What do Smoking, OCD and Hoarding have in common? – Hypnotherapy Glasgow


What do Hoarding, OCD and Quitting Smoking have in common?

Cathy Simmons, Hypnotherapist, London

Hoarding, OCD and Quitting Smoking

I was drawn to this article in Psychology Today, because of it’s title, “Why it’s hard to let go of clutter”  as someone who finds it, shall we say, less than easy to throw anything out.

Things that have been in boxes unopened since I moved in, suddenly become things that might “really come in handy one day”, as soon as the prospect of throwing then away looms.

In my therapy practise I specialise in helping people stop smoking, so am always on the lookout for more insights and the latest findings about the neurology of smoking and addictions – so I was fascinated to find that the same areas of the brain are involved with smoking, OCD and hoarding!

Structures called the anterior cingulate cortex and the insula are areas of the brain involved in conflict and pain, and, for a smoker wanting to quit, these are the culprits responsible for those overwhelming feelings of “something is wrong – got to have a cigarette”. The more you want to stop, the stronger the urge.

What is so interesting to me is that these areas are also involved in creating the anxiety and that feeling of “something is not right” involved in OCD and, indeed the anxiety caused to hoarders by the thought of throwing something away.

For me, this opens out even more possibilities for therapy. By having an understanding of this mechanism it is already possible to break the cycle that would otherwise lead to the cravings associated with quitting smoking, so that it is completely possible to stop smoking without the cravings. By utilising the same approach, we could also have new tools for helping to relieve the compulsions that can be so debilitating to those who live with them…

… and maybe it is about time I threw out those boxes!

By Cathy Simmons

For a really interesting read about what leads to the build up of compulsions and what may also possibly be behind hoarding have a look at the article




Secrets for self-control without suffering

by Kelly McGonigal, Ph.D.


Why It’s Hard to Let Go of Clutter

A new brain imaging study finds that letting go is literally painful. – Psychology Today

Published on August 7, 2012 by Kelly McGonigal, Ph.D. in The Science of Willpower


Have you ever been overwhelmed by a junk drawer, closet, packed garage, or pile of paperwork — but found it hard to just throw everything out?

A new study finds that for many, letting go is literally painful.

Researchers at the Yale School of Medicine recruited both non-hoarders and hoarders, and then asked them to sort through items like junk mail and old newspapers. Some of the items belonged to the experimenter, and some actually belonged to the participant. Participants had to decide what to keep and what to toss. While this was happening, researchers tracked their brain activity.

Unlike non-hoarders, hoarders showed increased activity in two regions of the brain when confronted with their own junk. Those two areas: the anterior cingulate cortex and the insula. And the more a hoarder reported feeling “not right” about throwing something out, the stronger this pattern of activation was.

When I read this very specific finding, I had an instant feeling of recognition. I know that neural signature. Both are these regions of the brain are associated with conflict and pain — and you see the same pattern of brain activation in other forms of psychological pain.

For example, the same regions produce gut-wrenching cravings among smokers or drug addicts trying to quit. The stronger the activation, the stronger the feeling of anxiety, discomfort, and need to use.

You also see the same brain pattern among shoppers hit with sticker shock. The pain of high prices provides a physical incentive to resist a purchase [see previous blog post], and you can predict whether or not someone will buy something by the strength of this brain pattern.

Perhaps the simplest way to think about the ACC-insula combo is that it creates the signal of “something wrong.” The brain circuit motivates you to look for an opportunity to prevent harm or relieve anxiety – so smokers smoke, shoppers put down the pricey item, and hoarders hold on to junk.

Interestingly, people who suffer from obsessive-compulsive disorder appear to have a very low threshold for tripping this brain circuit. The obsessions and compulsions are a response to the “something wrong” brain signal. Even though the signal may be a faulty habit of the brain, the mind searches for something to explain the feeling. That’s how people with OCD can settle on irrational beliefs and behaviors. If they wash their hands, or touch a wall three times, or repeat a mental mantra, they seem to “prevent” whatever harm their brain was expecting (but was never really coming). This reinforces the compulsions and makes them even harder to resist.

The same process may explain why hoarding is self-sustaining. Each time a hoarder holds on to something, he or she may feel safer and calmer. That relief can become addictive.

Previous research has found that hoarders also show greater activation in the ventromedial prefrontal cortex (vmPFC) when thinking about whether to throw something out. The vmPFC is associated with many mental experiences, but two seem particularly relevant to hoarding.

The vmPFC is the home of what I call “wantpower” – the belief that something is relevant to your goals and desires. Research has shown that greater activation of the vmPFC will predict whether someone will buy, eat, or do something. Hoarders often do feel an irrational conviction that something old and useless could have potential value in the future. The idea that they might need something, but have gotten rid of it, is painful.

But the vmPFC is also important for maintaining a sense “me”-ness. Greater activity in the vmPFC may suggest a greater sense of personal relevance and meaning. So perhaps hoarders look at something as simple as a piece of junk mail and feel it connected to their sense of self. That letter is “me”; that old chotzke is “me”; that pile of papers is “me.” This would explain why getting rid of something would be painful – it’s like throwing out your own arm.

You don’t have to be a hoarder or have OCD to know what this feels like, whether it’s a favorite old sweatshirt, a gift you’ve never used but can’t bear to throw out, or every drawing, craft, and school assignment from when your kids were in grade school.

[Full disclosure: I seem to have the opposite brain reaction when it comes to junk and clutter. I love throwing things out, and find it at least, if not more, fun than acquiring things. It’s almost a high to be able to say “I don’t need this anymore!” I’ve had to train myself to hold on to things that I’ll be nostalgic for in the future, like cards from family and other mementos.]

Whatever your willpower challenges — clutter, cravings, compulsions — there’s something to learn  from these studies of extreme cases.

As I argue all the time, mindfulness of our own brain habits seems to give us more control over our choices. The technique of surfing the urge, which helps addicts resist cravings and dieters resist temptation, may also help us deal with anxiety about getting rid of clutter. And taking a more skeptical view of our own impulses (not believing every worry, emotion, or “want”) can help us distinguish between our actual strength and the brains lies’ (“this will make you happy,” “this will protect you from your anxiety” or “you can’t handle this feeling, you HAVE to give in.”)


1. Tolin DF et al (2012). Neural mechanisms of decision making in hoarding disorder. Archives of General Psychiatry, 69, 832-841.

2. An SK et al (2009). To discard or not to discard: the neural basis of hoarding symptoms in obsessive-compulsive disorder. Molecular Psychiatry, 14, 318–331.

Contact: Hypnotherapy Glasgow, Linda Alexander on 07875 493 358 and 0141 632 1440

also linda.alexander@talktalk.net

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