It’s the giving season and for many folks it’s a joyous time. But what if there’s more to it than simply picking out a gift someone will enjoy? How do we navigate the waters of mental health disorders in our loved ones in a time of giving while being mindful of our own needs? Jennifer Sampson, co-founder of The Hoarding Project, takes a closer look at how she helped one client deal with her mother’s hoarding disorder during the holidays.
“Can I ask you an unrelated question?” It was clear that my client didn’t feel like talking anymore about her latest run-in with her ex-husband and wanted to change the subject.
“Sure,” I smiled and nodded.
“Ok.” She took a deep breath, looking uncharacteristically anxious. “So…I’ve been worrying about what to get my mom for the holidays. She has already everything.” She hesitated. “Like… everything.” She looked up at me quickly, trying to read my expression. “What do you think?”
She was one of my favorite clients, and we had a positive and good-humored relationship with one another. She wasn’t generally a nervous person. Usually, she was upbeat and funny during our sessions in spite of the difficult work we’d been doing over the last few months to help her process a particularly devastating divorce, so her shift in mood was a little confusing to me. I brushed it off, assuming she was just being rhetorical with her question and wanted to lighten the mood a bit.
“You know,” I began to answer, “I really don’t know too much about your mom, come to think of it.” I shrugged and joked, “Socks? Fruitcake? I don’t know. What does she like? Or is she just tough to shop for?”
My client’s face was deadpan. “No, I mean it. Her home is literally full. She can’t even move around in it because she has everything. You work with this kind of thing, don’t you??”
Whoa. I had really missed that one.
Though hoarding disorder is my area of specialization, sometimes even I drop the ball in recognizing that this mental health concern can show up where I least expect it.
And of course it does. Hoarding disorder affects 1 in 20 people in our country, making it one of the most common mental health disorders around. Even though my client had not come to therapy to work on this issue directly, it was still one that touched her life, and as we continued our conversation, I came to learn that her mother’s hoarding had been affecting her since childhood, leaving her relationship with her mom to be fragile, at best.
Since hoarding disorder is a relatively new diagnosis and one around which there is still a tremendous amount of shame and stigma, it is very common for people not to be inclined to discuss it- even with their therapists. My client told me that she had thought about mentioning it to me at a few different points, but didn’t want me to think badly about her or about her mom.
During the holiday season, it’s especially important that we, as mental health professionals, are paying attention to potential hoarding-related concerns as our clients are going home to spend time with their families of origin. It is quite likely that at least one of them has a loved one who is struggling with hoarding disorder. Spending increased time with them around this season of the year may provoke strong emotional reactions which may be difficult for us to understand and work with if we don’t fully grasp the context behind the feelings.
Listening for comments and questions like the one my client asked, or about frustration around a relative’s housekeeping or shopping habits maybe markers that additional screening for hoarding disorder is indicated.
And as for my client’s question about what to get for a person who has everything- or at least for a person who hoards? I tend to recommend gifting experiences rather than items. Game night with the family, rather than a new scarf. Dinner at their favorite restaurant, instead of a new book. These types of gifts reinforce the importance of relationship-building rather than possessions, which, if we’re being honest, is important advice for everyone to follow.
Learn more on hoarding and how you can help
- The Hoarding Project – What Is Hoarding Disorder?
- National Alliance on Mental Illness, Massachusetts – Hoarding and OCD, Stats, Characteristics, Causes, Treatment and Resources
- Elements Behavioral Health – DSM-V: Hoarding New Mental-Disorder Diagnoses
- The Hoarding Project on Facebook
- GoodTherapy.org – The Stigma Behind the Clutter: 7 Myths About Hoarding
Jennifer Sampson, PhD, LMFT is Associate Chair in the Couple and Family Therapy Program at Antioch University Seattle. She has been practicing individual, couple, and family therapy since 2007. Jennifer has served as the Executive Director and co-founder of The Hoarding Project since 2011, and she currently chairs the King/Pierce County Hoarding Task Force. She has published multiple articles in academic journals on hoarding, and completed her dissertation work on understanding the influences of unresolved trauma and loss and family dynamics on hoarding behavior