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Last login: Saturday, April 3, 2010
NorthParker: The best and most effective treatment for hoarding does NOT involve any medication whatsoever, and has no invasive element. Hoarding is an anxiety disorder that causes a deficiency in the brain's executive function. Ironically, most hoarders are perfectionists, and the hoarding develops because they are overly-anxious about making a mistake and discarding something that turns out to be useful or valuable. Their brain is unable to grasp that just because they can think of some remote, even absurd use for an item, it does not mean they are responsible for the item being used in that way. ("I can repair this cooking pot that has no handles, no lid, is all dented and warped, and then someone can use it.") They also worry about putting something away in the "wrong" place. Of course, there is no absolute right or wrong place to put things away, but the hoarder doesn't know that. The hoarder frets about where to put something, so much so that she becomes overwhelmed and unable to make a decision at all about it. So she puts the item down, anywhere, but believes she will get back to it and put it away "someday" as soon as she figures out the best place to put it. ~~ The treatment that is most effective and non-invasive is cognitive behavior therapy, in the form of exposure and response prevention. The hoarder can do this on his or her own, though it is best to have the treatment tailored to the hoarder's particular situation. The basic concept, WAY oversimplified, is for the hoarder to intentionally expose herself to the situation that causes anxiety, such as discarding something or putting something away where she cannot see it. At first the exposure will be dreadful and almost impossible, or even impossible, for the hoarder to tolerate, but after going through the process for a period of time, the anxiety starts to go away, little by little. Eventually the hoarder is able to tolerate the anxiety of making a mistake, and gain regain her functioning in the world. ~~ The treatment process is about the brain, not the stuff. If the focus is on decluttering the stuff, like the TV shows, then the hoarder's brain remains cluttered with its irrational thoughts and the clutter will build up again, because nothing has affected the disordered thought process. The focus must be on the brain, on the cognitive aspect of the treatment.
April 3, 2010 at 12:49 p.m.
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