What's one small thing to help your sleep? A real alarm clock
Phones have replaced many things: computers, calculators, cameras and maps.
But returning to an old-fashioned alarm clock instead of your phone might help you get up and go in the morning.
'Keeping the phone in another room will likely decrease the opportunity for distraction from sleep, and also decrease opportunity for sleep procrastination,' said Dr. Shalini Paruthi, sleep medicine attending physician at John J. Cochran Veterans Hospital in St. Louis and adjunct professor at St. Louis University School of Medicine.
A phone by your bed could mean easy access to scroll at night and an easy snooze button in the morning.
If you're planning to sleep better or wake up earlier to implement new routines in the new year, a small and helpful step may be trading your phone for an alarm clock.
The best-case scenario is that you wouldn't need to hit snooze.
'Ideally, a person has gotten enough sleep that by the time the alarm rings, they are well rested and actually ready to get up,' Paruthi said.
Hitting the snooze button once might help you psychologically by allowing you to ease into waking up, she added. But more than once isn't recommended because you aren't getting good sleep with the extra minutes.
At the end of a night of sleep, people usually go in and out of a cycle called REM, or rapid eye movement sleep, said Dr. Brandon Peters-Mathews, a neurologist and sleep medicine physician with Virginia Mason Franciscan Health in Seattle, in an earlier CNN article. This stage is important for memory processing and creative sleeping, and fragmenting that sleep could affect brain function.
Instead of setting an alarm for earlier than you need and hitting snooze, he recommends allowing deep, uninterrupted sleep until you absolutely must wake up.
'When you didn't get enough sleep or didn't get good quality sleep, the likelihood that an extra 5 to 10 minutes of sleep could make a meaningful impact is pretty low,' Dr. Joseph Dzierzewski, senior vice president of research and scientific affairs at the National Sleep Foundation, said via email. 'When we wake in the morning and aren't feeling refreshed, it is best to get up, start the day, and be intentional about taking steps that can set us up for success in the coming night.'
With a phone alarm on your bedside table, it is easy to reach over and hit the snooze button. But dedicated alarm clocks have many ways to get you up and out of bed.
'Alarms come with a variety of features such as vibration, lights, noises, puzzles,' Paruthi said.
Another benefit of not using your phone as an alarm is that you have an easier time removing it from your bedroom, which is helpful for sleep, Paruthi said.
'Ideally, a bedtime routine includes winding down, relaxing, and helping the brain transition from a 'go-go-go' state to a more calm, ready to fall asleep state,' she said. 'Having a phone at the bedside makes it really easy to roll over and start scrolling.'
The bright light and content on your phone might make you more alert instead of drowsy, and screens can also lead to procrastinating about sleep and getting less than you originally intended, Paruthi said.
And having your phone close by makes it more likely that you will use it, Dzierzewski said.
'Having a phone in close proximity could increase feelings of curiosity. … What might be happening that you aren't seeing?' he said. 'These feelings could be enough to entice you to roll over and check your phone, thus interfering with going to sleep, staying asleep or sleeping soundly.'
If you aim to sleep for eight hours but then reach for your phone to scroll, two hours can fly by quickly, leaving you without the necessary amount of sleep.
'If my phone is in another room, I am less likely to get out from under my warm covers, and thus sleep those 2 hours between 10 and midnight, i.e., getting the 8 hours my brain and body thrive on,' Paruthi said in an email.
The only way to wake up earlier or more easily is to get good quality sleep, Dzierzewski said.
Most adults should get seven to nine hours of sleep a night, according to the National Sleep Foundation. But population research from the foundation has shown that 60% of adults are not meeting that recommendation.
'Getting too little sleep or too much sleep can both be problematic and impact how well we function throughout the day,' Dzierzewski said.
For better sleep, the National Sleep Foundation recommends some more small steps. You should get bright light in the daytime; exercise for at least 30 minutes five days a week; eat meals at consistent times; avoid heavy meals, nicotine, caffeine and alcohol before bed; use a consistent wind-down routine; sleep in a quiet, cool and dark place; and put electronics away an hour before bed.
If you are getting enough sleep at night consistently but are still not sleeping well or waking up feeling rested, it may be time to get evaluated by a board-certified sleep physician for possible sleep disorders such as sleep apnea, restless legs syndrome or insomnia, Paruthi said.
Ready to do more? Sign up for our LBB Sleep newsletter to get better sleep in 2025. If you need help setting and sustaining your sleep goals, try these tips for building habits.
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CNN
3 hours ago
- CNN
‘The stuff under the stuff': People with hoarding disorder open up
Mental healthFacebookTweetLink Follow The habit crept up on Kim. She would arrive at garage sales as they were ending to pick up what remained. 'I'd load my car full of the free stuff on the side of the road: clothes, things that needed to be fixed, projects,' she told CNN. It was only once things spiraled that Kim, 53, who asked to be identified by her first name to protect her privacy, realized she had a problem that was all too familiar: hoarding, a disorder that she'd spent years urging her mother to seek help for. 'I used to get very frustrated and say, 'Mom, we've helped you clean out this room 10 times, and we come back three months later and it's completely full of sh*t ,' she said. 'I learned about hoarding disorder when I was younger but somehow didn't recognize it in myself.' At first, Kim would pile the things around her bed and throughout her bedroom, eventually expanding into other areas of her home, including her living room and sunporch. Besides the garage sales, she would collect stuff at thrift stores and stored goods she said family gave her 'to hold and keep.' Today Kim runs a Facebook support group for 2,100 people with hoarding disorder, which the World Health Organization categorized as a mental health condition in 2018, five years after the condition was to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. HD is characterized by excessive accumulation of possessions and difficulty in disposing of them . Kim only sought help when things became unsafe. 'The stuff starts piling up, the paths get narrower, and you start to trip (in your own house),' said the single mother. 'Putting things in the garbage is a big struggle — if we know it might go to the right home, that makes us feel better.' She thinks that mindset dates back to what her grandmother used to say: 'Use it up, wear it out, make it do or do without,' she said. 'That was a phrase that was knocked into my head ever since I was little,' and it makes her worry about wasting anything. What people hoard varies: Kim's focus is books. 'It would have taken me 10 lifetimes to read them,' she said of the many boxes she gave away after extensive therapy, including '500 Dr. Phil books.' Two-thirds of people with the disorder have at least one other psychiatric condition, while physical comorbidities such as arthritis and diabetes are common, according to a 2024 US Senate report. Around 14 million Americans are affected by hoarding disorder, with similar rates across other Western countries. Hoarding can trigger countless complications, experts say. Bathrooms and kitchens can become unusable, impacting diet and personal hygiene. Housing authorities can threaten eviction leading to homelessness, while in extreme cases children have been removed by social services. There is also risk to life. Excessive stuff, especially books and paperwork, pose a serious fire hazard and can hamper rescue efforts by blocking escape routes. Collecting may be in our DNA, according to Dr. Nick Neave, a professor in the psychology department at Northumbria University in the United Kingdom and director of the university's Hoarding Research Group. 'Throughout history possessions have always been very important — you see people buried with grave goods,' he said. 'That urge to collect things, it's part of your personality, your culture. So hoarding is normal — we've all got stuff we don't need.' What separates regular collecting from hoarding is often trauma, Neave said. 'All the people who hoard I've ever met had traumatic childhoods, whether it's physical abuse, sexual abuse, neglect, chaotic backgrounds, lack of parents.' This resonates with Kim, whose symptoms emerged after she experienced an abusive relationship, the death of a friend and a serious medical diagnosis. 'We call it the stuff under the stuff,' said Kim, who lives in New York state. 'One of our therapists calls it the one, two, three punch. You can handle one trauma, maybe two, but after that, a lot of people will have hoarding disorder creep in.' 'I tried to fill the hole in my heart and soul with the stuff,' she added. Neave says hoarding is a 'coping strategy which starts off working very well' but can 'spiral quickly into a severe addiction and mental health problem that is very difficult to resolve.' Shame and stigma can then lead to further isolation, he said. 'The obvious thing to do is get rid of the clutter, but that doesn't solve the problem of why they've got it in the first place. If you're not treating that issue, it'll come back.' Heather Matuozzo is the founder of Clouds End, which works with Birmingham Council in the UK to support about 300 renters through an intervention project called 'Chaos 2 Order.' 'When you live in property that's not yours the landlord can go to court and get an injunction to forcibly clear your house,' she said. 'No matter what justification you give it, it's morally wrong and also makes people who hoard worse.' She believes the pandemic led to an increase in prevalence of hoarding disorders. 'We saw the whole world hoard, as everybody had that (fear that) 'Oh my God, I'm going to run out',' she said. 'If you're already anxious, then you drop a pandemic on top of that, where everything closes and your support, which was tenuous enough in the first place, just disappears, you will be beside yourself and gathering to feel better.' Matuozzo believes that Birmingham may be 'the first hoarding-aware city in the world.' The model should be replicated elsewhere, she said. Sophia, who runs the Facebook group with Kim, first realized she had a problem at graduate school after a close relative was diagnosed with a severe mental illness. 'In between classes, I was shopping and would bring all this stuff back: dolls, books, jewelry, clothing, shoes, toiletries, school supplies. It was a way to disassociate.' Sophia, who also lives in New York state and does not want to be fully identified to protect her privacy, recalls the moment she knew she had to act — when she tried to get rid of some of her stuff. 'I had this nervous reaction; my whole body was shaking.' Soon afterward, she came across an advertisement for volunteers for a trial treatment with Dr. Carolyn Rodriguez, director of the Stanford Hoarding Disorders Research Program. Sophia said the program was massively helpful, but still, she relapsed. 'I was going plane, bus, train, automobile, just to get stuff,' she said. She has tried many varied therapies since then, including cognitive behavior therapy, or CBT, and eye movement desensitization and reprocessing, or EMDR, while leaning into the Facebook group for support. 'I love that there's community and that I can share,' she said. 'And if I can make it less jacked up or reduce harm, anybody can do that .' Stanford's Rodriguez is currently testing a virtual reality intervention. 'Many current treatments emphasize skills related to discarding and decision-making about possessions, which can be practiced in the patient's home,' she said via email. 'In many cases, real-life discarding is too difficult or in-home visits are unfeasible for reasons such as location, availability, or clutter being stacked so high that it's dangerous for a team to go inside,' she said. 'Practicing letting go of items is such an important skill to develop, so we wanted to create a virtual and safe environment to do so.' Nine participants were asked to take 360-degree photos of the most cluttered room in their house, as well as 30 possessions to discard. Once virtual equivalents were created, participants could navigate their way around using VR headsets and handheld controllers. 'For people who experience considerable distress even attempting to part with possessions, it's nice to be able to practice the activity in a virtual space as well as process the emotions of it,' said Rodriguez, who hopes to expand the project. 'In these one-hour sessions, they learned to better understand their attachment to the objects and practiced placing them in virtual bins for recycling, donation, or trash — the latter of which was taken away by a virtual garbage truck. They were then assigned the task of discarding the actual item at home.' The sessions were run as part of the 'Buried in Treasures' group treatment program. Based on a book of the same name by David Tolin, Randy Frost and Gail Steketee , it's a 16-week peer-led initiative running in numerous countries including the United States, Canada and Australia. Frost, also the Smith College Harold and Elsa Siipola Israel professor emeritus of psychology, developed the course with Lee Shuer, who now facilitates it around the world. Shuer, a certified peer specialist and hoarding disorder expert, said he never calls anyone a 'hoarder.' 'If you're trying to build trust and rapport, it's often such a turn-off. I self-identify as a finder-keeper in recovery, but a lot of people use collector, archivist, environmentalist, prepper. 'But it doesn't matter what we call it — we want to call it getting better.' Shuer started 'collecting' at school, as children often do. 'I didn't abandon that phase,' he said. 'Suddenly we weren't getting together to trade stickers and baseball cards. They were at parties, and I was reading comic books by flashlight at 3 in the morning, miserable.' In hindsight, he realizes he began to develop signs of depression in his teens and that the 'treasure hunting' ramped up in his 20s. 'It was a self-soothing coping skill for my extreme ups and downs with bipolar disorder and ADD (attention deficit disorder). As my mental health challenges continued to manifest and become more significant, so did the maladaptive coping skills.' Like others, Shuer's collections were broad, but he was particularly interested in video games, especially once he realized their social currency. 'I went from being an awkward outsider to being interesting because of my stuff,' he said. It was only with therapy that he really began to understand that dynamic. 'I realized Space Invaders was the key memory I have from the day of my grandfather's funeral. I was dropped off at a family friend's house and remember playing that.' That realization triggered a 'wave of emotion,' he said. The video games were 'an example of all the things around me that represented unresolved grief, guilt, loss.' Shuer described hoarding as 'intention without opportunity,' suggesting most of those with the condition are well intentioned and plan to use the stuff for good, though often it doesn't work out that way. 'The misunderstanding is that people love their stuff more than their family,' he said. The truth, he said, is that most of those affected are trying 'to be a good person, not a bad person.' They need help and understanding, which is what their peers can give them, Shuer said. The success of Buried in Treasures comes down to the social interaction with their peers, which enables people to open up in a reassuringly safe environment, he said. 'Learning the skills and being treated with respect like this is really empowering. You're also receiving that positive reinforcement that you're not some kind of social pariah and you're not crazy,' Shuer said. 'By the end of the course people often feel hopeful and that for the first time they have a chance. I believe that if you care enough and you want it bad enough, you can change anything. That was definitely a motivator for me.'
CNN
3 hours ago
- CNN
‘The stuff under the stuff': People with hoarding disorder open up
The habit crept up on Kim. She would arrive at garage sales as they were ending to pick up what remained. 'I'd load my car full of the free stuff on the side of the road: clothes, things that needed to be fixed, projects,' she told CNN. It was only once things spiraled that Kim, 53, who asked to be identified by her first name to protect her privacy, realized she had a problem that was all too familiar: hoarding, a disorder that she'd spent years urging her mother to seek help for. 'I used to get very frustrated and say, 'Mom, we've helped you clean out this room 10 times, and we come back three months later and it's completely full of sh*t ,' she said. 'I learned about hoarding disorder when I was younger but somehow didn't recognize it in myself.' At first, Kim would pile the things around her bed and throughout her bedroom, eventually expanding into other areas of her home, including her living room and sunporch. Besides the garage sales, she would collect stuff at thrift stores and stored goods she said family gave her 'to hold and keep.' Today Kim runs a Facebook support group for 2,100 people with hoarding disorder, which the World Health Organization categorized as a mental health condition in 2018, five years after the condition was to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. HD is characterized by excessive accumulation of possessions and difficulty in disposing of them . Kim only sought help when things became unsafe. 'The stuff starts piling up, the paths get narrower, and you start to trip (in your own house),' said the single mother. 'Putting things in the garbage is a big struggle — if we know it might go to the right home, that makes us feel better.' She thinks that mindset dates back to what her grandmother used to say: 'Use it up, wear it out, make it do or do without,' she said. 'That was a phrase that was knocked into my head ever since I was little,' and it makes her worry about wasting anything. What people hoard varies: Kim's focus is books. 'It would have taken me 10 lifetimes to read them,' she said of the many boxes she gave away after extensive therapy, including '500 Dr. Phil books.' Two-thirds of people with the disorder have at least one other psychiatric condition, while physical comorbidities such as arthritis and diabetes are common, according to a 2024 US Senate report. Around 14 million Americans are affected by hoarding disorder, with similar rates across other Western countries. Hoarding can trigger countless complications, experts say. Bathrooms and kitchens can become unusable, impacting diet and personal hygiene. Housing authorities can threaten eviction leading to homelessness, while in extreme cases children have been removed by social services. There is also risk to life. Excessive stuff, especially books and paperwork, pose a serious fire hazard and can hamper rescue efforts by blocking escape routes. Collecting may be in our DNA, according to Dr. Nick Neave, a professor in the psychology department at Northumbria University in the United Kingdom and director of the university's Hoarding Research Group. 'Throughout history possessions have always been very important — you see people buried with grave goods,' he said. 'That urge to collect things, it's part of your personality, your culture. So hoarding is normal — we've all got stuff we don't need.' What separates regular collecting from hoarding is often trauma, Neave said. 'All the people who hoard I've ever met had traumatic childhoods, whether it's physical abuse, sexual abuse, neglect, chaotic backgrounds, lack of parents.' This resonates with Kim, whose symptoms emerged after she experienced an abusive relationship, the death of a friend and a serious medical diagnosis. 'We call it the stuff under the stuff,' said Kim, who lives in New York state. 'One of our therapists calls it the one, two, three punch. You can handle one trauma, maybe two, but after that, a lot of people will have hoarding disorder creep in.' 'I tried to fill the hole in my heart and soul with the stuff,' she added. Neave says hoarding is a 'coping strategy which starts off working very well' but can 'spiral quickly into a severe addiction and mental health problem that is very difficult to resolve.' Shame and stigma can then lead to further isolation, he said. 'The obvious thing to do is get rid of the clutter, but that doesn't solve the problem of why they've got it in the first place. If you're not treating that issue, it'll come back.' Heather Matuozzo is the founder of Clouds End, which works with Birmingham Council in the UK to support about 300 renters through an intervention project called 'Chaos 2 Order.' 'When you live in property that's not yours the landlord can go to court and get an injunction to forcibly clear your house,' she said. 'No matter what justification you give it, it's morally wrong and also makes people who hoard worse.' She believes the pandemic led to an increase in prevalence of hoarding disorders. 'We saw the whole world hoard, as everybody had that (fear that) 'Oh my God, I'm going to run out',' she said. 'If you're already anxious, then you drop a pandemic on top of that, where everything closes and your support, which was tenuous enough in the first place, just disappears, you will be beside yourself and gathering to feel better.' Matuozzo believes that Birmingham may be 'the first hoarding-aware city in the world.' The model should be replicated elsewhere, she said. Sophia, who runs the Facebook group with Kim, first realized she had a problem at graduate school after a close relative was diagnosed with a severe mental illness. 'In between classes, I was shopping and would bring all this stuff back: dolls, books, jewelry, clothing, shoes, toiletries, school supplies. It was a way to disassociate.' Sophia, who also lives in New York state and does not want to be fully identified to protect her privacy, recalls the moment she knew she had to act — when she tried to get rid of some of her stuff. 'I had this nervous reaction; my whole body was shaking.' Soon afterward, she came across an advertisement for volunteers for a trial treatment with Dr. Carolyn Rodriguez, director of the Stanford Hoarding Disorders Research Program. Sophia said the program was massively helpful, but still, she relapsed. 'I was going plane, bus, train, automobile, just to get stuff,' she said. She has tried many varied therapies since then, including cognitive behavior therapy, or CBT, and eye movement desensitization and reprocessing, or EMDR, while leaning into the Facebook group for support. 'I love that there's community and that I can share,' she said. 'And if I can make it less jacked up or reduce harm, anybody can do that .' Stanford's Rodriguez is currently testing a virtual reality intervention. 'Many current treatments emphasize skills related to discarding and decision-making about possessions, which can be practiced in the patient's home,' she said via email. 'In many cases, real-life discarding is too difficult or in-home visits are unfeasible for reasons such as location, availability, or clutter being stacked so high that it's dangerous for a team to go inside,' she said. 'Practicing letting go of items is such an important skill to develop, so we wanted to create a virtual and safe environment to do so.' Nine participants were asked to take 360-degree photos of the most cluttered room in their house, as well as 30 possessions to discard. Once virtual equivalents were created, participants could navigate their way around using VR headsets and handheld controllers. 'For people who experience considerable distress even attempting to part with possessions, it's nice to be able to practice the activity in a virtual space as well as process the emotions of it,' said Rodriguez, who hopes to expand the project. 'In these one-hour sessions, they learned to better understand their attachment to the objects and practiced placing them in virtual bins for recycling, donation, or trash — the latter of which was taken away by a virtual garbage truck. They were then assigned the task of discarding the actual item at home.' The sessions were run as part of the 'Buried in Treasures' group treatment program. Based on a book of the same name by David Tolin, Randy Frost and Gail Steketee , it's a 16-week peer-led initiative running in numerous countries including the United States, Canada and Australia. Frost, also the Smith College Harold and Elsa Siipola Israel professor emeritus of psychology, developed the course with Lee Shuer, who now facilitates it around the world. Shuer, a certified peer specialist and hoarding disorder expert, said he never calls anyone a 'hoarder.' 'If you're trying to build trust and rapport, it's often such a turn-off. I self-identify as a finder-keeper in recovery, but a lot of people use collector, archivist, environmentalist, prepper. 'But it doesn't matter what we call it — we want to call it getting better.' Shuer started 'collecting' at school, as children often do. 'I didn't abandon that phase,' he said. 'Suddenly we weren't getting together to trade stickers and baseball cards. They were at parties, and I was reading comic books by flashlight at 3 in the morning, miserable.' In hindsight, he realizes he began to develop signs of depression in his teens and that the 'treasure hunting' ramped up in his 20s. 'It was a self-soothing coping skill for my extreme ups and downs with bipolar disorder and ADD (attention deficit disorder). As my mental health challenges continued to manifest and become more significant, so did the maladaptive coping skills.' Like others, Shuer's collections were broad, but he was particularly interested in video games, especially once he realized their social currency. 'I went from being an awkward outsider to being interesting because of my stuff,' he said. It was only with therapy that he really began to understand that dynamic. 'I realized Space Invaders was the key memory I have from the day of my grandfather's funeral. I was dropped off at a family friend's house and remember playing that.' That realization triggered a 'wave of emotion,' he said. The video games were 'an example of all the things around me that represented unresolved grief, guilt, loss.' Shuer described hoarding as 'intention without opportunity,' suggesting most of those with the condition are well intentioned and plan to use the stuff for good, though often it doesn't work out that way. 'The misunderstanding is that people love their stuff more than their family,' he said. The truth, he said, is that most of those affected are trying 'to be a good person, not a bad person.' They need help and understanding, which is what their peers can give them, Shuer said. The success of Buried in Treasures comes down to the social interaction with their peers, which enables people to open up in a reassuringly safe environment, he said. 'Learning the skills and being treated with respect like this is really empowering. You're also receiving that positive reinforcement that you're not some kind of social pariah and you're not crazy,' Shuer said. 'By the end of the course people often feel hopeful and that for the first time they have a chance. I believe that if you care enough and you want it bad enough, you can change anything. That was definitely a motivator for me.'
CNN
3 hours ago
- CNN
‘The stuff under the stuff': People with hoarding disorder open up
The habit crept up on Kim. She would arrive at garage sales as they were ending to pick up what remained. 'I'd load my car full of the free stuff on the side of the road: clothes, things that needed to be fixed, projects,' she told CNN. It was only once things spiraled that Kim, 53, who asked to be identified by her first name to protect her privacy, realized she had a problem that was all too familiar: hoarding, a disorder that she'd spent years urging her mother to seek help for. 'I used to get very frustrated and say, 'Mom, we've helped you clean out this room 10 times, and we come back three months later and it's completely full of sh*t ,' she said. 'I learned about hoarding disorder when I was younger but somehow didn't recognize it in myself.' At first, Kim would pile the things around her bed and throughout her bedroom, eventually expanding into other areas of her home, including her living room and sunporch. Besides the garage sales, she would collect stuff at thrift stores and stored goods she said family gave her 'to hold and keep.' Today Kim runs a Facebook support group for 2,100 people with hoarding disorder, which the World Health Organization categorized as a mental health condition in 2018, five years after the condition was to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. HD is characterized by excessive accumulation of possessions and difficulty in disposing of them . Kim only sought help when things became unsafe. 'The stuff starts piling up, the paths get narrower, and you start to trip (in your own house),' said the single mother. 'Putting things in the garbage is a big struggle — if we know it might go to the right home, that makes us feel better.' She thinks that mindset dates back to what her grandmother used to say: 'Use it up, wear it out, make it do or do without,' she said. 'That was a phrase that was knocked into my head ever since I was little,' and it makes her worry about wasting anything. What people hoard varies: Kim's focus is books. 'It would have taken me 10 lifetimes to read them,' she said of the many boxes she gave away after extensive therapy, including '500 Dr. Phil books.' Two-thirds of people with the disorder have at least one other psychiatric condition, while physical comorbidities such as arthritis and diabetes are common, according to a 2024 US Senate report. Around 14 million Americans are affected by hoarding disorder, with similar rates across other Western countries. Hoarding can trigger countless complications, experts say. Bathrooms and kitchens can become unusable, impacting diet and personal hygiene. Housing authorities can threaten eviction leading to homelessness, while in extreme cases children have been removed by social services. There is also risk to life. Excessive stuff, especially books and paperwork, pose a serious fire hazard and can hamper rescue efforts by blocking escape routes. Collecting may be in our DNA, according to Dr. Nick Neave, a professor in the psychology department at Northumbria University in the United Kingdom and director of the university's Hoarding Research Group. 'Throughout history possessions have always been very important — you see people buried with grave goods,' he said. 'That urge to collect things, it's part of your personality, your culture. So hoarding is normal — we've all got stuff we don't need.' What separates regular collecting from hoarding is often trauma, Neave said. 'All the people who hoard I've ever met had traumatic childhoods, whether it's physical abuse, sexual abuse, neglect, chaotic backgrounds, lack of parents.' This resonates with Kim, whose symptoms emerged after she experienced an abusive relationship, the death of a friend and a serious medical diagnosis. 'We call it the stuff under the stuff,' said Kim, who lives in New York state. 'One of our therapists calls it the one, two, three punch. You can handle one trauma, maybe two, but after that, a lot of people will have hoarding disorder creep in.' 'I tried to fill the hole in my heart and soul with the stuff,' she added. Neave says hoarding is a 'coping strategy which starts off working very well' but can 'spiral quickly into a severe addiction and mental health problem that is very difficult to resolve.' Shame and stigma can then lead to further isolation, he said. 'The obvious thing to do is get rid of the clutter, but that doesn't solve the problem of why they've got it in the first place. If you're not treating that issue, it'll come back.' Heather Matuozzo is the founder of Clouds End, which works with Birmingham Council in the UK to support about 300 renters through an intervention project called 'Chaos 2 Order.' 'When you live in property that's not yours the landlord can go to court and get an injunction to forcibly clear your house,' she said. 'No matter what justification you give it, it's morally wrong and also makes people who hoard worse.' She believes the pandemic led to an increase in prevalence of hoarding disorders. 'We saw the whole world hoard, as everybody had that (fear that) 'Oh my God, I'm going to run out',' she said. 'If you're already anxious, then you drop a pandemic on top of that, where everything closes and your support, which was tenuous enough in the first place, just disappears, you will be beside yourself and gathering to feel better.' Matuozzo believes that Birmingham may be 'the first hoarding-aware city in the world.' The model should be replicated elsewhere, she said. Sophia, who runs the Facebook group with Kim, first realized she had a problem at graduate school after a close relative was diagnosed with a severe mental illness. 'In between classes, I was shopping and would bring all this stuff back: dolls, books, jewelry, clothing, shoes, toiletries, school supplies. It was a way to disassociate.' Sophia, who also lives in New York state and does not want to be fully identified to protect her privacy, recalls the moment she knew she had to act — when she tried to get rid of some of her stuff. 'I had this nervous reaction; my whole body was shaking.' Soon afterward, she came across an advertisement for volunteers for a trial treatment with Dr. Carolyn Rodriguez, director of the Stanford Hoarding Disorders Research Program. Sophia said the program was massively helpful, but still, she relapsed. 'I was going plane, bus, train, automobile, just to get stuff,' she said. She has tried many varied therapies since then, including cognitive behavior therapy, or CBT, and eye movement desensitization and reprocessing, or EMDR, while leaning into the Facebook group for support. 'I love that there's community and that I can share,' she said. 'And if I can make it less jacked up or reduce harm, anybody can do that .' Stanford's Rodriguez is currently testing a virtual reality intervention. 'Many current treatments emphasize skills related to discarding and decision-making about possessions, which can be practiced in the patient's home,' she said via email. 'In many cases, real-life discarding is too difficult or in-home visits are unfeasible for reasons such as location, availability, or clutter being stacked so high that it's dangerous for a team to go inside,' she said. 'Practicing letting go of items is such an important skill to develop, so we wanted to create a virtual and safe environment to do so.' Nine participants were asked to take 360-degree photos of the most cluttered room in their house, as well as 30 possessions to discard. Once virtual equivalents were created, participants could navigate their way around using VR headsets and handheld controllers. 'For people who experience considerable distress even attempting to part with possessions, it's nice to be able to practice the activity in a virtual space as well as process the emotions of it,' said Rodriguez, who hopes to expand the project. 'In these one-hour sessions, they learned to better understand their attachment to the objects and practiced placing them in virtual bins for recycling, donation, or trash — the latter of which was taken away by a virtual garbage truck. They were then assigned the task of discarding the actual item at home.' The sessions were run as part of the 'Buried in Treasures' group treatment program. Based on a book of the same name by David Tolin, Randy Frost and Gail Steketee , it's a 16-week peer-led initiative running in numerous countries including the United States, Canada and Australia. Frost, also the Smith College Harold and Elsa Siipola Israel professor emeritus of psychology, developed the course with Lee Shuer, who now facilitates it around the world. Shuer, a certified peer specialist and hoarding disorder expert, said he never calls anyone a 'hoarder.' 'If you're trying to build trust and rapport, it's often such a turn-off. I self-identify as a finder-keeper in recovery, but a lot of people use collector, archivist, environmentalist, prepper. 'But it doesn't matter what we call it — we want to call it getting better.' Shuer started 'collecting' at school, as children often do. 'I didn't abandon that phase,' he said. 'Suddenly we weren't getting together to trade stickers and baseball cards. They were at parties, and I was reading comic books by flashlight at 3 in the morning, miserable.' In hindsight, he realizes he began to develop signs of depression in his teens and that the 'treasure hunting' ramped up in his 20s. 'It was a self-soothing coping skill for my extreme ups and downs with bipolar disorder and ADD (attention deficit disorder). As my mental health challenges continued to manifest and become more significant, so did the maladaptive coping skills.' Like others, Shuer's collections were broad, but he was particularly interested in video games, especially once he realized their social currency. 'I went from being an awkward outsider to being interesting because of my stuff,' he said. It was only with therapy that he really began to understand that dynamic. 'I realized Space Invaders was the key memory I have from the day of my grandfather's funeral. I was dropped off at a family friend's house and remember playing that.' That realization triggered a 'wave of emotion,' he said. The video games were 'an example of all the things around me that represented unresolved grief, guilt, loss.' Shuer described hoarding as 'intention without opportunity,' suggesting most of those with the condition are well intentioned and plan to use the stuff for good, though often it doesn't work out that way. 'The misunderstanding is that people love their stuff more than their family,' he said. The truth, he said, is that most of those affected are trying 'to be a good person, not a bad person.' They need help and understanding, which is what their peers can give them, Shuer said. The success of Buried in Treasures comes down to the social interaction with their peers, which enables people to open up in a reassuringly safe environment, he said. 'Learning the skills and being treated with respect like this is really empowering. You're also receiving that positive reinforcement that you're not some kind of social pariah and you're not crazy,' Shuer said. 'By the end of the course people often feel hopeful and that for the first time they have a chance. I believe that if you care enough and you want it bad enough, you can change anything. That was definitely a motivator for me.'
