More Than Clutter: Understanding & Treating Hoarding Disorder with Guest Dr. David Tolin

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.