The Bonnies talk about hoarding with Dr. David Tolin, a clinician and researcher who has worked extensively in this area. They begin by distinguishing hoarding disorder from ordinary messiness or collecting, and note that hoarding is characterized by difficulty discarding items, strong attachment to possessions, and often excessive acquisition.

They talk about how hoarding develops over time, including early onset in childhood or adolescence, and how stress or major life changes can make symptoms worse. Also, genetic factors and the idea that hoarding can run in families, while still requiring attention to behavior and environment.

They then focus on treatment. Dr. Tolin explains that hoarding is not the same as OCD, even though it has often been grouped with obsessive compulsive disorders. He describes current treatment approaches that emphasize decision-making training, problem-solving, distress tolerance, cognitive questioning, and motivational interviewing rather than simply forcing the person to throw things away.

They also discuss the importance of insight and motivation, since many people with hoarding disorder do not initially see themselves as having a problem and how clinicians can use Socratic questions to help people examine what their possessions mean to them and whether keeping them fits their values.

Finally, they address family concerns, childhood hoarding behaviors, and the limits of medication research noting that there are no randomized controlled trials of medication for hoarding disorder, though some open trials have suggested possible benefit from certain medications.

HIGHLIGHTS:

1:05 Clutter Versus Hoarding

4:21 The Fire Changed Everything

7:44 Meet Dr. David Tolin

8:38 Hoarding Is Not OCD

11:24 Defining Hoarding Disorder

15:32 Trauma, Stress, and Risk

18:56 Rethinking Treatment Goals

21:26 Therapy for Hoarding

27:47 Time, Values, and Insight

35:06 Health Hazards and Questions

36:21 A Severe Hoarding Case

39:26 Medication Evidence

41:38 Pediatric Hoarding Concerns

45:23 Insight and Self-Referral

connect with Dr. David Tolin

website: https://drtolin.com

CONNECT WITH THE BONNIE ZUCKERS:

Bonnie Zucker Ph.D.(west)

website: https://www.bonniezuckerphd.com

Newsletter sign-up: https://bonnie-zucker-ph-d.kit.com/d44b57fcdf

Books by Bonnie West: https://a.co/d/04aNJFDZ

Bonnie Zucker Psy.D. (east)

website: https://www.bonniezuckerandassociates.com

Books by Bonnie East: https://shorturl.at/MxvRZ

The content of Anxiety Matters Podcast is for informational purposes only and does not constitute mental health or medical advice, nor is it a substitute for professional mental health or medical advice, diagnosis, or treatment. If you are experiencing a mental health crisis, call emergency services or a local crisis line.