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Stopping Overshopping: An Approachto the Treatment of Compulsive-BuyingDisorderApril L. Benson a & David A. Eisenach aa Stopping Overshopping, LLC, New York, New York, USAVersion of record first published: 17 Dec 2012.

To cite this article: April L. Benson & David A. Eisenach (2013): Stopping Overshopping: An Approachto the Treatment of Compulsive-Buying Disorder, Journal of Groups in Addiction & Recovery, 8:1, 3-24

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Journal of Groups in Addiction & Recovery, 8:3–24, 2013Copyright © Taylor & Francis Group, LLCISSN: 1556-035X print / 1556-0368 onlineDOI: 10.1080/1556035X.2013.727724

Stopping Overshopping: An Approach to theTreatment of Compulsive-Buying Disorder

APRIL L. BENSON and DAVID A. EISENACHStopping Overshopping, LLC, New York, New York, USA

Compulsive buying is slowly gaining visibility and taking its right-ful place alongside such psychological siblings as eating disorders,alcoholism, drug abuse, and other compulsive and addictive be-haviors. It has three cardinal features: irresistible impulses to shop,loss of control over those impulses, and the persistence of suchbehavior in the face of adverse consequences. Only sporadic re-ports of treatment for this growing problem exist, and these areprimarily studies of psychopharmacological treatment, individualpsychotherapy, and cognitive-behavioral group therapy. This arti-cle describes the Stopping Overshopping Group Treatment program,a comprehensive 12-week experience that draws from psycho-dynamic psychotherapy, cognitive-behavioral therapy, dialecticalbehavior therapy, motivational interviewing, mindfulness, and ac-ceptance and commitment therapy.

KEYWORDS compulsive buying, overshopping, group therapy,psychotherapy, shopaholic, shopping addiction, compulsive shop-ping

COMPULSIVE BUYING: AN OVERVIEW OF THE MALADY

“‘Money,’ says an Arabic proverb, ‘is an excellent servant but a terriblemaster’—and compulsive buyers epitomize this, often poignantly” (Benson,2000, p. 503). The most widely used definitional criteria (McElroy, Keck,Pope, Smith, & Strakowski, 1994) define the disorder as a maladaptive pre-occupation with buying or shopping, whether impulses or behavior, thateither: (a) is irresistible, intrusive, and/or senseless, or (b) results in frequentbuying of more than can be afforded, frequent buying of items that are not

Address correspondence to April L. Benson, Ph.D., Stopping Overshopping, LLC, 300Central Park West, 1K, New York, NY 10024. E-mail: [email protected]

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4 A. L. Benson and D. A. Eisenach

needed, or shopping for longer periods of time than intended. According tothese definitional criteria, someone could be classified as a compulsive buyerbased on the quality and intensity of his or her preoccupation with shopping,without actually buying anything. The buying preoccupations, impulses, andbehaviors cause marked distress, are time-consuming, significantly interferewith social or occupational functioning, can result in financial problems, anddo not occur exclusively during periods of hypomania or mania. In short,the compulsive buyer is a person who allows shopping to destructively de-flect resources—whether of time, energy, or money—from the business ofeveryday life.

First described by Kraepelin in 1915 and then Bleuler in 1924, com-pulsive buying was largely ignored for the next 60 years; only in the last30 years have we seen specific and persistent inquiry into this disorder.However, there is now clear evidence, both empirical and anecdotal, thatcompulsive buying poses a serious and worsening problem, one with signif-icant emotional, social, occupational, and financial consequences. Such tollsinclude debilitating debt, familial friction, problems in the workplace, andsuch psychological difficulties as shame, guilt, depression, hopelessness, andanger (Benson, 2004).

Compulsive buying can be considered a culture-bound syndrome; itis generally reported only in cultures with “mushrooming credit facilitiesand boundless buying opportunities” (Dittmar, 2007; Lee & Mysyk, 2004).Globalization, however, is greatly extending its borders. In addition to theUnited States, research studies on compulsive buying have been publishedin Canada (Valence, d’Astous, & Fortier, 1988), Mexico (Roberts & Sepul-veda, 1999), Brazil (Bernik, Akerman, Amaral, & Braun, 1996), England(Dittmar, 2004; Elliott, 1994), France (Lejoyeux, Mathieu, Embouazza, Huet, &Lequen, 2007; Lejoyeux, Tassian, Solomon, & Ades, 1997), Germany (Scher-horn, Reisch, & Raab, 1990), Spain (Villarino, Otero-Lopez, & Casto, 2001),Holland (Otter & Black, 2007), Australia (Kyrios, Steketee, Frost, & Oh, 2002),China (Xiaoqing, 2010), and South Korea (Kwak, Zinkhan, & Crask, 2003).Magazines and newspapers in Austria (Wolf, 2011), South Africa (Women24,2010), India (Sen, 2010), and Singapore (Gan, 2009) have reported on com-pulsive buying in those countries as well. In recent years, visitors frommore than 100 different countries have visited the first author’s website,www.shopaholicnomore.com, suggesting that the disorder is nearly univer-sal (Black, 2010).

Estimates vary as to the number of compulsive buyers in the UnitedStates. The results of a large-scale telephone survey suggested that5.8%—approximately 17 million Americans—have exhibited symptoms ofcompulsive buying (Koran, Faber, Aboujaoude, Large, & Serpe, 2006). Amore recent and narrowly focused study assessed the prevalence of compul-sive buying in three sample groups (university staff, university undergrad-uate students, and customers of an online women’s clothing retailer). The

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Group Treatment of Compulsive-Buying Disorder 5

researchers identified 8.9% of the staff personnel, 15.5% of the undergraduatestudents, and 16% of the online customers as scoring in the compulsive-buying range (Ridgway, Kukar-Kinney, & Monroe, 2008).

Despite the variations in percentages and sample populations, suchstudies have unveiled compulsive buying as a serious specter hanging overmillions of Americans. Yet an accurate conception of the “typical” com-pulsive buyer remains elusive. Several research studies have supported thepopular stereotype, pinpointing a 30-something female who has been buy-ing compulsively since her late teens or early 20s. This paradigm experiencesirresistible urges, uncontrollable needs, or mounting tension that can onlybe relieved by the compulsive buying of clothing, jewelry, shoes, and cos-metics (Black, Gabel & Schlosser, 1997; Christenson et al., 1994; Scherhornet al., 1990). But there are significant methodological questions about thesestudies. First, they tend to rely on self-selected subjects. Equally trouble-some is the likelihood that women are more likely to be overrepresentedin these studies because our culture attaches far less stigma to women whoshop than to men (Dittmar, 2004). One notable exception is the large-scaletelephone survey, referred to earlier (Koran et al., 2006). In that study, theprevalence of compulsive buying among men was 5.5%, and among womenit was 6%. Likely, the spectrum of compulsive buyers is wide and reflects aset of people who differ from one another in age, gender, socioeconomicstatus, patterns of buying, the intensity of their compulsion, and underlyingmotivation. This diversity suggests that efforts to capture the essence of thearchetypal overshopper are likely to be fruitless.

Helga Dittmar explains compulsive buying as an attempt to close theself-discrepancy gap, which she describes as the perceived discrepancy be-tween actual and ideal self (Dittmar, 2004). In essence, that gap representsthe distance between how someone sees herself and how she would liketo see herself or be seen. Consumption is often misrepresented in popularculture as the path to this ideal self, and the compulsive buyer uses the pur-suit and acquisition of material goods to fill that gap. Dittmar theorizes thatsusceptibility to compulsive buying is the product of two factors: strongly ma-terialistic values and high self-discrepancy (2004). She evaluated 40 women,grouped into four possible combinations of these two factors (low materi-alism/low self-discrepancy, low materialism/high self-discrepancy, high ma-terialism/low self-discrepancy, and high materialism/high self-discrepancy)and found that only the women with both high materialistic values and ahigh self-discrepancy gap had strong compulsive-buying tendencies.

It is important to stress here the role of our culture in stimulating thisovershopping. We live in a culture of “competitive consumption” (Schor,1998), one that equates goods with the attainment of happiness. Women aretold that if they just use the right perfume, they will be irresistible to men;men learn that if they just drive the right car, they will be seen as strong andsuccessful. Goods, in short, are sold to us as something they manifestly are

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not: transformative agents, tickets to the selves we long to be. Beginning atcollege age, sometimes before, we are barraged by the credit card industry,which offers discounts, promotions, and teaser interest rates. “Barraged” isno exaggeration: In 2005, 2006, and 2007, an all-time high of nearly 6 billioncredit card offers went out to America’s 300 million people—more than 20offers per year to every man, woman, and child (Synovate, 2007). The resultof this easy credit, and that ubiquitous equation of “more equals better,” hasled to plummeting savings rates and a skyrocketing number of bankruptcies.The recent recession has, for the moment, reversed nationwide trends: Thesavings rate has risen sharply from a negative rate to a current 6.4% ofincome (Mui, 2010), and the Federal Reserve reported that the annual rateof household debt has fallen 3.5%, the largest recorded decline since 1980(Nutting, 2009).

Compulsive buying has three cardinal features: irresistible impulses toshop, the loss of control over shopping behavior, and the persistence of suchbehavior in the face of adverse personal, social, and financial consequences(Dittmar, 2004). Like other addictions, it is complex and multidetermined.Many shopaholics try to counteract feelings of low self-esteem through theemotional relief and momentary euphoria provided by compulsive shop-ping. These shoppers, who also experience a higher-than-normal rate ofassociated disorders, depression, anxiety, substance abuse, eating disorders,and impulse-control disorders, may be using their shopping to self-medicate.Others, as already suggested, buy compulsively in a vain attempt to gain so-cial status or move closer to what they believe is a better or ideal self; thesecompulsive buyers may have a lower rate of associated disorders than thatof the first group (Dittmar, 2004).

In an effort to conceptualize the course of a compulsive-buying episode,Donald Black has identified four distinct phases: anticipation, preparation,shopping, and spending (Black, 2007). The final phase is typically followedby disappointment with oneself and one’s actions. This phase structure wasfurther substantiated by Helga Dittmar’s investigation of mood and self-evaluation in both ordinary and compulsive buyers during three phasesof consumption: just before purchase, just after purchase, and at home. Ona scale from –1 (negative mood) to 1 (positive mood), the ordinary buyerwas situated at 0.25 just before purchase, 0.40 just after purchase, and 0.7 athome, indicating a steady, if minor, elevation in mood throughout these threephases (2004). The compulsive buyer begins at –0.25 just before purchase,rockets up to 0.60 just after purchase, and declines to 0.35 at home. Dittmarfound similar arcs when she compared self-evaluation. When judging, “Howdo you feel about yourself?” on a scale of 1 (very bad) to 6 (very good), theordinary buyer exhibited a steady rise from 4.3 just before purchase to 4.9just after purchase to 5 back at home. The compulsive buyer began at 3.3 justbefore purchase, jumped to 4.4 just after, then dropped down to 4.1 backat home (2004). Shopping and buying, then, function, at least in the short

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run, to elevate both mood and self-evaluation. This is part of the reason,despite the fact that these gains are short-lived, that compulsive buying is soappealing to overshoppers and so difficult to resist.

The Diagnostic and Statistical Manual of Mental Disorders-Fourth Edi-tion classifies compulsive buying as “an impulse control disorder not oth-erwise specified.” It is associated with a number of other addictions andpsychiatric disorders. Studies have suggested that more than a quarter ofcompulsive buyers have histories of alcohol abuse, drug abuse, and/or eatingdisorders (Christenson et al., 1994; McElroy, Keck, Pope, Smith, & Strakowski,1994). Mueller, Mitchell, et al. (2010) found that the greater the severity ofcompulsive-buying symptoms, the more likely it is that an individual is alsosuffering from another addiction or from one of the following: an anxietydisorder (most frequently obsessive compulsive disorder), an affective disor-der (most frequently depression), and/or an impulse-control disorder (mostfrequently pathological gambling).

TREATMENT MODALITIES

Drug treatment, individual therapy, couples therapy, counseling for compul-sive buying, Debtors Anonymous (DA), Simplicity Circles, and group therapyhave all been employed to help compulsive buyers, but data about the effi-cacy of most of these modalities are still scarce. The data that do exist oftenfail to pinpoint any clear correlations. Among drug treatments, for example,two identically designed studies with similar antidepressants, citalopram andescitalopram, showed contradictory results. In the first study, compulsive-buying symptoms vastly improved with the medication; in the other one,puzzlingly, relapse rates were the same whether the compulsive buyershad been on medication or on a placebo (Koran, Aboujaoude, Solvason,Gamel, & Smith, 2007; Koran, Chuoung, Bullock, & Smith, 2003). In additionto antidepressants, treatment with mood stabilizers, naltrexone (an opioidantagonist), and Topamax (an anticonvulsant) have been reported (Black,Manahan, & Gabel, 1997; Grant, 2003; Guzman, Filomensky, & Tavares,2007; Koran, Bullock, Hartson, Elliott, & D’Andrea, 2002). Due to the highincidence of comorbidity in compulsive buyers, it is difficult to determinewhether a drug exerts an independent effect on compulsive-buying symp-toms distinguishable from its effects on mood, anxiety, and other underlyingconditions. For these reasons, drug treatment alone is not ideal.

Individual psychotherapy helps people discover and tell their stories as ameans of understanding and ultimately gaining control over their symptoms.It may be the treatment of choice with a very high-functioning patient whodoes not have other addictive disorders, but those clients are very muchin the minority (Benson & Gengler, 2004). Individual psychodynamic casereports have been published (Barth, 2000; du Plock, 2000; Goldman, 2000;

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Horne, 2000; Krueger, 1988, 2000; Richards, 2000; Winestine, 1985), butthere have been no empirical data garnered from these. A more targetedmodality, counseling for compulsive buying, focuses on the specific problemand creates an action plan to stop the behavior. Its goal is to break thecompulsive-buying cycle and create a workable financial structure that willenhance, rather than erode, a client’s quality of life. As yet, there exist onlyanecdotal data about its efficacy (McCall, 2002).

Because money issues are an intrinsic part of marriage and often asource of intense and pervasive friction, couples therapy for overshoppingfocuses on the healing of both partners and on rebuilding those aspects of therelationship that the compulsion has eroded (Mellan, 2000). DA is a 12-stepprogram modeled after the Alcoholics Anonymous program. The major tenetof DA is that debt can be cured with solvency, which means abstinence fromany new debt, the equivalent of sobriety for an alcoholic, and it may be mosteffective when used in conjunction with another modality. Simplicity Circlesoffer a place to gather with others to discuss personal transformation and thesatisfaction of a simpler life; as such, they are a healthy way to meet some ofthe principal needs that a compulsive buyer seeks to fill through shopping,including belonging to a community of like-minded individuals (Andrews,2000).

GROUP THERAPY FOR COMPULSIVE BUYING

Though the data for group therapy with compulsive buyers are only gradu-ally being collected, they provide the most consistently positive evidence ofsuccessful treatment (Mitchell, Burgard, Faber, Crosby, & de Zwaan, 2006;Mueller et al., 2008). This is not so surprising: There are several reasons whytherapy with a homogeneous group effectively assists recovery from com-pulsive buying. First, the group setting diminishes feelings of aloneness andincreases feelings of being intuitively understood. This helps members bearthe overwhelming feelings of failure, guilt, pain, and humiliation that per-petuate compulsive-buying behavior. The feedback that group members getfrom each other helps members to correct distorted self-concepts, reframedysfunctional thoughts, and engage in fewer of the resulting maladaptivebehaviors. Group therapy also cuts through the denial of destructive behav-ior: Because group members know how compulsive buyers think, feel, andbehave, they can help to identify the defenses that are used to rationalizethe behavior and minimize the tendency to disown personal responsibilityand externalize blame. In a group, individuals can see people at many dif-ferent stages of recovery and know that others will be there to support themthrough the trials they will encounter along the way. In combination, thesefeatures of group therapy constitute a powerful rationale for using it withcompulsive shoppers.

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At least five different forms of group therapy have been developed forthis population since the late 1980s, each constituting a unique contributionto the field. The first detailed account of group therapy for compulsiveshopping was described by Janet Damon (1988), who included a relaxationexercise and guided visualization in each weekly session. Throughout the1990s, Leonard Brazer (2000) led outpatient treatment groups for peoplewith a variety of money disorders, including compulsive buying, for whichhe developed a weekly psychoeducational curriculum; Brazer also requiredhis group members to attend regular DA meetings. In the late 1990s, DavidParecki (2000) devised and co-led a group treatment program for compulsivebuyers at the California School of Professional Psychology; one feature of hissmall groups was the mutual exploration of members’ weekly journals. InSpain, psychologists at the University of Santiago de Compostela (Villarinoet al., 2001) conducted a group treatment for compulsive buying that taughtmedia literacy and employed in-vivo desensitization techniques to controlbuying impulses.

In 1993 at the University of Minnesota, James Mitchell and Melissa Bur-gard (Burgard & Mitchell, 2000) developed a cognitive-behavioral therapyprogram for compulsive buying that included homework assignments andrequired members to bring family and friends to one meeting. Mitchell andhis colleagues continue to practice the program, now at the NeuropsychiatricResearch Institute in Fargo, ND; a randomized control study of its efficacywill be discussed later. The same program is being used by Astrid Mueller, atErlangen University in Bavaria, Germany. She, too, has conducted empiricalresearch on its efficacy.

The overarching goal of treatment groups is the powerful awakeningof each group member to the reality of his or her buying behavior: itsextent, the context in which it occurs, and its emotional underpinnings. Ineach group, members learn about the internal and external triggers to theircompulsive buying and begin learning how to gain control of this behavior.Every group teaches skills and strategies: Some of the more common areplanning purchases in advance, delaying for a period of time before buying,not using credit cards, bringing a limited amount of cash or a debit cardwithout overdraft privileges, and engaging in nonbuying activities that meetthe underlying need that propels the buying impulse.

Other common features among compulsive shopping group-therapyprograms include the creation and use of a spending plan and the em-ployment of a buddy, either another group member or someone outsideit, with whom problem buyers can share their experiences as they developcontrol over their impulses. Almost all groups employ journal writing asa strategy for articulating feelings before, during, after buying—or aftersuccessfully resisting it. Cognitive-behavioral therapy groups use standardcognitive-behavioral methodology, in which the compulsive buyer learnsto recognize and restructure his or her dysfunctional thoughts. Relaxation

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techniques, experiential exercises, and visualizations are often includedwithin the sessions; all of these help compulsive buyers manage actualshopping experiences nondestructively. Nearly all groups include financialliteracy training, problem-solving skills, and lapse and relapse prevention.Some groups use the principles of DA, recite the Serenity Prayer, or readand discuss the 12 Steps.

Data from two of these groups have been published. Using measure-ments including Faber and O’Guinn’s (1992) Compulsive Buying Scale (CBS),the Yale-Brown Obsessive Compulsive Scale (Shopping Version; Y-BOCS-SV;Monahan, Black, & Gabel, 1995), and 4-week purchasing recalls (Mitchell,2010), Mitchell and colleagues (2006) compared the outcomes of a wait-list control group with an experimental group that received 12 sessions ofgroup cognitive-behavioral therapy during a period of 10 weeks. This studydemonstrated a significant improvement on the CBS, the Y-BOCS-SV, andthe purchasing recalls in the experimental group, both immediately and atfollow-up. By the end of treatment, 12 of the 48 participants reported com-plete remission within the previous 4 weeks; after a 6-month follow-up, morethan half the respondents reported a 4-week abstinence from compulsive-buying episodes. A similar study directed by Mueller et al. (2008) revealedsignificant improvement in a cognitive-behavioral therapy group for com-pulsive buyers—a significant reduction of compulsive-buying behavior thatwas well maintained during a 6-month follow-up, as measured by the CBS,the Y-BOCS-SV, and the German Compulsive Buying Scale (Raab, Neuner,Reisch, & Scherhorn, 2005; Valence et al., 1988), an adapted version of theCanadian Compulsive Buying Measurement Scale. Although the sample sizesof these studies were small, they are the first results to validate a treatmentfor compulsive buying as effective and lasting.

THE STOPPING OVERSHOPPING GROUP TREATMENT PROGRAM:STRUCTURE

The Stopping Overshopping Group Treatment Program is a comprehen-sive 12-week experience that draws from psychodynamic psychotherapy,cognitive-behavioral therapy, dialectical behavior therapy, motivational in-terviewing, mindfulness, and acceptance and commitment therapy. The pro-gram teaches specific skills, tools, and strategies to help group membersbreak the cycle that leads to compulsive buying and to develop the capacityto lead richer, fuller, more psychologically flexible lives in the process. Ap-proaching the problem from affective, cognitive, and behavioral standpoints,a wide range of techniques are employed to help each group member elim-inate self-defeating overshopping behavior and replace it with constructiveinterests, relationships, and competencies that are consistent with his or hercore values. Underpinning the entire program is the nonjudgmental stance

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of radical acceptance (Brach, 2003), which involves seeing one’s emotions,thoughts, and behaviors clearly and compassionately—essentially, noticingand allowing, not swallowing or wallowing, in whatever is present in thecurrent moment. This concept is paired with the development of mind-fulness, which involves bringing one’s complete attention to the presentmoment in a nonjudgmental way (Kabat-Zinn, 1994).

To be accepted into the group, the prospective group member mustbe aged 18 years or older and have a current problem with compulsivebuying, as measured by one or more of the compulsive-buying assessments.Group members need to have sufficient ego strength to do the considerableamount of work—often highly emotionally charged—that the group entails.Thus, all prospective group members are interviewed by telephone regardingtheir psychiatric history and substance use. The group is not appropriate forpeople who have current or past evidence of bipolar I disorder, psychoticillness, or active suicidal ideation. This intensive group is also not appropriatefor people who have met criteria for drug or alcohol dependence within thelast 6 months or for alcohol or drug abuse within the last month, as thesenegative behaviors could potentially increase in intensity.

The groups, which to date have not exceeded six people, meet for100 minutes, once a week for 12 weeks. Between 2005 and 2011, the firstauthor ran seven of these groups—three of them face-to-face in New YorkCity and the remaining four via conference call. The telephone format is aconsequence of the scarcity of targeted resources for this problem. Theseconference calls were held at the same time each week, and the telephonenumber and access code were the same throughout. We hope that the qualityand availability of group video conference calls improve enough to makethis a viable option in the near future.

As a preparatory screening, compulsive buyers were asked to com-plete the Faber and O’Guinn CBS (1992), the Valence CBS (Valence et al.),the Richmond CBS (Ridgway et al., 2008), a personal history and demo-graphic data questionnaire, and a 2-week purchasing recall form (Mitchellet al., 2006). To date, the three CBSs have been used exclusively for screen-ing purposes rather than for research, although empirical research to testthe efficacy of this model is forthcoming. The personal history question-naire asked about education, work, family, health history, social life, othersymptoms, and psychotherapy experience. It also asked prospective groupmembers about the history and nature of their overshopping problem. Thedemographic data questionnaire asked about income, use of credit cards,and debt. On the 2-week purchasing recall, the prospective group mem-ber listed any compulsive purchases made during the 2 weeks prior to thegroup starting. Completing these intake forms immediately increased peo-ple’s awareness of their overshopping behavior and gave the therapist impor-tant information to help him or her to get to know the group member morequickly.

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To Buy or Not to Buy: Why We Overshop and How to Stop (Benson, 2008)provides the content and basic structure of the work. Each individual receivesa copy of the book and two companion shopping journals. The larger journal,8.5 inches × 11 inches, is for semiextended narrative writing; the mini journal,3.5 inches × 5 inches, is for on-the-spot writing and reference and is meantto be carried in a purse or pocket. Group members read, construct lists,do narrative and structured writing exercises, monitor spending daily, andbring their journals to each session to share these assignments. They committo attending at least 9 of the 12 sessions, spending at least 30 minutesa day doing the reading and writing assignments, and completing a briefpurchasing recall each week about any overshopping episodes.

Each person is also encouraged to find and make use of the help of ashopping support buddy, someone from either inside or outside of the groupwho will be an advocate as he or she moves toward stopping overshopping.The exact form and nature of the relationship is determined by each specificdyad. It can involve any or all of the following: being available for telephonesupport, working on the journal writing together, being accountable to thebuddy for the weekly goal, revisiting what the overshopper has learned andobserved during the program, or accompanying the group member on actualshopping trips. An appendix in To Buy or Not to Buy: Why We Overshop andHow to Stop (Benson, 2008) offers shopping support buddies guidelines andtips for being helpful. A few group members have concurrently attendedDA or other 12-step meetings or have participated in online self-help groupsfor compulsive buying, which have sometimes augmented the group expe-rience. More often than not, however, compulsive buyers report that DAis largely composed of underearners whose presenting issues have seemeddifferent enough that the meetings have not proved very helpful.

Each group session is divided into four parts. The session begins with abrief meditation that includes offering “lovingkindness” to oneself and oth-ers, brightening the mind by summoning images of one’s good qualitiesand loved ones, and following the breath. Learning to follow the breathand observing one’s thoughts, feelings, and body sensations nonjudgmen-tally during that moment-to-moment process facilitates the development ofmindfulness by seeing clearly and accepting whatever is present. Offeringkindness to the self and to others facilitates the development of compassion.Next, there is a check-in with each of the group members about how theydid with individual goals for the week and about what, if any, overshop-ping they did. In the third part, each group member shares a few highlightsfrom their writing assignment for the week. Each session ends with a briefintroduction to the material for the coming week.

Committing to a specific, measurable, realizable goal each week pro-vides opportunities for repeated and reinforcing experiences of success.Once the group member chooses a goal, he or she posts it in the form ofa motivational interview, which incorporates the importance ruler technique

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(Miller & Rollnick, 2002), to a password-protected online Yahoo group thathas been created for them. Typical weekly goals include: not going into aparticular store or onto TV shopping channels, limiting browsing time on theInternet, unsubscribing from particular online retail sites, and cleaning outand organizing a portion of a closet or a dresser. For compulsive returners,resisting the impulse to return any previously purchased item is a typicalweekly goal.

Group members also use the Yahoo group to share with each other andthe therapist during the week, as there is limited time to do this during thestructured and content-rich sessions. Sometimes assignments are posted ifthere is not time to discuss it in the group. More often, individual membersuse the Yahoo group to share information, triumphs, and difficulties and tosupport one another. Sometimes group members call each other during theweek.

After each session, the therapist posts a debriefing note to the Yahoogroup to recap such things as how group members did with weekly goalsand what critical points arose during the session, and to remind them ofthe next week’s assignment. This reinforces the session, gives each memberpersonal attention related to his or her progress, and forms a bridge to thenext session.

THE STOPPING OVERSHOPPING GROUP TREATMENT PROGRAM:CONTENT

During the first half of the telecoaching group, we place emphasis on goalsthat are immediate and concrete. Members look at why they overshop, andthey examine the triggers and emotional, social, and financial consequencesof their behavior. Along the way, they acquire techniques and strategiesto rein in their overbuying. In the second half, our focus broadens anddeepens. Group members look at overshopping in a cultural context andexperience, firsthand, how embracing self-acceptance can foster and facilitatechange. They begin to enlist body, heart, mind, and soul in the struggle forperspective and balance. What stays constant between the two halves is thecontinuing acquisition of effective techniques and strategies.

In the first reading and writing assignments, group members explorewhy they overshop and how it all began. They write a short narrative aboutthe function of the behavior in their lives, and they complete a shoppingautobiography (McCall, 2002), answering questions about early family, peer,community, and media influences and how they learned to use money. Asentence completion exercise integrates all this material, tying together howit all began, where it led them, and how they see it now. Group membersrespond to prompts about what they saw in childhood, as a teen, and asa young adult, what messages they picked up, how that related to their

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overshopping, what they now realize, and how that realization will helpthem stop overshopping. This foundational work sets the stage for practi-cal exercises, which are utilized throughout the remainder of the program.Strong emotions often surface during this exploration, and group membersare encouraged to take this on only in manageable doses and to take breaksfrom thinking and writing if they stir up too many uncomfortable or painfulemotions. Group members are also encouraged to use the Yahoo group toshare their experience and to get support.

Next, group members examine what triggers their particular overshop-ping behavior and what the consequences or aftershocks are. They readabout common triggers—situational, cognitive, interpersonal, emotional, andphysical—and then create personal lists. Then they look at common finan-cial, emotional, occupational, and spiritual consequences of overshopping,as well as its consequences to body, living space, and personal develop-ment, and they enter this personal list into their mini journal. Finally, thetwo exercises are synthesized, woven into a personal shopping story thatlinks a trigger, the resultant overshopping behavior, and its consequences.

Members now begin to record their shopping urges in their mini journal.They begin to examine them by answering three key questions: (1) How doesyour body know you want to shop?; (2) What negative or positive thoughts,feelings, images, or memories go along with the urge?; and (3) What doyou think is triggering your overshopping? They continue to build upon thispractice throughout the program.

Simultaneously, they begin to explore their vision of their lives, whichenhances motivation for change. Through the exercise “How Do You Wantto Be Remembered?” (Hayes, 2005), group members give some thought tothe direction they want their lives to take and explore whether overshoppingfits in with that direction. In a recent group, members have concretized thisvision by constructing a dream board, a graphic representation consisting ofpictures and text, of desired ideas, experiences, goods, and services. At thispoint in the program, when members are beginning to question the long-term efficacy of their shopping behavior, they formalize the pros and consof their overshopping by completing an exercise at home, the decisionalbalance matrix. This involves carefully thinking through and then itemizingthe short-and long-term costs and benefits of both stopping overshoppingand of continuing to overshop (Miller & Rollnick, 2002). Completing thematrix helps participants to persuade themselves, on the straightforwardevidence of their own listing, of how profoundly the long-term benefitsof stopping outweigh the short-term benefits of continuing. It also helpsto prepare them for the inner temper tantrum that sometimes comes withabsorbing the short-term costs of stopping.

Once group members have explored their ambivalence about overshop-ping, another piece is added to the self-inquiry practice. Now, the three keyquestions mentioned earlier are augmented with four more: (4) What is my

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heart saying?; (5) What would be good about shopping?; (6) What is my headsaying?; and (7) What would be not so good about shopping? It is importantto note that in the context of these questions, the heart is the unbridled,pleasure-seeking part subject to the strong impulses of desire, whereas thehead is the rational, conscientious part that strives to control such impulses.Answering these questions not only promotes greater awareness, but alsocreates temporal, experimental space between the urge and the shoppingaction—a vitally important aid in gaining a foothold on impulses.

Addictive consumption can be likened to a perpetual itch (Chodron,2005), flaring up and moderating, but always there. To overcome it, groupmembers are introduced to a process of four Rs that help them unhook fromtheir urges: Recognizing the itch, Resisting the impulse to scratch, Relaxinginto the underlying feelings they were trying to get away from, and Resolvingto continue interrupting their habitual patterns. By consistently practicing thefour Rs, they learn experientially that resisting an urge eventually causes itto recede or go away.

Group members now extend their self-learning by painting their uniqueshopping self-portrait, which is accomplished in three separate but relatedexercises. The Shopping Patterns Checklist is the initial pencil-sketch stageof the portrait, created by assembling information as to when, where, withwhom, and for whom they shop, as well as what is bought and what they tellthemselves about why they are buying. Using a guided visualization, groupmembers revisit a specific purchase they made and later regretted. Because itis sensory rather than analytic, the visualization brings color and immediacyto the portrait. These two perspectives on overshopping are then connectedin a series of questions about the relationship between buyer and purchase.

An overarching goal of the program is to learn to live by skillfulmeans: to live one’s financial life mindfully and with utmost conscious-ness, achieved through a thorough examination of expenditures, goals, andvalue and their relationships to each other. The financial literacy part ofthe program—recognizing the centrality of savings, grasping the appallingcost of credit card debt, recording, categorizing, and evaluating every ex-penditure as to its relative necessity (which they now do for the rest of theprogram)—points the way to developing skillful means.

“You can never get enough of what you don’t really need” succinctlydescribes why overshopping is a misguided and doomed attempt to satisfyunderlying psychological needs and issues. At this point in the group, mem-bers investigate what it is they are really shopping for. First, they identify theauthentic underlying needs that currently ignite their impulses and propelthem into overshopping—such needs may be emotional, social, spiritual, orsome combination of these—and then they brainstorm tailor-made alterna-tives to meet those needs more directly and more positively. There is no one-size-fits-all approach. They look at ways to put acts of self-care, self-kindness,and self-respect into their lives—one more ingredient in the recipe they are

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creating for a better life. They also identify their dominant character strengthsby taking the Values in Action Signature Strength Survey (Peterson & Selig-man, 2004) and then consider how they can harness these signature strengthsto help them stop overshopping.

Although a goal of the program is to completely abstain from mindlessor compulsive buying, we all need to do some shopping. Not only do wehave to supply ourselves with necessary goods and services, but we alsosometimes purchase from a posture of wanting as opposed to needing,and group members have to learn to handle the hype, manipulation, andpressure coming at them from all sides. This is the place in the programwhere they are exposed to specific techniques for staying centered, clear,and focused, specifically targeted to each of the six major shopping magnets:malls and standalone stores, Internet shopping, TV commercials, magazines,catalog shopping, and TV shopping channels. They also learn more generaltechniques to help them identify, avoid, and deflect the various sources ofsocial pressure to consume, such as family, friends, sales associates, and theculture at large.

As they near the point of purchase, they are vulnerable to being dis-armed; shopping at a mall, on the Internet, or even from a catalog is almostguaranteed to stir up feelings. To counter this, we teach mindful shopping,shopping with a specific and very particular kind of plan. Prospective shop-pers carefully specify the following: the item(s) they intend to purchase, thepurpose of each, and the maximum amount they can afford and are willingto pay; when, where, with/for whom, and how long they will shop; howthey will pay for the purchase(s); and the risk for overshopping with theplan. If the risk is greater than 30%, they are asked, with the group’s help,to brainstorm a plan that provides more stability.

The time they have taken to think about and write down a purchasingplan constitutes one of several opportunities to slow down and mindfullyconsider a purchase. Another opportunity comes after they have found anitem that they want to purchase but before they have paid for it. This iswhen they learn to take a mindful pause, a short break during which theyask themselves and answer, preferably, in writing, six questions: (1) Why amI here?; (2) How do I feel?; (3) Do I need this?; (4) What if I wait?; (5) Howwill I pay for it?; and (6) Where will I put it?

This valuable pause costs nothing. It serves as a buffer between the urgeand the action: In that psychological space, the voice of the wiser side cancounter the shouts of the addicted side. The mindful pause interrupts theautomatic buying response and provides group members with the aware-ness that they have a choice: to buy or not to buy. Creating a plan, takinga mindful pause, and reviewing the plan after they have shopped requires agood deal of restraint, and group members are encouraged to reinforce theirprogress, first by acknowledging and affirming it (Mundis, 2003) and then byrewarding themselves with pleasurable activities, either free or affordable,

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that function both as acts of self-care and tailor-made alternatives toshopping.

Armed at this point, approximately 8 weeks into the 12-week group,with a myriad of practical skills, tools, and strategies, we focus now oncultivating four central resources of every overshopper—body, heart, mind,and soul—looking specifically at the way that each can direct (or misdirect)us in the struggle against compulsive shopping. Starting with the oft-ignoredwisdom of the body, often the first responder to overshopping urges, groupmembers practice noticing body sensations to clue themselves in to shoppingimpulses in statu nascendi and reduce their intensity.

The heart speaks the language of feelings, with an emotional alphabetthat ranges all the way from aching to zealous and an infinite range of shadesin between. Because many overshoppers have been taught to repress, deny,or distrust feelings and to mask, hide, or disregard them, they often expressthese feelings through their self-defeating buying behavior. Developing flu-ency in the language of the heart is best done by paying close attention to itsnuances. Although finding the right word to express a feeling can be diffi-cult, sifting through the various shades of an emotional spectrum can providemore useful information than an all-purpose angry or sad. Often, the pro-cess of naming an emotion will help people make connections between thatfeeling and important issues and events in their life, connections that leadthem to the discovery of an underlying need. Although group members havealready collected a significant amount of information about their emotionsin their shopping journal, they are now asked to focus on their feelings evenmore closely to refine their emotional vocabulary. The more precise theycan be about what they feel, the easier it will be both to understand what isbehind their behavior and to change it.

An additional route to the language of the heart that we use is a decep-tively simple yet extraordinarily powerful technique designed to cut throughthe armor that many of us wear over our emotions. Developed by OliviaMellan (1994), the money dialogue is a conversation that someone conductsbetween himself or herself and money, which is then commented upon bythe person’s mother, father, any significant other, and the person’s higherpower or inner wisdom. It was initially designed to help people gain agreater awareness of their relationship with money and to see how the atti-tudes of the significant people in their lives have affected that relationship. Inrecent years, Mellan and her students have expanded the concept and nowregularly ask clients to dialogue with their credit cards, jewelry, or CD col-lection: anything, in short, that they either use for overshopping or overshopfor. This exercise, which is done as homework, is often extremely powerfulwhen shared with the group and serves to crack open the code that hasbeen obfuscating the nature of the relationship with the particular object.The exercise reveals the symbolic significance of the object to the over-shopper and evokes the imagined reaction that the client’s mother, father,

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significant other, and higher power (or inner wisdom) might have to thedialogue. Through this, clients discover what is keeping them stuck in thatrelationship with the object. Often, they are profoundly affected and moti-vated to pry themselves loose from the object’s grip.

Next we turn to the mind and soul. First, to access the language ofthe mind, we focus on the mind’s subtlety and examine its unhealthydistortions, discovering how early, unexamined messages can powerfullyshape our present feelings and behavior. This is achieved by introducinggroup members to the concepts of core beliefs, underlying assumptions,and distorted thoughts and the relationships among them. They then surveyvarious forms of distorted thinking and learn a technique for challengingthose distorted thoughts (Beck, 1995). Finally, we tackle the soul, the birth-place of transcendence, whether aesthetic, philosophical, or religious, andlearn how it can balance and lighten the weight of the desire for mate-rial things. To help group members access the language of the soul, weintroduce them to the strengths of transcendence and try to foster thesestrengths, which include spirituality, appreciation of beauty and excellence,gratitude, hope, and humor. Each of these “allows individuals to forge con-nections to the larger universe and thereby provide meaning to their lives”(Peterson & Seligman, 2004, p. 519). Group members explore their spiritu-ality by responding to questions that help them identify their spiritual needsand hungers and then by thinking about ways to meet those needs and sat-isfy those hungers. Connecting with the blessings in their lives, they create agratitude list. A final exercise in this section of the program recruits the soulto the service of stopping overshopping; group members tune in to theirexperience on a moment-by-moment basis through the practice of sittingmeditation.

“What if I start again?” is an oft-expressed concern as the end of groupapproaches. The final set of tools that members add to their toolboxes is foranticipating and managing lapses and relapses: how to prevent them, how toprepare for the possibility that they can and will occur, and how to positiononeself to learn from any lapse or relapse. First, we discuss some triggeringsituations commonly associated with lapse and relapse, and group memberscreate their own lists of potential triggers (Mitchell, 2011). We discuss whatto do if these triggers cannot be avoided and learn techniques to help themnip a lapse in the bud. Group members do two experiments, the mental anddress rehearsal, both of which fortify them against lapses by preparing themfor a high-risk situation from which they emerge triumphant, without a sin-gle purchase. In the mental rehearsal (Villarino et al., 2001), group memberschoose a triggering situation from their list and take themselves through, inpainstaking mental detail, what it will be like to experience this situationand actually resist making a purchase. Then, in a dress rehearsal exercise,each group member actually puts himself or herself into this triggering sit-uation and commits to exiting from it without purchasing anything. Finally,

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the group learns a technique for planning for any upcoming high-risk situa-tion, the lapse and relapse prevention plan (Mitchell, 2011). To successfullyemploy this comprehensive strategy, they need to revisit and reuse all of themajor tools and skills they have acquired during the prior 12 weeks.

As they arrive at the final leg of what has been a long and arduousjourney, we leave them with a few notions for expanding their present andfuture happiness. First, we demonstrate that shop is not a four-letter word:When done mindfully, focusing more of their attention on ideas and ex-periences, less on goods and services, shopping can be both positive andproductive. Then we explore the question of “How much is enough?,” shar-ing personal anecdotes and ancient and contemporary wisdom that suggeststhat enough makes life rich, too much leans toward misery, and less is quiteoften more. We introduce the concept of “true wealth” (Hwochinsky, 1992),built by leveraging those nonfinancial assets, different for each person, thatinvigorate and vitalize: talents, hobbies, close connections with other peopleand animals, and communion with nature. A second lifestyle idea, volun-tary simplicity (Andrews, 2000), is a movement that encourages people toredefine the good life, to seek lives outwardly simple and inwardly rich. Athird stance toward life, wabi sabi (Powell, 2005), is an integral part of tra-ditional Japanese culture that values rustic simplicity—freshness, quietness,and understated elegance—and accepts and embraces the patina that comeswith age. Each of these stances is a way of looking at and living life beyondthe incessant gravity of consumerism and can anchor the work that theyhave done in the group. In one final written exercise, which they share withthe group, the members reflect on their experience during the previous 12weeks and distill their experience of the program to its essence.

CONCLUSION

Affluenza, aspendicitis, luxury fever—these often-used, tongue-in-cheek dis-ease names for our modern American plague of materialism and overcon-sumption reflect how compulsive buying is trivialized by our culture. Aserious discussion of social factors and costs, of how to craft public (andprivate) policies and remedies to mitigate it, feels like swimming against ariptide. Yet the costs of this “smiled-upon” addiction are enormous, whetherto individuals, to families, or to the culture at large. Group therapy as ahealing modality that reduces isolation offers ongoing support, and posi-tive peer pressure holds much promise, as suggested by the positive re-sults of two outcome studies of cognitive-behavioral therapy groups withcompulsive buyers. The group model described in this article, while includ-ing certain cognitive-behavioral therapy tools and skills, also draws uponpsychodynamic psychotherapy, dialectical behavior therapy, mindfulness,motivational interviewing, and acceptance and commitment therapy. The

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program focuses on intrinsic values, on making time for mindful, mean-ingful engagement with self, with others, and the community; it fosters theacquisition of ideas and experiences rather than goods and services. Anecdo-tal data, the group members’ subjective experiences, and a reduction in debtlevel noted during the course of these groups all suggest that the presentmodel works: it leads to both a significant reduction in overshopping anda meaningful increase in quality of life. We plan to test the efficacy of thismodel with rigorous empirical research in accordance with the highest ethicalstandards in the coming years.

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