Ambivalence – and a great deal of it – is a typical feature of hoarding disorder. Even clients who seek treatment for this debilitating condition bring considerable ambivalence to the goals and tasks of the treatment. Before you can work with a client’s ambivalence, you must first know what it looks like. Here are typical signs of ambivalence when working with people who hoard.
Arguing about what to keep or discard. One of the most difficult tasks of the treatment is assisting clients to discard possessions. When the client is arguing with you about what to keep and what to discard, the client has lost perspective on the problem. Arguing is a hallmark of ambivalence. If you are arguing with the client, you are no longer working with him. Treatment focuses on assisting the client to make decisions on his own about what to keep and discard not trying to convince the client that his views are unreasonable.
Blaming self to escape. Some clients will resort to anything to avoid working on the hoarding problem – including blaming or criticizing themselves for the problem or even the unreasonableness of their beliefs. As therapists, we often move in too quickly to soothe the self-critical client. When we do, the client escapes, for a few minutes, working on the problem and sitting with the emotional experiences he has organized his life around to avoid.
Diverting discussion to other topics. Some clients who hoard are desperate for social contact. When working with the client in your office or in his home, we will divert the discussions to other topics. Often, she reminisces about an object she finds, or she may wish to share photos of her grandchildren. Although some discussion such as this is appropriate, too much takes you and the client off task and away from working on the problem.
Tompkins, M. A., & Hartl, T. L. (2009). Digging out: Helping your loved one manage clutter, hoarding, and compulsive acquiring. Oakland, CA: New Harbinger Publications.
Tompkins, M. A. (2014). Clinician’s guide to severe hoarding: A harm reduction approach. New York: Springer Publications.