of difficulty with discarding and excessive acquisition are key features of compulsive hoarding and benefit from being addressed in conjunction to clutter itself.