02 Treating Hoarding Disorder


It is the treatment that we have found to
be effective in the short term and the long term. And what this requires is slow discarding
and teaching skills for how to deal with stuff. Minimum we’re really seeing that’s effective
is probably somewhere between, around 6 months. The goals of treatment are really clear. We’re trying to
reduce the amount of cluttered living space, increase the safety, we are also trying to
increase the appropriate use of space. We’re also trying to discard unneeded possessions,
and reduce the amount coming in the house. If you don’t reduce the amount coming in,
it’s gonna be a constant cycle. One of the first steps that I do immediately
is I want to cut off as much paper flow as I can coming in the house. If the paper is not there then you don’t have
to make a decision. This will reduce your junk mail by about 80%. This is a 1-888-5-OPT-OUT. This is a government agency. This goes to the credit bureau. This puts you on the “you can’t sell out my
information.” One of the first things I have people create
is a mail station. And for any of you who don’t have one of these,
create on tonight. It can be a table with a trash can underneath,
there you got a mail station. Put it no more than about 15 feet from where
your main entrance to the house is. The rule will be when you cross that threshold
you have got three minutes to take you mail from that day and sort through it. And pick out what you’re going to keep, what
you need to follow up on, and what needs to be thrown away. Immediately. I also like donation lists, people that get
on donation lists, like Purple Heart, and those that come to your home. A lot of times what they’ll do for efficiency
of gas, if they’re coming out to pick up for someone else, they’ll call people in the area
who have been on their list before and say, “hey we’re gonna be in the area, do you have
any stuff?” And so I’ll make a rule to say, well if they
ever call, we always say yes. Even if we have one sweater from them to pick
up we always say yes. How many of you heard of the 7 year rule? Yeah, there’s not even actually a 7 year rule. There is, you need to keep your tax paperwork
or anything you needed to submit for three years. They only reason you need to keep it for longer
is if you withheld more than half of your income that year, for any reason, then you
need to keep it for 6 years. The IRS also has what they call the 75 dollar
rule. This will save you a lot of hassle. So the IRS basically says, if you have a receipt,
like for your house that is worth less that 75 dollars, it’s probably not needed. It’s not worthwhile to keep it. I require my patients to bring something to
my office that they’re going to throw away every time they see me. In the beginning, I don’t care if it’s a candy
wrapper, I just care that you are getting in the habit of every time I see Laura, I
gotta find something to take it. Because this is again about creating habits,
ok? I’m trying to help their brain create a habit
for how to manage stuff. If you got in the habit of throwing away 10
pieces of paper a day or putting away 10 pieces of clothing or dishes or whatever, you could
probably be able to keep up on your home pretty easily. They feel like it’s to be huge! I’ve gotta put away 50 things! Because they’re perfectionists, right? It’s great to do things all at once, the problem
is is I don’t think we get those big blocks of time most of the time. They boxed some things up, they cleared out
the spaces, so now, is it perfect, no. But it was, the area the chairs were cleaned
out; the area underneath the table was put in some boxes that you can’t see on the side,
and they had two places to sit and eat. We would like to give you a little bit more
information on harm reduction strategies. First things first, you’ll want to clear a
path that’s 36 inches wide from the front door all the way to the back door. Beware of items that can impact structural
stability. Also, make sure there are no items on or in
the oven, make sure there are no items against a heat source like a radiator, furnace, water
heater, or anything else that’s hot. Make sure there are no items piled than 3
or 4 feet all the way around the home, and make sure there are no items in the bathtub
(this prevents from sewer gas build up). Now back to Laura, You’ve got to make these quick and imperfect
decisions. I tell my patients that making decisions for
them is like walking across quicksand. If they make their decisions really slow,
careful, and cautious, by the time they come to a decision they’re up to here. Now they’re completely stuck and can’t move. One of the things that’s important to remember
is OHIO. OHIO protects us from churning, which is Only
Handle It Once. Once something is in your hot little hand
you wanna make a decision about it, you don’t wanna put it off until later. It feels like it’s gonna be easier later,
but it’s always going to be harder. I try and give people questions of how to
make those decisions. Do I have one similar to this? When is the last time I’ve used this thing? When is the next time I would use it? These are questions that all of your brains
go through like that. You just don’t consciously have to walk your
brain through that decision making process, but they do. My general rule is, ok, before you buy anything,
I want people to what’s called an exchange system, and this is the way I’d encourage
you guys to think about your own homes. If I bring in a sweater, I need to be thinking
about what is a sweater I’m willing to get rid of in my closet now? Always ask yourself the questions, yes this
object may have value. Is it more important than your health? Is it more important than your safety? Is it more important than your house being
secured? Because you’re not saving the thing. Everything goes to the landfill eventually. This video was brought to you by ServiceMaster
of Kalamazoo, your local hoarding experts.

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