7/6/16  

1  

Randy O. Frost

BURIED IN TREASURES:

COMPULSIVE HOARDING AND THE MEANING OF THINGS

June 29, 2016

¡ 319 BC – Theophrastus

¡ 14th Century – Dante’s Inferno

¡ 1597 – Shakespeare’s Shylock in The Merchant of Venice

HISTORY OF HOARDING – ANCIENT REFERENCES

¡ 1842 – Nikolai Gogol’s Dead Souls (Plyushkin)

¡ 1890 – Sir Arthur Conan Doyle’s Sherlock Holmes

¡ 1947 -- The Collyer Brothers

HISTORY OF HOARDING – EARLY DESCRIPTIONS

7/6/16  

2  

¡ 1993 – First systematic Study

¡ 1996 – Cognitive Behavioral Model

¡ 2007 – First Treatment Protocol & Open Trial

¡ 2007-8 – First Genetic & Epidemiological Studies

¡ 2013 – DSM-5

HISTORY OF HOARDING – MODERN ERA

¡ Phenomenology

¡ Cognitive Behavioral Model

ROAD MAP

MANIFESTATIONS OF HOARDING

Acquisition

Saving

Disorganization

7/6/16  

3  

ACQUISITION

§ Buying

§ Free Things

§ Stealing

§ Passive

COMPULSIVE SAVING / DIFFICULTY DISCARDING

¡ Types of items § Clothes, newspapers, books, containers § Worthless & worn out??

¡ Attachments § Sentimental § Utility-based § Intrinsic

DISORGANIZATION

¡ Condition of Home

§ Clutter

§ Mixed importance

¡ Behavior

§ Churning

§ Out of sight fear

7/6/16  

4  

COGNITIVE BEHAVIORAL MODEL

Meanings

Information Processing Problems

Reinforcement

Behavior Patterns CLUTTER Vulnerabilities

VULNERABILITIES

¡ Genetics ¡ Dysphoric Mood ¡ Emotional Dysregulation

§ Anxiety Sensitivity § Poor Distress Tolerance

¡ Perfectionism ¡ Poor health or disability ¡ History of loss or trauma

INFORMATION PROCESSING DEFICITS

¡ Attention

¡ Categorization

¡ Memory

¡ Perception

¡ Association

¡ Complex Thinking

Decision-making Difficulties

7/6/16  

5  

MEANING

We need to listen to what people tell us about the meaning of their possessions.

WHAT DO PEOPLE SAY?

¡ Throwing away this possession is like throwing away a part of me.

¡ Losing this possession is like losing a friend. ¡ I see my belongings as extensions of myself;

they are part of who I am. ¡ This possession provides me with emotional

comfort. ¡ I love some of my belongings the way I love

some people.

7/6/16  

6  

WHAT DO PEOPLE SAY?

¡ I am responsible for the well-being of this possession.

¡ If I discard this without extracting all the important information from it, I will lose something.

¡ I can’t get rid of it unless it is to a good home. ¡ Throwing this away means wasting it. ¡ This is too pretty to throw away.

MEANING: SENTIMENTAL ATTACHMENT

¡ History ¡ Identity ¡ Connection to others & world ¡ Opportunity ¡ Safety & Comfort ¡ Humanness

MEANING: UTILITY-BASED

¡ Imagined Utility § Problems with planning the future § Problems with organizing behavior

¡ Excessive Responsibility

§ Maximum Usage § Fear of Waste § Fear of Harm

7/6/16  

7  

MEANING: INTRINSIC

¡ Visual sensitivity

¡ Creativity (nonproductive)

REINFORCEMENT

¡ Positive

¡ Negative

¡ No opportunity to test beliefs (avoidance)

¡ No opportunity to develop alternative beliefs (avoidance)

HOARDING: A GIFT AND A CURSE

¡ Gift § Recognition of potential & opportunity § Concern about waste § Aesthetic appreciation of the physical world

¡ Curse § Living in a landfill § Collecting life without living it § Aesthetics gone Awry

¡ Our Challenge § Preserve what is valuable § Ameliorate what is harmful

7/6/16  

8  

¡ Empirically supported Interventions § Cognitive Behavior Therapy § Buried in Treasures Workshops

¡ Medication ¡ Case Management model ¡ Task Force Model ¡ Harm Reduction Approaches ¡ Family Involvement

INTERVENTIONS

¡ Refinements to our understanding

¡ Refinements to our treatment

¡ Reductions to the stigma

THE FUTURE

THANK YOU! ���������

RFROST@SMITH.EDU