The New Technique That Could Help Hoarding Disorder

Greg Martin prepares to clean out his Mother's home of belongings in San Diego, Calif., on April 8, 2011. Sandy Huffaker/Getty Images for YOU Magazine

A recent study has demonstrated the potential for “imagery rescripting” (ImRS) to help people with hoarding disorder.

Hoarding disorder is a condition where people form intense emotional attachments to objects and accordingly experience difficulty discarding their possessions. It affects around two percent of the general population.

Psychology researchers from the University of New South Wales (UNSW) examined the impact of imagery rescripting on 176 people.

They aimed to determine whether rescripting negative and future-focused narratives around discarding would help people with hoarding disorder let go of their possessions.

Participants engaged with the study online, focusing their treatment around an item they struggled to let go of.

Four treatments were tested and the study found that the treatment strategy resulted in people who were happier, more motivated, and more likely to discard possessions.

An out-of-sight, out-of-mind mentality might mean permanent damage to some items if left in the attic. Graham King/Getty Images/TCA

Imagery Rescripting

Imagery rescripting (ImRS) is a therapeutic technique where distressing mental images are retrieved and reshaped to become more positive or less harmful. It has demonstrated success in treating disorders characterised by future-focused mental imagery.

Study author Isaac Sabel said in a UNSW release that people who hoard suffer from frequent intrusive and distressing mental images that induce anxiety and prevent discarding.

Sabel said that negative memories and fears of future events can manifest in mental images depicting upsetting events such as items rotting in landfills or the disappointment of a loved one.

In this study, imagery rescripting was used to introduce positive or benign information to rewrite the outcome of negative mental imagery associated with discarding.

Comparison of Treatments

The other three treatments administered were cognitive restructuring, imaginal exposure, and dwelling on positive imagery.

Participants who dwelt on positive imagery to improve their mood were used as a control group, while those engaged in cognitive restructuring and imaginal exposure were compared with those using imagery rescripting.

Cognitive restructuring requires patients to identify and disregard irrational and damaging thoughts while imaginal exposure involves engaging with anxiety-provoking thoughts to reduce their impact.

Yet, ImRS was found to be more effective at reducing anxiety, sadness, and anger compared to both treatments. ImRS also resulted in increased relaxation around discarding items.

Unique Efficacy of ImRS

Coauthor Professor Jessica Grisham said in the UNSW release that imagery rescripting has the potential to address both foundational traumas and distressing mental images preventing discarding.

“Images can link our past, present, and future,” Grisham said.

“Rescripting memories that may have triggered hoarding—going back and meeting those needs—may open up the doorway for greater treatment outcomes and greater positive impact on clients’ lives.”

People with hoarding disorder can feel a lot of pressure to discard so they can feel stressed and reactive; yet, imagery rescripting demonstrated a reduction in reactivity, she said.

Grisham added that imagery is known to act as an emotional amplifier, enabling engagement with neural features responsible for memory and emotional processing. She said ImRS creates an emotionally evocative and immersive experience.