Hoarding Disorder: Diagnosis, Treatment, and Misconceptions

Welcome to the Anxiety Society Podcast.

We're your hosts, Dr.

Elizabeth Mackinbell and.

Callie Werner, both therapists and individuals that have navigated our own anxiety journeys.

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We are here to push boundaries, challenge the status quo, and deep dive into topics that are sure to make you uncomfortable.

If you're ready to step outside of your comfort zone and explore the unfiltered truth that will help you change your entire relationship with anxiety and get back to living your life by, you're in the right place.

This is the Anxiety Society Podcast.

We live it, we contribute to it, and together we can change it.

And there's one thing that I need from you.

Can you come through?

Welcome back to the Anxiety Society Podcast.

Today we have a special guest, Jelani Daniel, a friend and clinician in the field, and we're going to be discussing hoarding, which is something that I am no expert in.

So I'm so excited to just catch up with you, Jelani, because we haven't talked in forever, but then also just to learn from your wisdom, you have to bring to us about hoarding disorder.

Yes.

I'm very happy to be here, very happy to be able to talk about this topic because it's not something that is often talked about, and certainly much more help and information is needed.

Yeah.

Thank you for having me.

Of course.

More anytime.

We would love to have you, but before we do that, I know I gave you a little precursor that we start with an anxious moment.

And so to give you a moment to think about yours, maybe that actually probably isn't helpful because it just builds up more anticipation.

Uh, but I'll go first.

And I think mine is I'm really trying to meet this deadline for that I put on myself for my dissertation because I think I would just work on it forever if I didn't do that.

And I want to be done with my PhD program, but I'm really struggling to find the time to do it.

And it's challenging because I get home at the end of the day, and people are like, just write for 30 minutes.

And I'm more of a like, no, I need four hours to sit and do that.

But, like, where do I find the four hours?

And so I just know I have all this work to do.

But the anti anticipation just keeps building because I haven't been able to touch it or do it.

And so that's my anxious moment.

What about yours?

Well, I can strongly relate to that as writing is a significant struggle of mine.

But my biggest anxious moment, at least for this week, I have two.

One being this podcast and that public speaking actually is the biggest trigger of anxiety for me has has long been that, but it's much better now after working on it over the years.

The other anxious moment though, is potty training my toddler utilizing the diaperless method.

So ye.

But it's been successful.

It's been surprisingly successful.

So in the end the anxiety diminished quite a bit because she is now much better.

I can't imagine.

I mean, I know it's like horrible to be that person that says, well, I only have dogs and I can relate even though I really can't.

But yeah, I have these two puppies at my house.

We're trying to find homes for now and I just find myself chasing them around.

Like, when are you gonna go next?

Let me make sure I get you outside.

So with a toddler, I can't even imagine.

But yeah, it's not.

And the accidents weren't going around the.

House, but yeah, yeah, well.

And then also with the public speaking piece, that surprises me, but I guess it also doesn't because you are an ERP therapist, exposure therapist.

Because I see you like signing up for talks at conferences and public speaking often.

And so it's a surprising anxious moment.

Those are all my exposures.

Personal exposures.

See listeners, we do our exposure work too, not just recommend it for others.

Well, Jelani, I'm gonna go ahead and introduce you to our listeners and then we will dive right into today's content.

Okay.

Jelani Daniel is a licensed professional counselor who has recently become a full time staff clinician at Psychology Houston.

He has 20 years of experience involved in the treatment of patients with anxiety, OCD and related disorders while working at various OCD clinics including the Meninger Clinic, Baylor College of Medicine, and the OCD Institute.

He also moderates a bi weekly hoarding and clutter support group that is virtual and free to the public.

Ooh, where do people sign up for that?

So you can go to Houston ocdsupport.org It's a website that was recently created.

Dr.

Hart, Dr.

John Hart and myself as well as some other people who are part of that project.

And so yeah, they can go there and be able to reach me and I can provide them information and to get them to be a part of the group.

Excellent.

That's such a great resource and something that I know has been valuable in your life forever.

Because when I was still just like a wee little lass, I remember my first public speaking opportunities were joining you and Dr.

Hart at the OCD support group, where we all sat around a roundtable, and I was so nervous.

Oh, me too.

I was, too.

You were not alone.

I was.

We've come so far.

We've come so far.

Yes, that's right.

Okay.

Well, the reason I can't wait to kind of dive into this topic is because I think with hoarding, it seems so far removed from so many people's lives, but really, in a lot of ways, it's right under our noses when we get to the nitty gritty of what hoarding disorder includes.

Right.

Because people often think, what is.

What is the show?

Hoarders.

Is that what it's called?

Yeah, there are multiple shows.

That's one of them, I think.

Hoarders Buried Alive or Hoarding Buried alive, something like that.

Yeah.

At least two or three of them.

Right.

Which you think of these extreme cases all the time, which definitely are out there, but that's not always the case.

And hoarding can look a lot of different ways.

And so I feel like whether our listeners are struggling with this, know someone that's struggling with this, something about today's episode will be relatable.

Yes.

So let's dive right in.

What would you say defines or destitutes hoarding disorder?

Hoarding disorders.

I guess if we look at it in terms of the DSM criteria, hoarding is defined as persistent difficulty in discarding possessions regardless of value.

And that's often a misconception in that people feel as though in the past it was seen as people who struggle with hoarding only struggle garbage or trash.

And that's not true.

At least we see that that's no longer really the case and that individuals may hoard items that could be unused and brand new.

So it's not trash, and it could be very high value items as well.

Right.

So we have that first criterion.

It's persistent difficulty discarding possessions.

The second one being, you know, this difficulty is due to perceived need to.

To save the items and the stress related to that.

The third criterion is then the accumulation of these items that leads to the clutter.

And that's the, you know, the big issue.

Right.

And the clutter is it's important to know that the clutter is of active living spaces.

So if someone has Say a garage or a shed or a storage unit that is cluttered.

That is not considered hoarding disorder.

Right.

It's if it prevents one from being able to utilize their active living spaces for their intentional purposes.

Okay.

I was going to ask a question about that too, because I wondered, like, in today's digital age, if there's.

If someone can be defined as a hoarder, if they, like, are saving a lot of digital things on their computer system or their photo library, would that be a characteristic of hoarding or.

No.

So it's a good question.

And that's something that is, I think, being looked at and talked about a bit more this day and age.

You know, in terms of digital hoarding, there is no, you know, like, DSM disorder in relation.

In relation to digital hoarding.

And I think, because at least right now, it's not something that, again, interferes with someone's ability to live.

Right.

So it's not causing that dysfunction in terms of like, say, like social psychological dysfunction or impairment in, like, social, occupational, or other ways of life.

Now, it may cause their devices to be a bit more difficult to use.

Maybe a lot of times you may have individuals who not only may have cluttered, like, you know, phone and, I don't know, music or whatever, images and stuff on their devices, but their email, their, you know, inboxes may be completely full, not able to receive any emails, things like that.

So.

So that could produce some impairment, but not usually to the state of where it's causing significant distress or just, you know, that we would define as a disorder.

But it's something that's still being, I think, looked into more in this day and age?

Got it.

That makes a lot of sense.

And then what about just the impact that hoarding has on the individual and the family members with, you know, psychological impact, social lives?

What are some of the.

The key things you see so much.

So for the individual now, it depends because sometimes part of what also goes along with the diagnosis is whether or not or how much insight a person has we can have.

You know, people can have varying levels of insight, you know, from being very insightful to being very absent and having no insight at all and not seeing it as a problem.

Right.

Those individuals who have no insight tend to have much more poor prognosis, tend to be the ones that are much more defiant, the ones that are not going to look for help.

And they see it as.

That is your problem, not mine.

Hoarding, though, can impact, could put a significant strain on, say, families or couples.

A lot of Relationships, especially if others within the home are not individuals who struggle with hoarding.

Sometimes you have maybe families that hoard together, and so that can just create, you know, exacerbate the whole living situation and become quite problematic.

Now, if you have children living within the home and they are, you know, it's the parents or some other guardian is the one hoarding, then that's creating a very, you know, dangerous situations for those kids.

And sometimes, you know, child protective services might have to get involved.

I mean.

I mean, we're also looking at.

There's so many risks that hoarding and the clutter itself can produce.

So, you know, fire hazards, for one, you know, all sorts of trip hazards, fall hazards, you know, items falling on top of people, pests, you know, attracting pests and whatnot.

Especially if there's animals within the home, you know, that could be an additional problem if, you know, fecal matter and all these other things that can just lead to health issues or just accumulation of dust and could also cause not only issues for the individuals within the residence, but also for maybe if, you know, neighboring homes or residences.

Right.

So if this is a very large clutter issue that, say, is attracting us, you know, mice, rats, roaches into the area.

Right.

You know, that's not just affecting that home or.

Right.

That residents could be affecting neighbors as well.

And so what.

What I would kind of want to know then is do you see more people that are struggling with this attract or not?

I guess the word would be like, collecting kind of the same thing, or is it more of like a vast range of different items that are building up in the house?

Does that question make sense?

The way I'm interpreting your question, Are you, like, making a distinction between hoarding and collection?

No.

So.

So sorry, I guess I should use the word hoarding.

Are they hoarding, you know, like I've seen on, again, tv.

Not the best place to.

And I will be the first one to say that I wouldn't treat hoarding disorder.

I would refer to you.

But do they.

Like, I've seen people who hoard animals, like, specifically are hoarding animals, but then I see other people that have just this vast array of different items that are living amongst their house.

Like, which one is more common?

And let me say that animal hoarding is a completely different thing altogether.

So when we talk about hoarding disorder, we're specifically talking about object hoarding.

Okay.

Animal hoarding.

Probably best that we don't go into that right now, but let's just say that that's.

It's just a completely different thing.

It doesn't follow the same type of, you know, mechanisms and psychopathology as object hoarding does.

Okay.

When it comes to object hoarding, I think it is important, though, to define a difference between hoarding and collecting, because a lot of times people will, like, even have friends I know who.

Who have other friends who have large collections of things.

And, you know, they often say, hey, you might need to go help them.

I think they're.

They're hoarding.

It's like, well, no, technically they're not.

And the thing is, collecting is different from hoarding in the sense that collectors typically will.

Even if they accumulate a large number of items, they are usually treating their items in a way in which they are displaying them.

You know, they have them out and organized.

And even if, say, they have a collection that is from, like, floor to ceiling filled with something, again, if it's organized and it's out for display, then dealing with a collection here, they're treating it with respect.

They're actually using their items.

And it's not cluttered in the sense of, like, disorganized and maybe things piled on top of.

Top of each other.

Clutter, again, tends to be cluttering active living spaces, preventing people from being able to utilize those spaces or.

Or whatnot for their intended purposes, and it causes dysfunction and despair.

That is really good to know.

Yeah.

So that's how you would explain it or educate it to someone that is getting the terms misconstrued.

Right.

Okay.

Yes.

And then for individuals that are struggling and they are.

You're.

You're kind of pointing out this would be destitute as a hoarding disorder.

Are they usually hesitant to make changes, or is it varied?

It varies, again, depending on insight.

But what you will often encounter are individuals who are experiencing ambivalence.

Right.

In the sense that they may recognize that they have a problem and that it's a difficult situation to deal with, and they want it to be better, but then at the same time, they are struggling and that they may not want to let go of items and let go of, you know, some possessions and that because they don't want to experience whatever comes with doing that, whether it's the emotions that may come up or the thoughts that may come up.

And so then what would you say you do to motivate individuals that are struggling with hoarding disorder?

One of the things that is important that I find to be important not just when it comes to treating hoarding disorder, but any disorder truly is helping individuals to Focus on the things that they find to be important, like how do they want to, how do they want to be in their lives?

What are the things that they want to do, they want to experience or they want to pursue that they're not doing so right now.

So for a lot of individuals, they may have isolated within the residence for so long and not have people over that they really are seeking connection, would like to have connection, but are feeling too much shame to be able to have people over.

So being able to keep those things in mind in terms of the things that they are seeking and things they would like to experience, like, all right, if you want to be able to have individuals over, you want to be able to socialize.

Right.

Let's keep that in mind.

Let's keep your eyes on the prize is one thing I like to say.

Yeah.

So like a lot of values based work, it sounds like, right?

Yes, definitely.

Okay.

Yeah.

And then what about just like, when you think about common misconceptions with hoarding, I know we've talked about a few, right.

Like collecting items versus clutter.

Are there any others that pop up in, in your head that need to be demystified?

Yeah.

So, you know, we were mentioning earlier about the TV programs.

And so a lot of people, people who don't experience this and don't know much about hoarding tend to think that, oh, everybody who struggles with hoarding is like that.

It's like the extreme situations.

And no, that's not the case.

And you know, it has a, you know, wide variety of how it's displayed, but you know, a lot of different, varying levels of severity.

And most people are not like what you see on tv.

Well, there are many people like what you see on tv.

That is not typically the case.

And when I, individuals I work with, I actually don't come across those extreme cases that often.

But that's, that could be due to a lot of reasons and that a lot of times in those extreme cases they may not be able or willing to look for help.

Right, right.

Or, you know, and feeling a lot of shame.

But in terms of other misconceptions also in relation to tb, those clean outs are not as helpful as one might believe.

Yeah, it's not like really a treatment modality, right?

No, it's not at all.

Clean outs do not treat the individual.

Cleanouts treat the house.

So if a person is not receiving therapy in addition to say a clean out, then it's, it's highly likely that the individual is just going to revert back to hoarding more, keeping more items, and more often than not they actually hoard.

The situation becomes worse than what it was before.

Wow.

And it's wild to me that like I, I've seen an episode or two of that and like they don't ever mention the therapy side of, of things with that, which is infuriating.

Yeah.

And I think so.

A lot of people don't realize that therapy is an important process, important part of that process.

And so without it, you know, people, the individual, individuals are not learning how to be able to be able to maintain, you know, a home, say once it's been cleaned out and tidied or so therapy is important for individuals to learn how to be able to approach these situations much more effectively.

Learning how to feel their feelings, learning how to, learning how to face these anxiety provoking situations.

And it's not just anxiety, but it's fear of experiencing guilt, sense of regret, shame, and so on and so forth.

Yeah.

And so when you go to a person's house, can you usually or can you always tell if someone is struggling with hoarding by the way they keep a certain area in their home?

The interesting thing is I can often tell before you even get into a.

Home really, what are some of the key like questions that you ask to get to that place?

Some of the telltale signs is that the clutter often isn't just contained within the home.

You will often see signs outside of a home, whether it be plants and often dead plants all around or other things just out in the yard or oftentimes people's vehicles may be filled with clutter too, or patios or front porches.

All these sorts of things can be signs if we're talking about a home or balconies in relation to apartments, whatnot.

But in terms, in terms of how to I guess like assess whether or not someone is struggling hoarding it.

I'm looking for, looking at emotional attachments.

I'm looking to see because actually I should back up in the sense that not all cases of clutter are hoarding disorder.

I think that's also another like, important misconception and that everybody thinks that if there's ever a cluttered situation, oh, that person is, quote unquote, a hoarder.

And also I don't even like that word hoarder.

I tend to use the word, the phrase, like someone struggling with hoarding disorder or things of that sort because hoarder.

Can be very identifying.

Yes.

Carries that stigma, labels a person as their disorder.

Yeah, it's a great point.

Right.

So but going back to what I was saying, if I can get back on track to what I was saying.

Well, you mentioned that not everyone that has clutter is someone that is hoarding.

Right.

So even individuals with OCD can often have cluttered residences.

Let's say an individual with contamination ocd, where they may struggle to touch, you know, touch anything that they just feel is contaminated, say, like trash.

I've seen individuals where they don't like to throw things away, they don't like to touch trash cans, so instead they just leave the trash all over the place.

And over time, that can accumulate into clutter.

Okay, so that's similar to, like what we do in OCD work, right?

We.

Our acronym is wtf.

What's the funct?

Like, identifying the function behind the behavior is important to diagnose hoarding.

Okay, that's great to know.

Yes, absolutely.

Yeah, I'm learning a ton.

Yeah.

Because not everybody has an emotional attachment to items.

So in those cases of ocd, it may be whether it's.

They just don't want to touch the items or whether, you know, it could also, for individuals with adhd, often may have difficulties with clutter in which they may use items and just place them wherever, after they're done with them, move on to something else, move on to another things, and just kind of might be very disorganized and just struggling to stay on task and continue to tidy up areas.

And so just over time, clutter can build.

But again, it's not due to an emotional attachment.

It's just due to maybe some, whether it be executive functioning issues and.

And whatnot, the attention deficit issues that can lead to clutter.

I mean, lots of other reasons, depression, dementia, schizophrenia, all of these can at times lead to cluttered situations.

And so it's not always hoarding disorder.

Ah, okay.

And then what would you say causes hoarding?

And I know there's probably not a clear cut answer.

Yeah, that's a really good question.

Yeah, it's not really clear cut.

There.

There are known to be some genetic factors, like hoarding often does run in families.

You may see situations where it's, you know, a parent and a child both living in a home and both are hoarding.

And so, you know, kids can be or have a genetic predisposition to developing hoarding disorder.

You can see it as early as childhood.

But the thing is, even for everyday children, it could be quite normal for children to want to keep items and struggle to part with items that let go of it.

But it's more of a Sign of a problem.

If you see this continuing to develop over time and an accumulation of items just struggle in life, go of anything and there's no budge or no change in that.

And again, if there's emotional connection or emotional attachment to items, then you know, there could be, those could be early signs of a problem.

But usually hoarding doesn't become a big problem until there again is accumulation of items, till it becomes clutter.

Would you say there's preventative work that if some kids are having some of these characteristics, preventative work they can do before it gets to that point?

That's a good question.

And see, the thing is, we usually don't see kids because oftentimes parents are going to be involved in keeping kids in check of like cleaning up their rooms and things.

Whether it's by force or whatever, kids just ultimately succumb to making those changes.

But again, you usually don't see the problem arise until it's much later in life, once a person has actually had time to accumulate a large amount of possessions where it's causing the clutter and dysfunction.

Because you can have somebody struggling with for decades, but it's not really seen as a problem until again, it's, they can't use plenty of different spaces, can't use a bathroom, can't use their living room, kitchen, whatever, because of the clutter over, has accumulated over time.

Yeah.

And then you often see with like many disorders, when life gets stressful, symptoms exasperate.

So if someone who is struggling with hoarding is dealing with more stress in their lives, do you often see those symptoms also exasperate?

They can so, so also tying into an earlier question about like, misconceptions.

So trauma is often, people often assume that if somebody is struggling with hoarding, then they must have experienced trauma.

Now, while many individuals who do struggle with hoarding have experienced trauma.

But it is not to say that all people who struggle with hoarding experience trauma.

I don't even know, I don't know what the statistics are, but I'm not even sure that the majority of individuals with hoarding struggle or have experienced trauma.

But certainly when certain types of stressors may be experienced, it can lead to individuals maybe accumulating more items because the accumulation of items tends to be like a coping mechanism to deal with negative thoughts, negative feelings, like, oh, if they're feeling sad and depressed and down, let me acquire something and I'll feel better.

Right, Right.

And that cycle continues like, okay, well, I feel better, but I still, I don't feel all that great.

And I don't, you know, I'm still kind of sad.

Maybe I should get some more stuff so I can feel even better and then buy more stuff.

But still, you know, just continues on and on and on and on and on.

Yeah, that's so interesting.

And so then when someone is struggling, like if you have an anonymized case or something, that comes to mind, like, what is the treatment process look like?

Are you going in the home with them?

Are you virtually coaching them?

Like, how does treatment look?

So I typically start off with, with home visits so that I can really get a good look at, you know, the condition of the home, the content of the clutter, and just starting off with prioritizing what spaces are important for the person to try to get back, to regain reclaim, so to speak, sooner than later.

Right.

We'll focus in those areas in terms of assessing, first of all, what is difficult for them in discarding the items.

What comes up, whether it be, well, if I let go of these items, then I'm going to feel that I'm wasteful, or if I let go of this, then I am going to feel a sense of regret because I could have used it again, or if I let go of this because of sentimental value, then I'm going to feel like I'm letting go of a loved one who passed away.

So there's all sorts of reasons as to why people may hold on to items and so want to assess that first.

And then, you know, also just looking at, well, what are they?

Whatever they're afraid to experience.

So if they're afraid to, you know, feel again, regret and anxiety, sadness and whatnot, you know, we can start off by, in a sense, we're doing an exposure.

We can look to discard an item that might be low on their, low on their hierarchy in terms of not causing a very high amount of anxiety or distress and seeing, well, and let's see what happens.

What do you expect to experience by letting go of this?

And let's compare it to what actually occurs in doing so.

We're setting up this opportunity for learning so that they can see for themselves, like, oh, I really thought this was going to be a much worse situation, much worse experience, but it wasn't as bad as I thought.

And we wanted to continue building on those experiences to help building their confidence and helping to again, build a sense of learning so that they can see that they have the ability, that they have the potential to be able to be successful in this.

Like a lot of anticipatory anxiety builds.

That's a part of this.

Yes.

And trying to develop more willingness to experience, you know, this.

The discomfort, whether, again, uncomfortable thoughts, uncomfortable emotions, whatever, that they may be reluctant to experience.

And is it a lot like exposure work, in a sense, where you start small and then work your way up to maybe some of the larger items?

So it depends.

I actually, if.

If we can.

I like to be able to work with larger items that they may be more willing to let go of first so that we're making more space sooner than later.

Right.

Certain items I don't like to start off with first tend to be paper or miscellaneous items.

And that's because a stack of papers can.

There can be, you know, hundreds or thousands of pieces of paper and, you know, one stack of paper and like, that can be very time consuming to go through.

Interesting.

Especially if a person feels like they need to go through all the different sheets.

You know, that's just not something to focus on early on.

Right.

In the treatment.

And it makes sense because, like, if they have a larger item moved first, they can see that progress, and that would build motivation.

Right.

Okay.

Yes.

Yeah.

Also, just to add to that, an important part of that process of taking pictures, before and after pictures, because it can be very difficult for individuals to objectively see the progress that they've made because you can do all this decluttering, and then they're like, it doesn't look all that different.

But if you take some pictures, you can definitely see it very clearly about how it's different.

And so that they can see that progress and feel more confident and what they're doing.

Yeah.

Just as you're saying this, it makes it so much more painful to.

And I'm not even in it with a family member.

Right.

But to just consider what happens with those Hollywood shows, like how they just.

I know we talked about this already, but go in and wipe it clean.

When there's, like, a very strategic approach to take to help someone get better and recover, that's not happening.

Which blows my mind.

Yeah.

Well, I will say that I think, you know, oftentimes with those shows, they do have a therapist on board.

And so there's a lot that we probably don't see behind the scenes in terms of, like, the therapy taking place.

So just to be fair to the shows, but whether or not it is sufficient, I think is questionable.

I don't think so.

Unless, again, they're receiving, you know, months of treatment afterward, because hoarding is not a quick and easy process to treat.

It does take Believe it's the average time that for treatment is about a year, if I'm, if I'm.

If I recall correctly.

And sometimes it could be a lot more.

It just depends on the situation, depends on the size of residents, you know, the abilities of the individual.

Is this an elderly person who can't really move much, or are we dealing with someone who's maybe younger and maybe has support and help?

So it just varies.

And how often are you usually meeting with someone?

Like, is it weekly?

Yeah, try to meet weekly.

And after the initial home visits, can often do virtual coaching and doing much of the same.

But it just.

It also just depends on what clients are able to handle, what they can manage, what they can afford.

You know, one of the unfortunate things about I think these situations, often clients may be more on the lower SES side and may not be able to afford treatment as much.

And, you know, I don't know of any insurance that, you know, reimburses for recording treatment, you know, or if they do that, probably not very much, which.

Is wild because like we have talked about, there can be fire hazards, there can be safety, medical problems that come from the, the hoarding behaviors.

That.

Right?

Yeah.

It's so surprising.

Yeah.

And then with family members, is there anything.

Because I'm sure family members are such a big part of this.

Right.

Especially if the individual that engages in the hoarding has a lot of shame or like you said, just doesn't necessarily want treatment because of that shame.

How would you, or what advice would you give a family member that knows they have a loved one struggling?

So this is a tough.

Can be a tough one.

And so one thing that I often encounter is may have actually loved ones who attend, like my support group or, you know, any other, find some other support for themselves prior to being able to get support for the person who's struggling with hoarding, especially if that individual who struggles doesn't have as much insight, you know, isn't very willing to work on the issue.

You know, there's a former.

I have a former colleague named Greg Chassen who is, I believe, in University of Chicago right now, and he has developed modality referred to as family, as motivators.

It's a wonderful idea.

And what it does is instead of bringing in the individual who struggles with hoarding, it brings in the family to receive the therapy in terms of giving them guidance as to how to be able to do this step by step with their.

With their loved one.

Wow.

And so it's something that's still.

We're Trying to, it's being disseminated a bit more.

Dr.

John Hart and Greg and myself, Dr.

Chasin, we did a training in Houston, I believe a few years ago in regard to just boarding treatment as well as family as motivators.

But still that's not enough.

There needs to be a lot more, hopefully a lot more training can become available in the future because just being able to incorporate the family can be a very effective way.

Much more cost effective way of doing this.

Now, again, just to give a bit more tips to family members, if you have a loved one who struggled with hoarding and they are reluctant or resistant, it's really important to try to approach this person with compassion and really just giving them, letting them be heard, being able to listen to them.

Because oftentimes what happens in these tense family situations is that there's just a lot of arguing going on.

And so that person is struggling with the hoarding tends to just dig in their heels deeper.

Yeah.

And especially because they don't feel heard.

They just.

And especially if individuals are just like throwing away items that belong to the person struggling, that does not help.

If you're throwing things away without their permission or throwing things away, say like when they're gone, that that just leads to them not trusting you and again, can actually make the hoarding symptoms worse.

Yeah, yeah.

So it's.

And I know it's difficult.

I don't envy people being in those situations.

I experienced it myself because my dad used to was an individual who struggled with hoarding.

And so I know how frustrating it can be.

And it's tough.

I mean, I'm not gonna lie, it is tough.

There's not a ton of resources, but again, support groups such as mine, there's.

The International OCD foundation has a lot of resources.

Nami, so national alliance on Mental Illness has some resources.

And there's, there's.

Professional organizers can also be utilized in some ways.

You know, there's like a subset of professional organizers who are certified in chronic disorganization, as they call it, that they can often be utilized, whether in conjunction with a therapist or maybe as a replacement if one cannot find a therapist.

Because truly there are not a lot of therapists even in this, like a city of Houston, the size as large as we are, there are not many therapists who really treat hoarding disorders.

Yeah, well, as you were saying that I was thinking we always talk about how there aren't enough OCD providers and then you take it to look at hoarding, there's even less hoarding providers like, providers that specialize in hoarding.

And so, yeah, I.

I can't imagine.

And like, yeah, candidly, you are one of the only people that I would know to reach out to.

To help someone with that treatment.

And so it does.

It seems so scarce and needed.

If a family member is interested in learning more about the family Assisted motivation, is that what it's called?

Family as motivators.

Family as motivators.

Where should they go?

Dr.

Chasin, he's out of University of Chicago.

He has a website.

I believe it's Gregchassen.com.

chassis is C H-A S S O N.

Okay.

You can look there.

Those are the only ones that come to mind.

I can't think of anything.

It's still so new too, right?

That's in the work.

Well, I mean.

I mean, it's been in as a pilot study since, like, 10 years ago, but it's still something that's being, you know, put out there more.

Right.

You know, get more people trained in it.

Yeah.

No, I can't tell you how much I've learned today.

Even just like, as soon as you said, well, we don't use the word hoarders, I was like, of course we wouldn't.

That makes so much sense.

Like, why would you put someone as that identity, like, put that in there to their identity when it's something that they're working on to become fully functioning?

But even just the differences between behaviors and how some things aren't actually classified as hoarding, and there's a function behind it that you're having to look for.

I've learned so much, and I could actually talk to you about this topic all day because it's interesting and it's necessary, and we need to be raising awareness on it.

So I cannot thank you enough for joining us for this episode today.

Thank you very much for having me here.

It's been a pleasure.

Yeah, of course.

And we often do Q and A episodes.

And so, listeners, if there's questions that you didn't get answered that Jelani and I spoke about, please submit them on our website.

And, Jelani, we might ping those to you to get answers for.

Yeah, that'd be great.

Yeah, amazing.

Well, really appreciate it.

We'll have to have you back sometime.

That'll be wonderful.

Thank you very much for having me.

Thank you.

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