This week Aaron Norris is joined again this week by Dr. Robin Zasio. They had originally posted on Facebook to get people’s questions they wanted to ask her. She is a licensed clinical psychologist and licensed clinical social worker who has been specializing in the treatment of OCD and anxiety disorders for over twenty years. You may recognize her from several different shows, but the one that he was introduced to her on was “Hoarders.” He was always so fascinated how calm and collected and patient she was with the people with whom she worked.
- What is the proper name to give to the hoarding disorder?
- How is OCD defined?
- What warning signs should you look for in somebody with a hoarding disorder and need to call in a professional?
- What is the International Obsessive Compulsive Foundation, and how do they help people with hoarding and anxiety disorders?
- How does she work with people with a hoarding disorder, and how does she keep them calm?
- What’s a good strategy for knowing when not to add something to your collection, even if it’s on sale?
- If people consider themselves collectors, is it a good idea to talk to them about it and understand their reasoning?
Continuing their discussion on hoarding, last week they talked about what is going on in the background when somebody is facing a hoarding issue. Aaron asked if she could put a name to the disorder of hoarding since some think it is OCD. Robin said with the increase in knowledge about anxiety disorders, one thing that has happened is they have actually created a category that is called obsessive-compulsive disorders. Underneath that category, you have individualized conditions that included hoarding disorders as wells as a few other ones. By its very nature, OCD is very different than hoarding disorder.
OCD is when somebody has very intrusive thoughts that are unwanted. They may be chopping carrots, then suddenly, they may have the thought of what if they stab themselves in the neck. They question why they are having the thought and if they will actually do it. They develop strange thoughts and may engage in a lot of avoidance behavior because they do not want to be triggered. Hoarding disordered has principled obsessive thoughts. This means they may want to go out just to see what treasures they can get. This could mean checking out garage sales or going to the Dollar Store and seeing what they can get for that $.98. They get that thrill of the deal. There is an obsessiveness about finding those items, or when they see an item to get it.
They may also have an obsession to hold onto things because they hear that if they let go of it, in some way they will lose the memory. The compulsive part is the actual acquisition of the item and holding onto it. It looks really different, but it has those same obsessive-compulsive properties.
Aaron said it is fair to say that by the time a real estate investor is called, there are one of three things happening. One could be a child has inherited a house after a hoarder parent has passed away. Another could be the Health Department has come in because neighbors complained of a health violation, so they are being forced. The final could be financial reasons and it is a quick sale. The investors typically come in and are dealing directly with people. Aaron asked at what point a risk would be involved. From a real estate standpoint, you never want to go into a transaction where somebody is not willing or able to sign paperwork. If you are not trained, you may not know.
Aaron asked what warning signs they should look for to see if somebody is not doing anything to do a transaction and to take a break and get somebody else involved. Robin said the first thing she would do, and this was covered in the last segment, is when she looks around her house she sees how organized everything is. If somebody looked around her house and told her she needed to get rid of 75% of her stock, that would be tough. Everything that she has is there for a reason. For somebody with a hoarding disorder who cannot let go of their things, you are asking them to do the very same thing. The person on the outside may be looking around and seeing what is broken and what is trash. They may wonder why they are having a hard time giving it up, but they do not realize there is a chemical imbalance that prevents them from doing that.
There are psychological issues, so when people are suddenly forced to move out of their place or get rid of what they have, you risk them succumbing to depression and suicidality. Sometimes the can even undergo psychosis where they can be pushed to such an extreme brink and level of psychological overwhelm that they could have what could be termed as a nervous breakdown. It is really important that, as with any one of us, when looking at purchasing a property you have wind that there is somebody living there and has excessive acquisition to get a sense of where that person stands. Some may be glad somebody else is taking the home or taking everything out of it since they cannot do it themselves and want to be done with it. This could be the case, but there should be some investment in understanding that person and where they have been. You would need to see if there are substance abuse problems that need to be factored into when the new homeowner is having to deal with them and whether there could be any potential danger in terms of aggression. Understanding the psychological history of that person to the best degree they can is very important.
Sometimes when dealing directly with family members, the hoarder is still in the home and the family is saying there is a health issue and they are taking them out of the situation. Aaron asked if there is a local specialist to which they can refer them. Sometimes they are not dealing directly with the people, but they want to help them process and not be at a high-risk rate. Aaron wondered if you would refer them to a social worker or psychologist with a specific area of specialty. Robin said the thing to remember when talking about a general therapist or counselor is that it is really not about their licensor as it is about their training. There are lots of people who are not psychologists who have degrees like Robin’s or below her doctorate. They have the training and can do the exact same work that someone at a doctoral level can do because they have had good training. The most important thing she looks at is where they have been trained and at what level.
There is an organization called the International Obsessive Compulsive Foundation. Their website is www.iocdf.org. They have a provider database, and it is probably the most comprehensive and specialized database for people who specialize in anxiety and hoarding disorders. The reality is most people who are specialists get into that provider database because they are all extremely passionate about making sure they receive the proper care and will not go through a cleanup process as they are going through the psychological process of being able to deal with what has led to the problem.
You can also Google hoarding disorders task forces. There are a number of them across the country. They are helpful because they are typically formed by people who are volunteers who help individuals struggling who may not have resources. Finally, Dorothy Breniger is part of the hoarders team, and she worked many times together with Robin as well as was a contributor to her book. She is an organizer, and while organizers are very clear they are not mental health professionals, often times they can have a lot of experience in working with people who struggle with excessive acquisition. She would be a great point of contact, at least to help direct. LA is ginormous, and we are talking about the difference between Orange County versus somebody who lives in LA. These two are not exactly user-friendly.
Aaron and Robin next went on to talk about how awesomely patient she is with some of her strategies. Aaron actually posted on Facebook regarding the scenario a lot of people deal with in their lives. A lot of people wanted tips regarding real estate investors who play good cop/bad cop and specifically bring people into the transaction to have somebody be firm who will deal with the situation to get them through the process. The good cop will then try to make sure they are taking care of in the right way.
Aaron knows some people in the industry since they have talked about the change in dealing with banks, REOs, and short sales to now dealing with people who are not exactly people persons. When Robin deals with those people, Aaron was always amazed when he watched the videos where she stayed completely calm and professional. Aaron asked how you keep those people calm and bring them back into the fray when there is a little bit of a meltdown. Robin said the way she works with people is even though she does not struggle with hoarding, she gets that chemically their brain does not process things like ours does. Coming from there, she does not go to this place of logic and things that make sense, like how they are in danger and putting the community in danger. Telling them things like that is not always the most helpful thing since they feel they are being shamed and will likely get defensive.
Coming from the mental health standpoint, she understands that it is difficult and they cannot make decisions. She really validates how she knows it is difficult and they do not want to be told to get rid of their things. The dilemma is that their house is either being sold or has been sold. At the end of the day, they know they will have to leave. She makes sure they are on the same page. Although none of them necessarily agree they need to be pushed into a corner to get rid of everything, it is just the case and you cannot change that. Robin figures out how to make this really difficult process as easy as they possibly can knowing there is nothing easy about it. How can they try to do something really difficult in the most streamlined way? She wants them to know she is there for them and will help them along the way if they let her know what it is she can do to help them.
In essence, you are still doing the good cop/bad cop because you are telling them where they are at and that they need to get rid of their things. However, you are doing it in a way that hopefully will be more user friendly for them in letting them know their position. She figures out with them how they can work together to make something really tough be a little bit easier. She figures out who can be involved and where that person is involved. She will want to know if they have friends or family members who will support them. She will ask them if they have been seeing a therapist or psychiatrist. What are your resources whereby they can pull everybody they feel safest with to help you through this process?
Dr. Robin is very much about using analogies and saying she may not struggle with hoarding, but she does understand how hard it would be if somebody told her to get rid of 75% of her belongings. She would not even know where to start. On that level, she understands how hard it is and really tries to say how she will not pretend how they feel. However, she would tell them how she understands how tough it would be if she were in a similar situation.
It is really about moments of empathy rather than sympathy. Aaron watched a really great video on this the previous night. The person who was empathetic came down to the level of the person who was crying and sat there with them. They said they did not understand what they were going through, but they felt it with them. Validation is so big, including validating their pain, struggle, or how difficult things are. At the point the real estate investors are coming in, there are so many people who have not been validated. Instead, they have been blamed or shamed and therefore do not trust people anymore. They expect you to do the same thing. However, when they feel someone is genuinely getting to their level and understanding how they cannot feel what they feel but get what they are saying and want to help, then it can make a difference.
This may not always be the case. Robin has had people before who were nothing short of hating her. These are the people who have been forced into a situation and have not had that desire to change. She has also had people who were forced into the situation, and through that process of some of the things being discussed they have been able to come around and see there will be a better life for them. This is the key. Everything about the mental health community in terms of trying to help people is what has been taken from your life as a result of your illness and what you can do to restore it.
This is definitely an interesting strategy since Aaron thinks he would have approached it the wrong way. He would have leaned into the fear factor of being on a limited time, so it needs to go away and they need to focus on the transactional. Realtors are really focused on the human side. Robin wants to get the people struggling to buy into the future of what it would look like once you are past the process. Aaron asked if this is effective. Robin said yes; and what is interesting is if you imagined having to be somewhere and having a co-worker sitting next to you trying to push you to go. The more you pressure them, the more anxious they will get. However, if you give them a specific timeframe, it might make it less stressful. The more you pressure someone, the more anxious they tend to get.
It really comes at a level of calmness. If you have somebody who is high intensity anxiety or upset or angry and you start pressuring them, it is like TNT. It is like trying to fix dynamite with dynamite versus staying calm. If you stay calm, you will actually bring them down just by that kind of demeanor.
Aaron liked when she talked about the thrill of the deal. Aaron’s mom used to say, “the more you buy, the more you save.” Everybody likes a good sale. You really have to be sincere for it to work. Aaron asked if it is a good idea to talk to them if they feel they are a collector and talk about why they love it so much. Aaron wondered if this way you can get to what they really want to keep. He wondered if there were any strategies around this. Robin said there are a couple. Going back to the first segment, the question to ask is whether their item has a home. If you are looking at a picture on the floor and there is no wall space, you have to do one of two things. You need to let go of it, or you need to switch out another picture for it. Pictures do not typically sit on the floor.
Robin is well known for her excessive amounts of shoes. She has gotten to a place where it is full. When she is out and sees something, she asks herself if she has a pair she can throw out to make room for the new pair. If she can’t, then she does not buy it. This is a rule she has made for herself. It has to have a home because she does not want to be walking into her closet on a floor of shoes. This is a very important strategy, and it’s hard. When we have that thrill seeing something on sale and wanting to take advantage of the deal, you have to look at other factors too. If you are not going to be able to access it and it will be thrown in with a bunch of other things that will be covered up by other things, it is not a good deal.
Even though you are looking at the fact it is 75% off, you are now paying $9.99 plus tax for something you cannot even access. They frequently see these situations where there are piles of duplicates because they have seen it as a good deal. However, they do not see it as a bad deal because they do not consider the fact they are actually not using it. Robin said she has 16 corkscrews as well; and even though it was marked down to the $.99 pile from $10, she is not even using the other 16. This is why she will walk away from it.
A big part is individuals recognizing this process as cognitive distortions. This means thinking distortions or thinking errors. They do think like catastrophizing and that if they do not buy it right now they will never get the deal again. They think it is such a unique piece that they will never find again and will always regret it. They get caught up in all these negative thinking patterns, and they do not challenge them to even see if it is accurate.
Robin’s aunt would be so upset if she let something go. However, she would not be upset about it now that she is in Heaven. However, when buying at the time people do not think about these things. They just think about how upset the other person would be if they do not let it go. However, they won’t have to know. The people then reframe the negative thinking patterns to betting if they looked at it differently and their relative knew the struggles you were living, the other person would instead encourage them to live in a safe, comfortable environment. However, they do not go to this place because there is so much anxiety and fear over these things they tell themselves and tend to give into them. Challenging their negative thinking is what is really important.
Family component is also important. They have to get to a point where they stop badgering them and get to a place of compassion. That family member is really suffering. This is always apparent in Dr. Robin’s show about hoarders, and it is always good to watch since it is always packed with different lessons.
Tune in next week as Aaron continues his discussion with Dr. Robin Zasio. For more information, you can visit her Anxiety Treatment Center office in either Sacramento, Roseville, or El Dorado Hills. You can always email her at firstname.lastname@example.org or email@example.com. You can also give them a call at (916) 366-0647. Their website is also www.anxietytreatmentexperts.com. Finally, her title of her book again is The Hoarder and You: How to Live a Happier, Healthier, Uncluttered Life. You can find it on Amazon or at Barnes and Noble.
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