When More Isn't Enough

Help for hoarders.

Part 1: What Happens When the Camera Stops Rolling?

Ever wonder what therapy is about for participants on hoarding reality shows?

Dr. D.J. Moran, a recognized expert in Acceptance and Commitment Therapy, was on TLC's Hoarding: Buried Alive on April 16th and 17th. The episode entitled "Overwhelming Pile of Junk" featured a woman named Debbie who has accumulated materials and clutter that ultimately resulted in the alienation of her family. (Visit here for a schedule of when it will be rebroadcasted.)
The show did a nice job of profiling the severity of Debbie's hoarding behavior and follow up to treatment... but viewers often wonder what professionals do to help folks dealing with issues like hoarding. What happens when the camera stops rolling and therapy begins? How does treatment work?

I wasn't privy to any of the details of the case, but I know that Dr. D.J. typically uses behavior therapy and Acceptance and Commitment Therapy with the people he helps. In Acceptance and Commitment Therapy (usually pronounced ‘ACT'), people are asked to clarify what is important to them - to really get in touch with their values. And then they are asked to explain what private events (fears, anxieties, emotions, and sensations) come up when they try to live according to their values.

It turns out that people like to avoid feeling certain emotions. It seems we are taught fairly early on in life that we should feel happy all the time. We're taught to control our emotions... to make sure we don't feel unpleasant feelings or else something bad will happen. ACT therapists call that Experiential Avoidance. Have you ever heard anyone say to their child: "Stop crying or I'll give you something to cry about?" Isn't that giving the message that the feelings of sadness or pain should be ceased, or else another punishment was impending? That people should avoid certain natural experiences?

ACT asks people to get in touch with that, and challenges people to simply have their own feelings. Try to really let that resonate with you as you read this: It is OK to feel the way you feel. You don't have to try to change your feelings. Your behavior might need to change in order to live in a valued-direction life... but you don't have to change the way you feel. You can simply notice the emotion, the sadness, the nervousness... and proceed to do the important actions anyway!

Notice a few things that Debbie said on her episode of Hoarding: Buried Alive:
Debbie: "I don't spend a lot of time in the house... the quicker I can get out of the house the better. I don't want to dilly dally there because the house makes me feel bad."

Debbie: "I sometimes just want to block it out. I'll just put my mind elsewhere and imagine that this isn't my house I don't really live here. Or I'll just shut my eyes and think someday this will go away. Someday life will be better."

Can you see how those phrases are experientially avoidant? In an effort not to feel certain things, she chooses to live her life in a way that led to the accumulation of the materials in her house. An ACT therapist would invite Debbie to simply notice the house makes her "feel bad" and in the presence of bad feelings, she can still remain in the house. It is the escaping from her feelings that contributes to escaping from the house. And the less she is in the house, the less time there is for organizing it.
Living life the way you truly desire is provocative.

If you want to do certain things in your life that you believe are important, guess what? You'll get nervous, frustrated, tired, and sad. It's when those emotions are something to be avoided that you will find yourself doing things other than what is important to you... because they are easier, and have no emotional value... but is that what you really want to do?

The author and this blog are not affiliated with Discovery Studios.

Jennifer Patterson is a psychologist with expertise in compulsive behaviors.

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