Imagery rescripting, a technique commonly used in cognitive behavioural therapy (CBT), is showing promising results as a potential treatment strategy for individuals with hoarding disorder, according to a recent study conducted by psychology researchers at the University of New South Wales (UNSW). This technique involves rehearsing alternative outcomes of discarding items through the power of imagination, suggesting a new avenue for addressing the complex challenges those hoarders face.
Hoarding disorder is a condition that significantly impairs individuals’ ability to function and tends to worsen with age. Those affected by this disorder often develop deep emotional attachments to their possessions, leading to excessive accumulation of items and severe difficulty in discarding anything, regardless of its actual value. This behavioural pattern can result in considerable clutter encroaching upon the livable space within their homes, often preventing normal home activities and posing serious health and safety risks. The disorder can isolate individuals, exacerbate stress, and deter them from seeking treatment due to stigma and a lack of effective interventions.
The research team, led by Mr Isaac Sabel from the Grisham Research Lab at UNSW, an experimental clinical psychology group, has explored the benefits of imagery rescripting in treating hoarding disorder. This method engages individuals in altering the anticipated adverse outcomes associated with discarding items by substituting them with positive or neutral alternatives. By doing so, it addresses the intrusive and distressing mental images that frequently occur in those with hoarding disorder, which can hinder their ability to part with items.
The study encompassed 176 participants who exhibited strong hoarding tendencies. They participated in an online intervention that involved selecting an item they had struggled to discard. Participants were asked to write down their feared outcomes if they were to discard the item and then engage in an exercise to rescript these outcomes based on one of four different therapeutic approaches: imagery rescripting, cognitive restructuring, imaginal exposure, and a control condition focusing on positive imagery. Following these interventions, the participants were encouraged to attempt to discard the item.
The findings revealed that those who engaged in imagery rescripting reported increased happiness, motivation, and a greater likelihood of discarding the item than those who underwent other interventions. This technique also proved more effective in reducing negative emotions such as anxiety, sadness, and anger while enhancing feelings of relaxation and happiness around the act of discarding. Furthermore, the study indicated that the effectiveness of imagery rescripting might be influenced by an individual’s ability to visualise vividly; participants who could more clearly imagine various scenarios tended to find discarding less challenging.
These promising results have been further validated in a second study led by UNSW researchers. This study compared imagery rescripting with thought listing, another previously found effective in facilitating the discarding process. Preliminary findings suggest that imagery rescripting not only outperformed thought listing in improving motivation and positivity around discarding but also showed potential for broader application in treating hoarding disorder.
Hoarding disorder affects approximately 2.5% of the working-age population in Australia, equating to around 715,000 individuals. The condition is often linked to significant psychological distress and social impairments comparable to those experienced by individuals living with schizophrenia. It can lead to unsanitary living conditions, increased risk of accidents, and substantial social and financial costs to restore homes to a safe, liveable state.
The study conducted by UNSW highlights the potential of imagery rescripting not only as a treatment for reducing the distress associated with discarding but also as a means of addressing the deeper psychological issues that fuel hoarding behaviour. By focusing on sensory-rich details to create immersive and emotionally evocative experiences, this technique offers a novel therapeutic avenue that could be particularly beneficial in early interventions and for individuals in remote areas where access to traditional therapy is limited.
More information: Isaac Sabel et al, Imagining Letting Go: a Preliminary Test of Written Imagery Rescripting to Facilitate Discarding in a High Hoarding Sample, Journal of Psychopathology and Behavioral Assessment. DOI: 10.1007/s10862-024-10171-y
Journal information: Journal of Psychopathology and Behavioral Assessment Provided by University of New South Wales
