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Section 3
Therapy for Hoarding Disorder

CEU Question 3 | CEU Test | Table of Contents | Addictions CEU Courses
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On the last track, we discussed the various motivations that shop-aholics have for compulsive spending.  These motivations included:  substituting for love and affection; gender-related motivations; and thrill seeking.

On this track, we will examine techniques to incorporate a shop-aholic partner into their therapy.  These techniques include:  destroying inhibitive myths; hoarding questionnaire; supportive detachment; and increasing affection.

Incorporating a Shop-Aholic's Partner Into their Therapy - 4 Techniques

#1 - Destroying Inhibitive Myths
The first technique is "Destroying Inhibitive Myths."  I have found, like you, that many partners of shop-aholics are eventually the primary reason that compulsive spenders seek therapy.  However, many shop-aholic partners assimilate false myths that justify a passive role in their partner’s compulsive spending.  Some of these myths include, "True love can conquer all," "I can sacrifice myself to make my partner stop hurting," "It’s useless to try to help," and "If I get too close, we’ll just end up fighting." 

Jean, age 54, was the wife of compulsive spender, Mike.  Over their 27 year long marriage, Jean had abided Mike’s many indulgences such as eating out several nights a week, expensive food and wine, and the acquiring of timeshares the couple could not reasonably afford.  It wasn’t until Mike had spent the entirety of his daughter’s college fund that Jean urged him to go to counseling.  Jean stated, "I thought I could balance out our relationship.  I never bought new clothes, I kept getting promoted, and I would save thousands by bulk shopping and using coupons.  I thought I could make enough money so we wouldn’t have to suffer." 

I explained to Jean, "Whenever you saved extra money, you only gave your husband a larger pool from which to extract money.  Instead of addressing the issues underlying Mike’s compulsive spending, you unintentionally encouraged it.  Although your intentions were well-meaning, they in fact did not benefit your husband at all."  Think about your Jean.  Is he or she harboring myths that rationalize his or her passive roles?  How would you address this client?

#2 - Hoarding Questionnaire
As we discussed on track 1, some partners of shop-aholics develop a contradicting spending personality.  Instead of balancing the relationship out, however, the contradicting personality, such as a hoarding personality, can exacerbate a compulsive spender’s behavior.  I suspected that Jean had developed a hoarding spending personality.  To convince her, I asked her to take the "Hoarding Questionnaire."  The questionnaire included the following questions which I asked her to answer with "often," "sometimes," "rarely," or "never":

3 Hoarding Questions

  1. Does it bother you to spend money impulsively on some nonessential purchase to please yourself or a loved one?
  2. Do you go to great lengths to save even small amounts of money, no matter how much time and effort it takes? 
  3. Do you begrudge your partner almost any expenditure of money?

After she finished taking the questionnaire, Jean had answered all questions with either an "often" or "sometimes."  Do you think a "Hoarding Questionnaire" will be able to convince your client they have a contradicting spending personality?

#3 - Supportive Detachment
The second technique is supportive detachment.  You know the importance of objectivity.  The same concept applies here.  I find it useful to explain the concept of enabling to help the client and his or her partner understand the importance of supportive detachment.  Jean, Mike’s wife, needed some help removing herself personally from the situation.  She stated, "I don’t understand.  I am not part of the problem.  Why do I need to change my behavior?  He needs to change, and change fast because I just can’t take it anymore!" 

I explained to Jean, "There’s a real danger that if you become too closely involved with Mike’s struggle, you’ll try to take over the fight yourself, preventing your husband from developing the strength he needs in order to heal.  However, you all can be involved, supportive and healing without having to race to the rescue.  It may be difficult at first, but you must steel yourself to be able to witness an occasional slip or stumble in your partner’s struggle to heal without feeling it’s a personal defeat or a slap in your face."  Think of your Jean.  How would you explain the concept of supportive detachment to him or her?

#4 - Increasing Affection
In addition to destroying inhibitive myths and supportive detachment, the third technique is increasing affection.  As we discussed in track 2, many shop-aholics use compulsive spending to express or replace affection.  Bonnie, age 34, would buy electronics, clothes, and other gifts for herself and her husband Hugh.  Bonnie stated, "I feel good about sacrificing my money for my loved ones.  It doesn’t even feel like a sacrifice sometimes.  I just live for the happy look on their faces."  Hugh, however, stated, "How can I be happy when she brings home bags of credit card debt?  Why can’t she just function like a normal person and give me a peck on the cheek instead?  That’s all I really want." 

I explained to Hugh, "Shopping will never be able to meet Bonnie’s needs.  I know that you feel it is her responsibility to overcome her own problems, but as her husband, don’t you want to help her at least?  You can do this by expressing your own love for her without buying her gifts.  For example you could share your feelings and thoughts with each other, or cuddle every evening." 

A few weeks later, Hugh had developed his own routine for expressing affection.  Hugh stated, "Whenever Bonnie comes home, I give her a foot massage.  Before we go to bed every night, we tell each other about our days, how we felt, and we give each other feedback.  Last Friday, I cooked a candlelit dinner and our son spent the night at his grandma’s.  I think Bonnie’s really enjoying it.  She’s been taking an active part in physically expressing her love."  Think of your Hugh.  How could he or she increase his or her affection towards the compulsive spending partner?

On this track, we discussed techniques to incorporate a shop-aholic partner into their therapy.  These techniques included:  destroying inhibitive myths; hoarding questionnaire; supportive detachment; and increasing affection.

On the next track, we will examine reactions that occur when clients are confronted with their compulsive spending.  These reactions include:  shame; gender-related reactions; and defensiveness.

Peer-Reviewed Journal Article References:
Baucom, K. J. W., Sevier, M., Eldridge, K. A., Doss, B. D., & Christensen, A. (2011). Observed communication in couples two years after integrative and traditional behavioral couple therapy: Outcome and link with five-year follow-up. Journal of Consulting and Clinical Psychology, 79(5), 565–576. 

Bratiotis, C., Davidow, J., Glossner, K., & Steketee, G. (2016). Requests for help with hoarding: Who needs what from whom? Practice Innovations, 1(1), 82–88.

Tolin, D. F., Wootton, B. M., Levy, H. C., Hallion, L. S., Worden, B. L., Diefenbach, G. J., Jaccard, J., & Stevens, M. C. (2019). Efficacy and mediators of a group cognitive–behavioral therapy for hoarding disorder: A randomized trial. Journal of Consulting and Clinical Psychology, 87(7), 590–602.

Online Continuing Education QUESTION 3
What are three techniques to incorporate a shop-aholic partner into their therapy? To select and enter your answer go to CEU Test.

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