Phone Counseling for Cluttering

Case Example

While it is not always recognized as a serious problem, cluttering and compulsive hoarding can debilitate a person. The woman in this example had been unable to have guests over to her house for years before we began to work together. Moreover, after failing to keep her house clean with the help of six different therapists, her self worth had been seriously undermined and she felt quite powerless.

Peg was a retiree in her mid-sixties who had been working with different therapists over the past 7 years to stop her compulsive hoarding. Those therapist had mostly been trying to reward her when she would spend time cleaning or challenge her “irrational thinking” — all to no avail. When she first requested a phone session with me, she was socially isolated and told me how much she wanted to be able to clean her house enough to have guests over from her church group. As I listened, I wondered what could make sense out of her cluttering and decided to see if an exercise called a symptom deprivation would help.

I began by asking her to describe what her house would look like once it was as clean as she wanted it to be. She told me that she would just want there to be an sink empty of dishes, the surfaces to be clear of mail and papers, and all of the boxes of stuff to have been sorted and either given away or sold. I asked to imagine for a moment that she lived in that clean house. I paused for a few seconds to allow the scene to feel real, and then I asked her “What is something you would have to do in order to keep the house clean?” She said she would have to attend to the mail when it arrived instead of letting it pile up until it covered most of her tables. I said, “Good. Now while you are in that very clean house, I’d like you to imagine walking over to the mailbox and getting the mail. You then immediately sort it and deal with any bills or anything that needs to be done and put it where it belongs.” I paused as she did the visualization. “Is there anything that feels unwelcome about this reality?”

She responded, “It feels cold and sterile. And I feel lonely.” At this point, I felt like I was beginning to make sense of the cluttering, but I needed to try one more exercise to be sure.

This time I asked her to imagine being in her house as it is with all the clutter, and to try saying, “This clutter helps me…” and finish the sentence without pre-thinking an ending. She quickly responded, “But I hate the clutter. I can’t stand it.”

At this point I wanted to acknowledge and validate her hatred of the clutter, but I also wanted to validate the part of her that just told me how cold, sterile and lonely she would feel without the clutter. I asked her if it would feel OK to say, “Even though I hate the clutter, part of me needs it because…” and finish that sentence. She was able to do this one and came up with “Part of me needs it because it makes me feel creative and cozy and free. I feel kind of free like a baby who made a mess.” After a few more rounds with this setence-stem, she said “Part of me needs it because it is like a warm nest or like a womb.”

Now I felt that things were getting clear. I asked her if it felt true to her that this part had actually wanted to hold on to the clutter because it felt free and creative and like a nest or womb, and that without it she would feel cold and sterile and lonely. She paused for a long time and seemed to be really searching around inside. Then she said “I think so. But it’s hard to believe after all these years of fighting with it.”

I empathized with her and we paused for a minute or so. Then I said, “Well maybe we can see how it feels for you to say ‘There is a strong part of me that won’t let go of the clutter because it makes me feel free and creative and it’s like a nest or womb. Without it that part would feel cold and sterile and lonely.’” She repeated the sentence and told me that it felt powerfully true. I wrote that sentence on a email for her to read twice a day until our next phone session.

We had two more sessions, and each time she returned feeling less and less conflicted about cleaning up and getting rid of things. During these sessions, we focused on how letting go of the clutter and hoarding will really lead to losing something important. She decided that she will take a pottery class to keep her sense of freedom and messy creativity. By our third phone session her place was manageable for the first time in years and she had hosted a dinner party earlier that week.

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