Recent Thoughts About Hoarding Disorder and Yoga

by Ram

Taking Out The Garbage by Edith Vonnegut*

I was at an Ayurveda conference last year when one of the participants approached me to discuss her mother, who was diagnosed with HD. Being a neuroscientist, I assumed HD to be Huntington’s disease, a neurological condition that results in the progressive breakdown of nerve cells in the brain. In the middle of the conversation I realized that she was referring to another condition: Hoarding disease. I was puzzled because I never thought of hoarding as a disease.

As I kept reading about this condition from various sources, I was amazed to learn that hoarding disorder (HD), as it’s officially known, is a serious condition that is as common as schizophrenia, bipolar illness, and obsessive-compulsive disorder (OCD). In the latest version of the DSM manual (Diagnostic and Statistical Manual of Mental Disorders), hoarding, which was previously classified under OCD, is now classified independently of OCD suggesting the higher prevalence and seriousness of this disease. A recent review published in the “Journal of Psychiatric and Mental Health Nursing” found that 2-5% of the population met the criteria for hoarding disorder. According to the Mayo Clinic:

“Hoarding disorder is a persistent difficulty discarding or parting with possessions because of a perceived need to save them.”

As a result, any thought of getting rid of the items triggers serious mental stress to the individual. Excessive accumulation of items, regardless of the actual value, often creates cramped living conditions with homes/garages that are filled to capacity and narrow pathways leading through mounds of clutter. The clutter may include but is not limited to household utensils, paper materials (e.g., mail, cards, books newspapers), clothing, containers (e.g., boxes, paper and plastic bags), garbage, rotten food, pet’s stuff, and, of course, wealth. Hoarding disorder ranges from mild to severe, and may not have much impact in some cases, while in other cases it seriously affects the individual’s functioning on a daily basis. Symptoms of hoarding disorder begin relative early (around 30) and worsen with age. People with hoarding disorder often don't see it as a problem, making the diagnosis and treatment challenging. Attempts to “de-hoard” usually fail since the problem may recur, often within a few months. Moreover, hoarders whose homes have been cleared without their consent are known to experience extreme distress and may become further attached to their possessions thus putting them in a downward spiral of the disease.

Medicines alone may help reverse some of the associated symptoms such as depression, fear, worry, and/or anxiety but does not appear to reduce the hoarding behavior. Psychologists and counselors suggest the following:

1. Hoarders need to be sympathized and held with respect
2. Help the person to recognize that hoarding interferes with every aspect of life
3. Find out what will help motivate the person to discard or organize 
4. Encourage the hoarders to come up with suggestions to clear the clutter to make their living environment safer

What does this have to do with yoga? Well, in the yoga philosophy, the first of the eight rungs or limbs is the yamas, and are considered as universal morality (see Yama Drama: Considering the First Branch of Yoga). Yamas serve as moral, ethical, and societal guidelines to lead a healthy, conscious, honest, and ethical life. Of the five yamas that help us to relate to our surroundings and environment and to achieve oneness with it is aparigraha. (see The First Branch of Yoga: The Yamas). The term can be translated to mean noncovetousness/non-possessiveness/non-hoarding. Aparigraha means to limit possessions to what is necessary or important, and having what is truly necessary and no more. The more we accumulate and hoard material possessions, the more we get attached to and worry about losing these possessions. 

According to Patanjali, coveting material wealth increases greed and possessiveness, and distracts an individual from doing a charitable act. But hoarding is not just about accumulating material possessions but also about filling/holding thoughts and emotions that affect our normal mindset and thinking process. We tend to fill our minds with fear, worry, anxiety, grief, anger, rage, jealousy, and judgments, among others ,and we do not let go of these emotions. Over time, these emotions build up and accumulate as unexpressed or suppressed emotions that can trigger mental and/or physical pathological conditions (see Aparigraha (Non-Hoarding) and Healthy Aging for more on this topic). Was Patanjali was referring to acute hoarding or chronic hoarding leading to a neurobehavioral disorder? Whatever be it, the very act of hoarding can be devastating to both mind and body, and need to be seriously addressed. 

Since yoga can help both the body and mind to function at their best, there is a possibility that yoga can also get rid of compulsive hoarding or hoarding disorder. What is the easiest and effective way to ward off emotional hoarding? Meditation helps to bring the awareness of oneself from moment to moment. While meditation may not cure a person from the act of hoarding, it may help the individual to react to life differently. This reaction and suitable action measures comes from a true awareness to the physical or emotional turbulence. Additionally, yoga asanas may also help, and there are several anecdotal reports about various asana posture for HD. In the scientific literature, there are several published reports about the effectiveness of Kundalini yoga for the treatment of psychiatric disorders including OCD. According to the authors of one such study, the Kundalini OCD protocol includes techniques that are useful for other neurobehavioral conditions, including anxiety disorders, fear and anger management, and reversing mental challenges, and for converting negativity into positive thought. According to the authors of An Introduction to Kundalini Yoga Meditation Techniques That Are Specific for the Treatment of Psychiatric Disorders, the yoga protocol also successfully addresses phobias, addictive and substance abuse disorders, major depressive disorders, grief, and insomnia. Additionally, the authors also provide information about contraindications and list of dos and don’ts to keep the yoga practice safer. 

Let me also add that while I consider yoga to be a powerful tool for improving neurobehavioral health problems, such as HD or OCD, it is one of the many solutions. One may need to use it as an add-on practice to western medicine, including drugs and/or therapy. You need to do whatever it takes to help you get better and the yoga mat is one of those solutions.

And if you’re a parent, spouse or significant other, or a family member of an individual with HD, kindly encourage the individual to take some form of yoga class as it has been shown to successfully address phobias, addictive and HD. Consider taking these classes yourself so you can provide the most calm and supportive environment possible for the HD individual.

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Goodbye, Lotus Pose

by Nina

Trees in the Ocean by Brad Gibson

Today in my weekly yoga class, my teacher asked me to demonstrate a pose—Marichyasana 2—that I used to be able to do. But because the arthritis in my right hip prevents me from taking Half Lotus position (which I used to do with ease), I had to turn him down. It got me thinking. Naturally, not being able to get into Half Lotus on one side also means that Full Lotus is also unavailable to me. Even if one day I get a hip replacement (I’m hoping that won’t be necessary because so far I’m not getting any worse, thanks in part to yoga), I still won’t be able to do Lotus. So, well, that’s it for me, folks! 

As some of you may know by now, I’ve been working on non-holding (see Non-Holdiing (Aparigrapha)) by getting rid of objects that I have no use for but to which I have an emotional attachment. So I decided today that I should just let go of Lotus pose (and all its variations, such as, Arda Padma Paschimottansana) in the same spirit. And I said to myself, “Goodbye, Lotus pose.”

For most of us long-time yoga practitioners, some poses that we used to be able to do will become inaccessible to us as we grow older. And in a culture that tends to value the ability to do showy and athletic yoga poses, this can be hard. I recently wrote a special post for a reader who felt terrible sadness about what she saw as the loss of her practice (see Practicing with Pain). People who start yoga later in life may just need to rule out certain types of poses entirely. Yet the ability to do these kinds of poses has no relationship to the rewards we can reap from the practice.

A few days ago, a long-time friend who is in his late seventies was telling me about how he had to give up tennis, which he loved, because it was so hard on his joints. But the thing about yoga is that even as I let go of certain showy poses, I’ll never have to give up the practice. The rich repertoire of poses, modifications, and props ensures that people of any ability will benefit from the practice, even those who are profoundly disabled. If you can breathe, you can do yoga.

And the practice of letting go of poses we can no longer do or poses we will never be able to do—of non-holding—may help strengthen us to weather the other losses that life inevitably holds in store for us with equanimity and grace.

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Non-Holding (Aparigraha)

by Nina

"Holding on to one's thoughts is also a form of possessiveness…." —BKS Iyengar

Untitled Drawing by Milton Zolotow, one of hundreds

Ram's recent post on aparigraha (non-hoarding) left a strong impression on me. In it, he mentioned several meanings for aparigraha, including "non-possessiveness, non-holding, non-indulgence, non-acquistiveness." Recently I've been thinking a lot about the "non-holding" aspect of aparigraha.

Non-holding has been on my mind because I've started to feel weighed down with possessions. That's partly because in the last few years, both my parents and Brad's parents died, and we ended up with a lot of their stuff. Some of the things were useful, like the beautiful dining room table we inherited from my parents. We are using that table now and gave our old table to our daughter who started her own household, so a kind of balance has been established. A lot of the other stuff isn't at all "useful" but still has a tremendous emotional power over me. For example, we inherited a couple of boxes of samples of my father's graphic design work, scrapbooks that Brad's mother created during the high school, college and the early years of her marriage, and some of my chic mother's favorite clothes that I'll never wear because they don't fit. It has been surprisingly hard to even consider getting rid of these things, and yet….

This is on my mind today because I just got back from a trip where I visited two longtime friends, each of whom happened to be in the same position, having things, either in her house or in a storage facility, that there was no real use for but to which she had strong emotional attachments. We all agreed that it was material we would need to part with at some point, and yet we all shared that it was surprisingly painful to even consider doing.

About a year ago, I started a practice of getting rid of at least one thing every day. I kept it up for a few months—in the beginning it was easy because every time I opened a cabinet I saw something of my own that I really didn't need—but then it became harder and harder. I would open a box of my parent's stuff, feel overwhelmed with emotion, and then close it up again. And I eventually gave up the daily practice. There's something about fall for me, though, that feels like the time to get back to business. My conversations with those two friends this weekend motivated me even more. So I returned from my summer vacation and decided to resume my getting-rid-of-one-thing-a-day practice. Today I went back and read Ram's post and a bit of the Yoga Sutras. This time I was struck by concept of "non-holding" as being about not holding on to thoughts (as Iyengar wrote) and emotions (as Ram wrote). Of course, with our parents' things that we three women are holding on to, it is not the objects themselves that we are having such a hard time letting go of, but rather the thoughts and emotions that the objects evoke.

I feel that this new understanding of "non-holding" will help make it easier for me to keep up with my letting-go practice this year and start to move from the easy tasks to the harder ones.

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Aparigraha (Non-Hoarding) and Healthy Aging

by Ram

Naushon Tree by Brad Gibson

In the Sadhana Pada of the Yoga Sutras by Patanjali we are introduced to the eight rungs/limbs/steps of yoga whose practice helps us to develop attention as a tool to discriminate between ignorance and awareness and truth from illusion, the means for liberation or enlightenment. One of the eight limbs is aparigraha, which has several meanings, including non-possessiveness, non-holding, non-indulgence, non-acquisitiveness. Verse 2.39 in the Yoga Sutras describes aparigraha as:

aparigraha sthairye janma kathanta sambodhah

When one is steadfast in non-possessiveness or non-grasping with the senses there arises knowledge of the why and wherefore of past and future lives. —trans. by Swami Jnaneshvara

 Aparigraha comes from the word parigraha, which means reaching out for something and claiming it for oneself; the "a" prefix' before parigraha turns it into an antonym. Thus, aparigraha is the concept of non-possessiveness or non-hoarding. Aparigraha means to limit possessions to what is necessary or important and taking what is truly necessary and no more. Nina briefly touched on this topic in one of her earlier postings (see Yama Drama).

Our senses are like portals or gateways into our body, mind and consciousness. We are what we eat, smell, see, hear and touch. Through our senses, we absorb the world around us. If we take in harmonious impressions, we will in turn be healthier. If we absorb disharmonious impressions through our senses, we are inviting with it all kinds of body-mind problems. Through these five senses we get attracted to material possessions and surround ourselves with them. Hoarding is the accumulation of things that may have little or no value. So great is the need to accumulate these things that they then becomes difficult to part with it. Hoarders accumulate and store old newspapers, food cartons, cans, mail, notes, clothes, garbage and other debris. Hoarding begins slowly and builds over time. Hoarders will not give up their possessions as they develop an emotional attachment to their belongings and have a distorted view about the importance/lack of importance of material possessions. People who develop a habit of hoarding identify their possessions as a part of their identities. Losing or disposing of a possession may produce extreme anxiety or a sense of loss and grief. Researchers believe that individuals who are experiencing emotional upheavals in their lives when faced with aging and the possibility of outliving their resources may begin to collect and save as these material possessions provides them a sense of security—sort of a comfort zone.

But hoarding is not just about accumulating material possessions. It is also about hoarding/holding thoughts and emotions that affect our normal mindset and thinking process. Hoarding, be it mental or physical, is associated with an inability to process information and make decisions when confronted with a large amount of information, attention and focus deficits and a failure of categorization. We tend to fill our minds with fear, worry, anxiety, grief, anger, rage, jealousy, and judgments, among others, and we do not let go of these emotions. Over time, these emotions—whether it be bitterness, fear, emotional damage, rejection or abandonment—build up. If you hoard/accumulate unexpressed or suppressed emotions and if they are not getting released, they keep building up in your body. Ultimately these pent-up emotions can trigger mental and/or physical pathological conditions. Thus, hoarding emotions can be devastating to both mind and body.

What is the easiest and effective way to ward off emotional hoarding? A simple method is meditation (dhyana), the cheapest and simplest recourse to a healthy body and mind (see Balancing Your Emotions with Your Breath). While meditation may not cure a person from the act of hoarding, the person having a meditation practice will react to life’s turbulence differently. This reaction and suitable action measures comes from a true awareness; awareness to the emotional turbulence arising from within that has remedial effects. As explained in an earlier post (see Never Go to Bed Angry), the individual will not only have the capacity to transcend the physical and emotional upheaval but will also not evoke the same physical and emotional reactions that are commonly seen in a person who does not meditate.

Just as you take a car for a regular tune up, you also need to detoxify and tune up our body and mind on a periodical basis. Disposing of any unwanted material possessions and detoxifying our mind-riddled emotions on a regular basis is a panacea for healthy aging and living. If you can do it for your car, you might as well think about doing the same for your mind and body.

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