got too much stuff

Got Too Much Stuff?

How to deal with all that clutter and deal with your anxiety about

letting it go.

Presented by Stephnie Thomas, MS, NCC, LGPC

Anxiety Disorders Specialist,

The Anxiety and Stress Disorders Institute of Maryland, LLC

Voicemail: (410) 938 8457 ext 2

Cell: (410) 236 1470

[email protected]

Has your “clutter” become “hoarding?

First Step Take a look around your house (or apartment).

Is your stuff helping you live a productive, healthy life?

Is it getting in the way?

Are other people bothered by your clutter?

Are you too embarrassed to have friends or handymen come in to your home or areas of your home?

Can you walk around all your furniture easily?

.

Has your home become a health hazard or a fire hazard?

Are there areas of your home that you can’t use because there is so much stuff piled up in there?

Take a look at the next few slides: Which number is your space?

Are you here?

Or here?

Where are you between these extremes?

Exercise: Each person was asked to bring in 2 items:

1. One item from your home that your family members would treasure and want to keep after you are gone

2. One item from your home that you treasure but know that your family members would not want to keep after you are gone

Exercise (cont.) In small groups, discuss what

makes each item special to you

What makes each item something your children (or other family members) would either treasure or want to discard

What is the difference between hoarding and collecting?

A collection is defined as a group of treasured objects that one takes pleasure in collecting and showing to others.

What is the difference between hoarding and collecting? (cont.)

Hoarding can be defined as having so much stuff that one is unable (or unwilling) to take pleasure in showing it to others.

Other definitions for hoarding include:

Other definitions for Hoarding Hoarding is usually considered a subtype of Obsessive

Compulsive Disorder (OCD).

Like other compulsive behaviors, hoarding is an effort to manage the anxiety raised by obsessive doubts.

There are varying levels of hoarding behavior. A diagnosis of OCD of the hoarding type is made when there is significant distress or disruption to feelings of self-worth, interpersonal relationships, education, occupation, housing, finances, legal issues, or health as a result of hoarding behavior.

What is Hoarding? (cont.)

Symptoms vary from person to person, but may include: Saving items seen by most people as unneeded or worthless, (i.e., not true collectibles). Compulsively buying or saving excessive quantities of items of any kind.

What is Hoarding? (cont.) Treating all saved items as equally valuable--

whether or not the object has sentimental, financial or functional value.

Experiencing intense anxiety or distress when attempting to discard-or even think about discarding-what most others view as useless objects.

What is Hoarding? (cont.) Engaging in saving activity to combat anxiety-

provoking thoughts such as: What if I run out?

What if I need to know something and don't have the information available?

What if I put it away and can't find it?

What if the way I organize it isn't the right way?

What if I throw it away but the day comes when I really need it?

What is Hoarding? (cont.) Being unable to use furniture, rooms,

or entire homes in standard ways due to saved items.

Significant deterioration in housekeeping due to excessive clutter.

What Causes Hoarding? There appears to be a strong genetic

component to Obsessive Compulsive Disorder of the hoarding type. Modeling and conditioning may also play a role in the development of this disorder.

OCD usually involves over-activity and/or under-activity of brain regions that underpin the observed behaviors.

What causes Hoarding (cont.) Hoarding worries and behaviors can begin

in childhood, even as young as age five.

The latest research indicates there may be a link between hoarding and Attention Deficit Disorder

Similar areas of the brain are implicated in hoarding and executive functioning problems

OK– I recognize I have a problem, but how do I change?

1. Psychotherapy 2. Exposure Therapy 3. Medication 4. Working with a professional organizer

to reduce and organize clutter 5. Often a combination of all of the

above works well

Psychotherapy Treatment

Involves exploring the impact of learning, triggers, worrisome thoughts, and intense emotions.

Helps you explore acquiring behaviors (triggers) and how that impacts your clutter.

Medication Treatment Medications used to treat anxiety

and OCD (e.g. Paxil, Luvox, etc.) and to sharpen attention (e.g. Ritalin) can be helpful.

Co-morbid conditions such as depression may also need to be addressed.

Using a Professional Organizer Professional organizers help you categorize

and store items so that your space is less cluttered

They will also encourage you to discard unneeded items

Problem: most lack training in helping you learn how not to acquire too much new stuff.

Exposure Therapy Treatment Exposure therapy involves practicing new

ways of responding to uncomfortable thoughts and feelings that arise when hoarding behavior is challenged.

It is often conducted in the home with pragmatic emphasis on both reducing the clutter and managing the doubt and anxiety that perpetuate the clutter.

Exposure Therapy Treatment

The key is learning to "allow" feelings of anxiety to be present without attempting to neutralize them by saving things.

ERP: What is it? Exposure and Response Prevention

The client deliberately exposes him or herself to the feared situation and deliberately chooses not to engage in their normal behaviors

Example: The hoarder walks into his apartment carrying his mail. Instead of adding the mail to the pile of unopened mail (the normal clutter response) he chooses to go through each item right then and there and discard junk mail WHILE BEING UNCOMFORTABLE WITH LETTING IT GO

Response prevention Confront demoralization and self-contempt

Learn to tolerate uncertainty

When certainty will finally be obtained!

Response prevention (cont.) Change the reaction to symptoms of

arousal from catastrophizing to acceptance and curiosity

Change the attitude from avoidance to approach

Use practice not testing

Therapy goals: Avoid repetitive questioning (e.g., "Why? Why

do I have so much clutter/hoard? Why did I let this get out of hand?").

Understand that recovery doesn't require an answer to "Why?“

Remember: OCD and/or hoarding are/is not logical.

Ask instead: "What is my objective? How can I best get there?"

Therapy goals (cont.) What do I value?

Is it more important to have a functional space or to have my stuff around me?

Are family members refusing to come to my apartment because of my clutter? – am I willing to change to see my grandchildren more often?

Has my spouse moved out because of my clutter? Do I want him/her back?

What do you want your space to look like? This?

Or This?

This? A semi-functional room

Or this – a fully functional room?

Develop the ability to tolerate intense emotions.

Rate the intensity of feelings on a scale of 1 to 10. Observe changes in the intensity of feelings. Notice that feelings come and go; saving things is not required to reduce anxiety.

Accept that less than perfect is "good enough."

Towels do not have to be folded with military precision, cans do not have to be arranged in alphabetical order, etc.

Take care with items of consequence (e.g., bills, medicine, safe deposit box keys), but relax with things of less consequence (e.g., today's newspaper, "junk" mail, spare toothbrushes). Correctly making that distinction is often the key to recovery.

Accept that less than perfect is "good enough.“ (cont.)

Practice a "so what" attitude if you make a mistake. Ask yourself what is the worst that could happen and how could it be fixed.

Ask yourself if it is worth the time and effort to change something you have done or whether you have better things to do.

One way to avoid clutter For every item that comes into

your home, at least one item has to leave your home Doing this will very effectively address the

acquiring behavior that is typical of most people who struggle with clutter

Which bedroom do you want?

"Only Handle It Once." (OHIO) Deal with each item only once.

Check things only once instead of storing them to check more thoroughly later.

Deal with things as soon as they come into the house.

Do not retrieve items from the trash when second thoughts intrude and raise doubt.

OHIO

Keep Discard Donate

Simplify decision making. Limit choices, (e.g., keep, recycle, sell,

give away, throw away).

Make clear decision rules for each choice, (e.g., keep 10 hole-free plastic bags, throw away dirty bags, recycle remaining bags).

Simplify decision making. (cont) Use broad categories instead of many

specific ones, (e.g., "gift wrap items" instead of paper, lace ribbons, small, medium & large bows).

Accept that others, including experts, may do things differently.

OHIO

• How useful is it?

• How often do I really use this item?

• Have I used it within the last 6 months? (12 months for seasonal items)

• Does it have special sentimental value?

Keep

OHIO

• Items that are broken, chipped, or soiled.

• Junk mail. That “special offer” will be repeated!

• Newspapers at the end of every day.

Discard

OHIO

• Magazines after 1 – 2 weeks. If you haven’t had time to read it within that time frame, chances are that you will never read it

• Clothing: anything ripped, torn, or soiled

Discard

OHIO

• Leftover food (if it’s been in the fridge for more than a week …)

• Containers from food service places (e.g. Burger King bags, napkins, salt sachets, etc.)

Discard

OHIO

• Anything that is in excess. For example: do I really need 40 shirts, 20 pairs of shoes, 60 pens, 3 sofas, and 30 coffee mugs?

Donate

OHIO

• Ask yourself how you can help others by donating this item

Donate

OHIO

• If you are internet-savvy, think about posting your items to sell on Ebay.

Donate

Organize and file systematically. Place like things together in a designated

place, (e.g., place grain products in one cabinet, bottled and canned goods in another).

Use broad headings when filing, (e.g., house, cars, medical, insurance, job, education).

File only important papers.

Buy and keep "just enough." Sales will be repeated.

If you run out, it is not a disaster.

Keep items you use--throw out others, (e.g., You have five handbags--you use one; one has a broken handle; one has a hole in the bottom; one is too small; and, one is a color you do not like. Keep the one you use; throw away the damaged ones; and give away the other two).

Focus on functionality.

Select a target, (e.g., an area such as the kitchen or even a corner of a particular room).

"Excavate" the target by throwing away and organizing.

Maintain the clear space.

Use the cleared space only for its intended purpose.

Seek assistance or another opinion.

Individuals who hoard often have a difficult time determining what is "important vs. unimportant," "just enough vs. excessive," or "necessary vs. inconsequential."

Enlisting the aid of a trusted friend or professional can provide guidance in developing appropriate guidelines and persevering with your goals.

Acceptance Not Control No technique, coping skill, behavior therapy

or practice will ultimately work if the patient remains afraid of and struggling against the sensations of arousal or the intrusions of anxious thoughts. This is the basic paradox to be learned over time.

(Sally Winston, ASDI)

Take home message

Recovery occurs when the symptoms no longer matter

(Claire Weekes)

Levels of recovery Significant improvement

Clutter/Hoarding is under control

cognitive recovery You accept you have a problem with clutter/hoarding

insight recovery The physical symptoms you get when you think

about cleaning your space are information

existential recovery symptoms do not matter – you are able to clean your

clutter anyway!

(Sally Winston, ASDI)

Remember your goals. What do you want your space to look like?

References Freedom from Obsessive Compulsive Disorder, Grayson

Chapter 13, OCD Workbook. Hyman

Randy Frost

Noppinger

Gail Steketee

Edna Foa

The Doubting Disease, Help for Scrupulosity and Religious Compulsions, Ciarrocchi

Who to call to find help ASDI

Dr. Sally Winston, 410 938 8454 Sally coordinates services at ASDI & will match you with a

therapist or in vivo specialist trained in helping with clutter

Maryland Association of Professional Organizers

National Association of Professional Organizers

New Group being formed Eve Berkow and I are forming a low-fee

group for clients who struggle with clutter.

The group will meet on Tuesdays at 1pm at our ASDI office in Towson, beginning sometime in 2011

But, I have Medicare, and no one will take my insurance!

Eve Berkow at ASDI is able to work with a limited number of Medicare clients

In 2011 Eve and I are beginning a group for clients who struggle with clutter .

Call Eve at (410) 938-8450 if you are interested in the group or individual work.

Presented by Stephnie Thomas, MS, NCC, LGPC

Anxiety Disorders Specialist,

The Anxiety and Stress Disorders Institute of Maryland, LLC

Voicemail: (410) 938 8457 ext 2

Cell: (410) 236 1470

[email protected]

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