Top 25 List: August 2012

Here's a snapshot of the best reads for the month.

Why It’s Hard to Let Go of Clutter

A new brain imaging study finds that letting go is literally painful.

Have you ever been overwhelmed by a junk drawer, closet, packed garage, or pile of paperwork —but found it hard to just throw everything out?

A new study finds that for many, letting go is literally painful.

Researchers at the Yale School of Medicine recruited both non-hoarders and hoarders, and then asked them to sort through items like junk mail and old newspapers. Some of the items belonged to the experimenter, and some actually belonged to the participant. Participants had to decide what to keep and what to toss. While this was happening, researchers tracked their brain activity.

Unlike non-hoarders, hoarders showed increased activity in two regions of the brain when confronted with their own junk. Those two areas: the anterior cingulate cortex and the insula. And the more a hoarder reported feeling “not right” about throwing something out, the stronger this pattern of activation was.

When I read this very specific finding, I had an instant feeling of recognition. I know that neural signature. Both are these regions of the brain are associated with conflict and pain—and you see the same pattern of brain activation in other forms of psychological pain.

For example, the same regions produce gut-wrenching cravings among smokers or drug addicts trying to quit. The stronger the activation, the stronger the feeling of anxiety, discomfort, and need to use.

You also see the same brain pattern among shoppers hit with sticker shock. The pain of high prices provides a physical incentive to resist a purchase [see previous blog post], and you can predict whether or not someone will buy something by the strength of this brain pattern.

Perhaps the simplest way to think about the ACC-insula combo is that it creates the signal of “something wrong.” The brain circuit motivates you to look for an opportunity to prevent harm or relieve anxiety—so smokers smoke, shoppers put down the pricey item, and hoarders hold on to junk.

Interestingly, people who suffer from obsessive-compulsive disorder appear to have a very low threshold for tripping this brain circuit. The obsessions and compulsions are a response to the “something wrong” brain signal. Even though the signal may be a faulty habit of the brain, the mind searches for something to explain the feeling. That’s how people with OCD can settle on irrational beliefs and behaviors. If they wash their hands, or touch a wall three times, or repeat a mental mantra, they seem to “prevent” whatever harm their brain was expecting (but was never really coming). This reinforces the compulsions and makes them even harder to resist.

The same process may explain why hoarding is self-sustaining. Each time a hoarder holds on to something, he or she may feel safer and calmer. That relief can become addictive.

Previous research has found that hoarders also show greater activation in the ventromedial prefrontal cortex (vmPFC) when thinking about whether to throw something out. The vmPFC is associated with many mental experiences, but two seem particularly relevant to hoarding.

The vmPFC is the home of what I call “wantpower”—the belief that something is relevant to your goals and desires. Research has shown that greater activation of the vmPFC will predict whether someone will buy, eat, or do something. Hoarders often do feel an irrational conviction that something old and useless could have potential value in the future. The idea that they might need something, but have gotten rid of it, is painful.

But the vmPFC is also important for maintaining a sense “me”-ness. Greater activity in the vmPFC may suggest a greater sense of personal relevance and meaning. So perhaps hoarders look at something as simple as a piece of junk mail and feel it connected to their sense of self. That letter is "me"; that old chotzke is "me"; that pile of papers is "me." This would explain why getting rid of something would be painful—it’s like throwing out your own arm.

You don’t have to be a hoarder or have OCD to know what this feels like, whether it’s a favorite old sweatshirt, a gift you’ve never used but can’t bear to throw out, or every drawing, craft, and school assignment from when your kids were in grade school.

[Full disclosure: I seem to have the opposite brain reaction when it comes to junk and clutter. I love throwing things out, and find it at least, if not more, fun than acquiring things. It's almost a high to be able to say "I don't need this anymore!" I've had to train myself to hold on to things that I'll be nostalgic for in the future, like cards from family and other mementos.]

Whatever your willpower challenges—clutter, cravings, compulsions—there's something to learn  from these studies of extreme cases.

As I argue all the time, mindfulness of our own brain habits seems to give us more control over our choices. The technique of surfing the urge (read more about it here), which helps addicts resist cravings and dieters resist temptation, may also help us deal with anxiety about getting rid of clutter. And taking a more skeptical view of our own impulses (not believing every worry, emotion, or “want”) can help us distinguish between our actual strength and the brains lies’ (“this will make you happy,” “this will protect you from your anxiety” or “you can’t handle this feeling, you HAVE to give in.”)

Studies:

1. Tolin DF et al (2012). Neural mechanisms of decision making in hoarding disorder. Archives of General Psychiatry, 69, 832-841.

2. An SK et al (2009). To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder. Molecular Psychiatry, 14, 318–331.

Kelly McGonigal is a psychologist at Stanford University. Her latest book is The Willpower Instinct: How Self-Control Works, Why It Matters, and What You Can Do to Get More of It. She is also the author of Yoga for Pain Relief and The Neuroscience of Change.

Follow Kelly on Twitter: http://twitter.com/kellymcgonigal or on Facebook: http://www.facebook.com/kellymcgonigalauthor

Teaser photo credit: http://www.flickr.com/photos/sirexkat/2216497536/ (used under creative commons license).

Top 25 List: August 2012