Institute on Compulsive Hoarding and Cluttering

The MHA-SF Institute on Compulsive Hoarding and Cluttering (ICHC) is a center for information, training, education, policy and dissemination of research on compulsive hoarding and cluttering.

The ICHC includes:...

The Oprah Effect (Resulting from 11/2007 Show)

Gulp, Half a Million Dollars??

Goals of therapy for hoarders, health/fitness-The Oklahoman-Friday, November 30, 2007

-- Avoid repeatedly asking: "Why? Why do I hoard?" Recovery doesn't require an answer to "Why?" Remember: obsessive-compulsive disorder is not logical. Ask instead: "What is my objective? How can I best get there?"

-- Develop an ability to tolerate intense emotions. Rate intensity of feelings on a scale of 1 to 10. Observe changes in intensity of feelings. Notice that feelings come and go; saving things is not required to reduce anxiety.

-- Only Handle It Once. Deal with each item only once as soon as it comes into the house, instead of storing items to check more thoroughly later. Do not retrieve items from the trash when second thoughts raise doubt.

-- Simplify decision-making. Limit choices, (e.g., keep, recycle, sell, give or throw away). Make clear decision rules for each choice, (e.g., keep only 10 plastic bags, dispose of or recycle others). Use broad categories instead of many specific ones. Accept that others, including experts, may do things differently.

-- Buy and keep "just enough." Sales will be repeated. If you run out, it is not a disaster. Keep items you use, dispose of others.

-- Focus on functionality. Select a target, for example, an area such as the kitchen or a corner of a room. "Excavate" the target by throwing away and organizing items. Maintain clear space. Use the cleared space only for its intended purpose.

-- Seek assistance or another opinion. Hoarders have a hard time determining what is "important vs. unimportant," "just enough vs. excessive" or "necessary vs. inconsequential." Seek guidance from a friend or professional. Persevere with your goals. -Source: www.anxietyandstress.com

Woman Struggles to Overcome Hoarding

Online Video/Chicago

Chicago  --  It's one woman's battle to live a more normal life. She's trying to beat an obsessive-compulsive disorder called hoarding. It affects millions and many experts say it's almost impossible to cure. In this special report, Mark Saxenmeyer shows us how one local woman is trying desperately to prove them wrong.

Center for the Advancement of Health

However, group therapies had significantly lower dropout rates, but the same effectiveness as individual treatment. “Group therapy, with its characteristics such as … encouragement, reciprocal support, imitation and interpersonal learning [could] result in an increased motivation,” the authors write.

“This is a relatively weak finding, but still interesting,” Mathews said. “It suggests that group therapy, which is more cost-effective by far than individual therapy, may actually be the preferred form of therapy. If this is true, it would potentially help to make treatment more available to people with OCD, as it is less expensive, and requires fewer hours from trained personnel, so is easier to implement.”...

IndyStar.com 

 Change your thinking, change your life
Learning to redirect thoughts can fight depression and other mental illnesses, cognitive behavioral therapists say...

Computerized Cognitive Behavioral Therapy (CCBT)

delivers cognitive behavioral therapy via a computer software program. Providing this therapy as a first-line treatment for people with anxiety and depression heralds a significant shift toward providing new services closer to people at home and in the community. ...

Taking Out the Trash

SSW prof’s new book aims to help compulsive hoarders

Are you a compulsive hoarder? Visit the amazon.com page for Buried in Treasures and fill out this questionnaire.

Extension educator teaches families how to deal with clutter

by Kim Colavito Markesich - January 22, 2007

Inositol and OCD 

By Frederick Penzel, Ph.D.

Obsessive Compulsive Disorder: Children Who Hoard

July 23, 2005

Even Forbes.com is talking about it 
Paxil Treats 'Compulsive Hoarding'

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11.10.06, 12:00 AM ET, Excerpts:
FRIDAY, Nov. 10 (HealthDay News) -- The antidepressant Paxil (paroxetine) is effective in treating people with a condition called compulsive hoarding syndrome, researchers report.

Compulsive hoarding, which may affect up to 2 million people in the United States, is often found in patients with other diseases, including dementia, Alzheimer's, schizophrenia and anorexia. It's most often seen in patients with obsessive-compulsive disorder (OCD). Researchers aren't certain whether compulsive hoarding is a subtype of OCD or a separate disorder...(see "read more" above)

SRIs Work for Compulsive Hoarders

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By Vivian Richardson, Ivanhoe Health Correspondent/Reported November 6, 2006
ORLANDO, Fla. (Ivanhoe Newswire)

Excerpts:
At its mildest, compulsive hoarding can mean taking too long to complete tasks because things get lost in disorganized piles. At its most severe, most or all rooms of a person's home will be unusable because of clutter. Nothing is thrown away, "even though everybody else around the person can see this stuff is minimally valuable or not valuable at all," Dr. Saxena said.

Dr. Saxena and colleagues tested the effectiveness of paroxetine (Paxil) -- a serotonin reuptake inhibitor (SRI) -- for the treatment of OCD patients with compulsive hoarding syndrome. They discovered both the hoarding and non-hoarding patients with OCD had similar responses to the medication. The finding contradicts past studies which suggested the syndrome was difficult to treat.

Dr. Saxena says studies from other programs have shown people with compulsive hoarding have brain abnormalities. "Most people out in the lay public just think that these people are being lazy or they're being willfully stubborn, wanting to keep this stuff even though everyone is telling them to clean it up," he explained. "They really can't just go home and clean it up because the fears and anxieties are very powerful, very overwhelming, and that's going to require treatment."...

SRI medication effective in treating compulsive hoarding patients

In a paper published on-line in advance of publication in the Journal of Psychiatric Research, Sanjaya Saxena, M.D., Director of the Obsessive-Compulsive Disorders (OCD) Program at the University of California, San Diego (UCSD) School of Medicine, reports the surprising finding that the serotonin reuptake inhibitor (SRI) medication, paroxetine, is effective in treating patients with compulsive hoarding syndrome.

The study of 79 patients diagnosed with obsessive-compulsive disorder (OCD) – 32 of them with compulsive hoarding syndrome – suggests that further controlled trials of SRI medications for compulsive hoarding are now warranted.

Compulsive hoarding, which may affect up to 2 million people in the United States, is found in people with many diseases, including anorexia, schizophrenia, Alzheimer's disease and dementia. It is most often found in patients with OCD, though researchers are not yet sure if it is a subtype of OCD or a separate disorder...

Cognitive Behavioral Therapy Helps Children With Obsessive-compulsive Disorder

What is CBT?

The BT in CBT stands for behavior therapy. Behavior therapy helps people learn to change their thoughts and feelings by first changing their behavior. Behavior therapy for OCD involves exposure and response prevention (E/RP).

Exposure

For exposure to be of the most help, it needs to be combined with response or ritual prevention (RP). In RP, the person?s rituals or avoidance behaviors are blocked. For example, those with excessive worries about germs must not only stay in contact with "germy things," but must also refrain from ritualized washing.

          Exposure is generally more helpful in decreasing anxiety and obsessions, while response prevention is more helpful in
          decreasing compulsive  behaviors. Despite years of struggling with OCD symptoms, many people have surprisingly little 
          difficulty tolerating E/RP once they get started.

Cognitive therapy (CT) is the other component in CBT. CT is often added to E/RP to help reduce the catastrophic thinking and exaggerated sense of responsibility often seen in those with OCD. For example, a teenager with OCD may believe that his failure to remind his mother to wear a seat belt will cause her to die that day in a car accident. CT can help him challenge the faulty assumptions in this obsession. Armed with this proof, he will be better able to engage in E/RP, for example, by not calling her at work to make sure she arrived safely.

Other techniques, such as thought stopping and distraction (suppressing or "switching off" OCD symptoms), satiation (prolonged listening to an obsession usually using a closed-loop audiotape), habit reversal (replacing an OCD ritual with a similar but non-OCD behavior), and contingency management (using rewards and costs as incentives for ritual prevention) may sometimes be helpful but are generally less effective than standard CBT. 

 People react differently to psychotherapy, just as they do to medicine. CBT is relatively free of side effects, but all patients will have some anxiety during treatment. CBT can be individual (you and your doctor), group (with other people), or family. A physician may provide both CBT and medication, or a psychologist or social worker may provide CBT, while a physician manages your medications. Regardless of their specialties, those treating you should be knowledgeable about the treatment of OCD and willing to cooperate in providing your care.  Read more here: Source

Compulsive hoarding study could improve diagnosis and treatment of psychiatric disorders

A PET imaging study conducted at the UCLA Neuropsychiatric Institute indicates the neurobiology of America's estimated 1 million compulsive hoarders differs significantly from people with other obsessive-compulsive disorder (OCD) symptoms. The findings indicate that different medications could improve treatment success.

The study is the first to examine the neurobiology of people with compulsive hoarding and saving, one of several symptom clusters associated with OCD.

The study identified lower brain activity in the anterior cingulate gyrus of compulsive hoarders, compared with other OCD patients. This brain structure helps govern decision-making, focused attention, motivation and problem-solving, cognitive functions that are frequently impaired in compulsive hoarders. The study also found a correlation between severity of hoarding symptoms and lower brain activity in the anterior cingulate gyrus across all of the study subjects with OCD.

In addition, the hoarding group showed decreased brain activity in the posterior cingulate gyrus compared to healthy control subjects who had no OCD symptoms. The posterior cingulate gyrus is involved in spatial orientation and memory. The decreased activity in hoarders may explain why they have difficulty with excessive clutter and fear of losing belongings....

Cognitive-Behavioral Therapy (CBT)

Proven to be effective for many anxiety disorders, Cognitive-Behavioral Therapy (CBT) is a form of counseling that focuses on teaching clients to:

• gradually confront the things they fear in order to feel less afraid.
• learn healthier ways of coping with stressful situations.
• become aware of-- and then change-- the way they think in critical situations.

CBT is different from other kinds of psychotherapy or "talk therapy." Whereas some forms of therapy focus on helping the person to discover why they feel anxious, CBT emphasizes teaching the person how to feel less anxious. Whereas traditional psychotherapy often takes place over several years, CBT is designed to be a relatively brief treatment with distinct, tangible goals. The advantages of CBT are a lack of unwanted side effects and long-lasting beneficial effects that continue even after the person leaves treatment. The disadvantages are that the effects of CBT may take a longer period of time to develop—although sometimes effects can be seen after just a few visits, and that CBT involves more time and effort on the part of the person with the anxiety disorder.

For a more thorough description of CBT, click here.

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San Francisco Chronicle
COGNITIVE THERAPY
Don't Tell Me About Your Childhood
The Bay Area embraces a 'here and now' approach to psychotherapy with surprising results
Suzanne Leigh/Sunday, August 6, 2006

The Bay Area embraces a 'here and now' approach to psychotherapy with surprising results Suzanne Leigh Sunday, August 6, 2006 It used to be that seeing a psychotherapist involved delving deep into the past: Our narcissistic mothers and controlling fathers came under microscopic scrutiny as we grappled with gaining insight into our tarnished lives.

Under the therapist's prolonged probing we chewed over our "stuff" and "baggage" and family "dysfunction" and relationship "co-dependency." And the next week we came back for more. But that scenario has gradually shifted. Many psychiatrists and psychologists in the Bay Area no longer encourage patients to languish in the past. Instead they propel them into the here and now with a powerful tool: cognitive therapy... Read more here.