Family

1. How do different cultures view the importance of family?
2. Religious differences?
3. Occupational obligations?
4. Gender roles?

Rough Draft

Madeline Tallman

Professor Kerr

EN 101

14 September 2010

Obsession with Possession

The act of collecting items is very common among the human race. As homo sapiens evolved, they moved from collecting items solely for survival (e.g. food, hides, wood) to items of less necessity. Today, collecting knick knacks and totems is seen as a characteristic of human nature. However, if that “hobby” is taken farther than the societal norm, abnormal psychologists step in. Hoarding is the act of obsessively collecting items that have little to no use to the average person. This can be excessive clothing, food, and newspapers, or written notes, unfinished projects, and gifts. While the over-abundance of “stuff” to many is viewed as unnatural and odd, to a hoarder, all the collected items have some sort of worth that could possibly later come of value. In order to understand the reasoning behind hoarding, one must first understand what it is, who is affected, and the treatment methods used. 

In a scientific sense, hoarders generally have an abnormal or altered psychological process that affects brain activity (1). Neurology researchers at the University of Iowa Roy J. and Lucille A Carver College of Medicine who conducted studies on patients with brain injuries that later developed hoarding habits found that damage to the prefrontal cortex of the brain was a vital contributor to this behavior (2). However, there is differing opinions among psychiatrists and psychologists about the causes of hoarding in otherwise healthy patients. Many experts believe that this behavior is linked or is a side effect to other disease like obsessive compulsive disorder, anorexia, dementia, depression, and even psychosis. For those suffering from depression, for example, hoarding can ironically be a way for one to “organize” one’s life(4). While he/she might not be able to control the aspects of life that are causing distress, hoarding objects is something completely controllable to that person. Hence, creating some kind of order that alleviates depression in the short term. There are other experts who believe that hoarding should be classified as a separate disorder, not to be so heavily associated with the aforementioned diseases. Because treatment is case-by-case to an extent, differing cognitive-behavioral processes can determine whether or not hoarding is linked to an existing disease or independent of any. There does seem to be a general consensus among psychologists that hoarding symptoms reflect an “underlying psychobiological dysfunction,” but by itself, it’s more difficult to accurately classify (5).  

The question as to whether or not cultural differences affect the degree and prevalence of compulsive hoarding has been asked by many researchers. While investigation in transcultural hoarding habits is still being conducted, there is evidence to support the fact that OCD is consistent among varying cultures (3). Studies by Stefano Pallanti, M.D., Ph.D. of the American Journal of Psychiatry have shown that OCD prevalence rates are on average between 1.9% (Korea) to 2.5% (Puerto Rico). If the hypothesis that hoarding is linked to OCD has statistical significance, then culture’s “minimal influence” on OCD could parallel the its influence on hoarding as well. This would mean transcultural differences would not impact the proportion of hoarders from different nations. Common excuses for the irrational behavior by its sufferers are consistent from culture to culture as well. These range from not wanting to lose something that might be of value in the future to not wanting to upset a family member that might be hurt if an object is discarded (4). Experts have deducted that the problem is a psychological attachment and not a social attachment. Psychologists researching for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders that will be published in 2013 have observed that compulsive hoarding is more prevalent among older patients. Symptoms seem to be noticeable in childhood but do not become life-affecting until the patient reaches his/her mid-30’s. These studies have also supported the hypothesis that hoarding behavior can be taught from parent to child. That is to say if a parent obsessively hoards certain objects, the offspring can pick up those behaviors in adolescence  and act similarly during adulthood. (5) Psychologists disagree on the origins of the disease, but to whom it affects remains a consensus. 

Treating obsessive hoarding needs to be planned out from multiple angles. For many patients, recognition of a disorder might not happen until much later the initiated treatment (5). Patients are normally given the standard OCD medication, serotonin reuptake inhibitors (SRI’s), but these have proven to be minimally effective (4). Cognitive Behavioral therapy is usually administered alongside the medication to help eliminate the obsessive qualities in patients. This begins by creating a hierarchy of importance of the patients belongings--important enough not to discard to insignificant and disposable. Forced disposal, however, causes patients return to their original habits after treatment ceases. The reason for a hoarder’s obsession varies from patient to patient, and it is crucial to understand the unique reason for each patient in order to begin treatment. Psychologist have to work with the hoarder’s altered reality of what is valuable, not their own. By forcing normal logic on patients and hoping that they’ll learn by imitation can prevent progress and even reinforce hoarding behaviors. The unusual reality of hoarders involves their perception of responses and judgements of “levels of unhappiness” in others. This is often the case when one cannot dispose of an unwanted gift, the fear that the giver will be deeply hurt even if the gift is of little importance. Psychologists target that aspect of the disorder and, through behavioral adjustments, try to adjust that thought process. The typical therapy procedures of listening to patients explain their feelings before the psychologist makes any decisions is not helpful in this situation. Vocalized expressions are not focused on as much as physical actions. A psychologist must watch the patient to see if progress is being made through what they do rather than what they say. It is easy for patients to break promises about what they will do, so that observance is necessary (5). Like most psychological disorders, treatment for hoarding varies from person to person, causing psychologists to customize each case. 

Hoarding is a disorder that not only affects the sufferers, but also their family members and close friends. Destructive behavior can put other’s in danger and has caused parents to lose their children to social services. Those affected may have other unknown disorders or diseases that if undiagnosed, can prove disastrous for that person. If proper treatment consisting of medication and cognitive-behavioral therapy is instilled, those habits can be revoked and more enjoyable life can be given to struggling patients. 

Final Outline

Madeline Tallman

Dr. Kerr

Eng 101 H Essay 1

September 13, 2010

Obsessions with Possessions

Thesis: In order to understand the reasoning behind hoarding, one must first understand what it is, who is affected, and the treatments used. 

1. What is it? 
1. Definition of Hoarding: excessive collection and retention of objects 
2. Hoarders usually have “aberrant psychological processes or brain activity
3. Prefrontal cortex controls collecting behavior
4. Patients with damage to right mesial prefrontal lobe experienced hoarding habits
5. Opinion 1- independent of OCD
6. Opinion 2- linked to many other social disorders like

1. Anorexia
2. OCD
3. Dementia
4. Psychosis
5. Depression

1. With depression, it can be used as an ironic way to “organize one’s life”
2. By itself, harder to classify
3. Blame on perfectionism to avoid embarrassment
1. Who is affected?
1. OCD is consistent from culture to culture
1. Culture promotes “minimal influence”
2. More research is needed, especially for collective v. Individualistic cultures
3. Different cultures have similar excuses
1. Object could gain value
2. Family member could care
3. Holds useful information
4. Suggested to be psychological rather than social attachment
5. More prevalent in older patients
1. Symptoms may start in childhood but not become life affecting until mid-30s
6. More common among adults who grew up in depression or had parents that few up in the depression
1. With lack of money then, everything was valuable, you’d never know when you might need something
2. Now, even if money is not as much an issue, those thought processes continue
7. Children of hoarders are more likely to learn the behavior from their parents
2. Treatment
1. Recognition of disorder might not happen until much, much later than initiated treatment
2. Patients use normal OCD medication- serrotonin reuptake inhibitors, only sometimes effective and not very much
3. Same criteria for men and women
4. Cognitive behavioral therapy
1. Hierarchy of importance of hoarded goods
5. Forced disposal can cause parent to hoard later
6. Reasons vary
1. Reason for hoarding is essential before treatment can begin
7. Work with hoarder’s reality, not one’s own
1. Forcing normal logic and hoping they’ll catch on can prevent progress
8. Figure out hoarder’s sense of value
9. Figure out hoarder’s perception of how others respond 
1. Hurt drastically if a gift is disposed of
10. Tend to feel self doubt
1. Afraid that if something isn’t written down, it never happened
2. Not to a delusional level
11. Watch hoarder’s behavior during treatment, don’t listen to what they say so much
1. Promises are easy to break
3. Conclusion

Tentative Outline for Essay 1: Obsessions with Possessions

1. Thesis: In order to understand why someone may develop hoarding habits, one has to first understand who is affected, the universality of the disease, and the treatment needed.

2. Body Paragraph 1: Who is affected

• Linked to other diseases
• Learned
• Who is affected
• Multiple opinions/studies

3. Body Paragraph 2: Cultural Similarities

• Specific studies 

4. Body Paragraph 3: Treatment

• Medications
• Therapy
• Steps
• Reality of hoarders

5. Conclusion

List

1. How often do people make lists?
2. Are people who make lists generally more organized?