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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
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¡ 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
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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
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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
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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.
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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
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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
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¡ 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! ���������