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HEALTH JOURNAL

December 6, 2011

Shop 'Til You Stop: How to Treat Compulsive Spending
By MELINDA BECK

Daily door-buster deals … friends and family discounts … free shipping if you spend over $150! For an estimated 6% of Americans with compulsive buying tendencies, this is a tough time of the year. "The whole culture conspires against us in the holiday season," says April Lane Benson, a Manhattan psychologist who has treated compulsive shoppers for 15 years. Besides tempting sales, pressure to top last year's gifts and the urge to shop for oneself, she says, "the holidays bring up a lot of unfulfilled longing for some people—and that's one reason why they shop, as a salve for disappointment." While the stereotypical compulsive shopper is traditionally a woman in her 30s, experts say the ease and speed of Internet shopping is luring more men and more young people. Over Black Friday weekend, men outspent women $484 to $317, on average, according to the National Retail Federation. Men also spent an average of $200 online—twice as much as the average woman. In a 2005 survey of 195 U.K. teenagers, who grew up with the Internet, 44% showed signs of compulsive shopping habits, according to research published in the British Journal of Psychology. "The Internet is dangerous for compulsive buyers in two ways," says psychiatrist Elias Aboujaoude, director of the Impulse Control Disorders Clinic at Stanford University School of Medicine. Transactions move so quickly, it is hard to pause to reassess the buying urge, he says. The Internet also lets people dissociate from reality and assume a grandiose alter-ego fueled by virtual cash. "Online, money is no longer anchored to reality, so what do we do? We spend more," Dr. Aboujaoude says.

The holidays are a tricky time for shopaholics, an estimated 6% of the U.S. population, as bargains beckon and cultural cues all egg people on to spend. Melinda Beck on Lunch Break looks at who falls prey to compulsive shopping and why.

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When does "retail therapy" cross the line into compulsive shopping? Experts say purchasing turns pathological when people continue to do it even though it causes financial problems, disrupts work, family or social life or involves deceit, such as hiding bills and packages. Feeling out of control is another tipoff. "It's like that old saying—if you think you have a problem, you probably do," says Terrence Shulman, director of the Shulman Center for Compulsive Theft, Spending and Hoarding in Franklin, Mich. Compulsive Buying Scale
Take a quiz to see if you may be a compulsive shopper.

Understanding the neurobiology of compulsive buying disorder, as it's officially known, is still in its infancy. It's generally considered an impulse-control problem, like gambling or sex addiction. Some sufferers describe feeling their hearts race, cheeks flush and abandoning all sense of caution when they're stalking favorite items. "Usually, the idea is, 'I see it, I like it, I want it, I'll buy it—and damn the consequences,' " says Donald W. Black, a professor of psychiatry at the University of Iowa. But the thrill fades fast and is often followed by remorse, and then more shopping to feel better again.

Many compulsive shoppers also suffer from depression, anxiety or eating disorders, and about half of them are also hoarders. In an as yet unpublished study, Dr. Black and colleagues found that 26 compulsive shoppers had similar executive function (the ability to plan, organize, reason and anticipate consequences) as 32 control subjects. But they were far more distractible, inattentive and fidgety—all symptoms of attention-deficit hyperactive disorder (ADHD). Compulsive shoppers themselves often have a sense of what drives them. Some suffer from low selfesteem and think the perfect dress or accessory will help overcome it. "Buying $300 jeans, I felt better than everybody else," says Brian Kearney, a 20-year-old college student from Rockaway, N.J., who was also battling an eating disorder. He says he knew he had a serious issue when he was spending over $1,500 a month on designer clothes, shoes and sunglasses and expensive gifts for friends. Ryan Nicodemus grew up with divorced, cash-strapped parents, so when he got a telecommunications job in Dayton, Ohio, he made up for lost time. "When the latest iPod came out, I always had to buy it, and the latest computer, the latest TV and the latest videogames," he says. "It didn't matter how much money I made, I always spent more." Arzu Yonak says she shopped out of boredom growing up in rural Ohio. The habit got out of hand when she had an internship in New York—and her father's credit cards—at age 20. "I remember having five shopping bags in one hand and the phone in the other, saying 'Mom, I can't stop!' " Others may subconsciously use shopping as a respite for a marriage or job they feel trapped in, or a solace for loneliness or grief. Mr. Shulman says many of his clients are nurses, doctors, teachers and

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caregivers who give to others all day long, neglecting their own needs. Some are compulsive giftgivers, either desperate to be liked or to exert control. "The good news is that simply identifying the causes can help ease the temptation," Mr. Shulman adds. Cognitive-behavioral therapy that helps people do that is the most effective treatment to date. Clinical trials with antidepressants have yielded mixed results. Financial planners can also help people devise rational spending plans, starting with cutting up credit cards. Debtors Anonymous, a 12-step program with meetings in 400 cities, has also helped many change their lives. Psychologist and hoarding expert Randy Frost has clients engage in "non-shopping trips"—first driving past a favorite store, then walking in, then holding a particularly tempting item—all without buying. "We're conditioning them to tolerate the urge," says Dr. Frost, who concedes that a few diehards have met him in the parking lot with their arms full of purchases made before the exercise began. Dr. Benson, the Manhattan psychologist, counsels clients to figure out what need they are really trying to fill by shopping and tend to that instead. "You can never get enough of what you don't need," she says. As for gifts, she suggests giving thoughtful acts and memorable experiences rather than material things. "Memories get better over time, whereas things end up at the Salvation Army," she says. Mr. Kearney says he went on a "journey of self-discovery" with the help of a psychologist. "If I see a pair of $300 jeans now, I think, 'Why did I want them so bad?' I can feel just as good in sweat pants, and if people are going to judge me on what I'm wearing, then I don't want to know them." Reformed shoppers offer other tips: "Find other things that take up your time," says Ms. Yonak, now 29, who runs a fashion public-relations firm, Socialite Style. She also suggests buying only clothing that is on sale, returnable and wearable to at least three places. Some have found their new frugality so satisfying that they are helping others achieve it. Mr. Nicodemus, the gadget lover, and a friend, Joshua Millburn, quit their jobs and became "The Minimalists," writing books and a blog about living a meaningful life with less stuff. He concedes that every now and then, he sees something he wants, like an iPad—but if it doesn't add value to his life, he goes without it. Australian Jill Chivers called a halt to her compulsive shopping in 2009 with more than 100 pairs of shoes, 16 pairs of blue jeans and 12 animal-print jackets and vowed to spend a year without buying new clothes. She succeeded and started an online program, Shop

Associated Press

6% of Americans exhibit out-of-control spending in their lifetimes.

Signs of a Problem
•6% of Americans exhibit out-of-control spending in their lifetimes •Most compulsive shoppers earn less than $50,000 a year. •Compulsive shopping typically starts in late teens or early 20s. •People typically overspend for several decades before seeking help.

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•Many compulsive shoppers also suffer from depression, anxiety, substance-abuse or eating disorders. •About half of compulsive shoppers also hoard.

Your Wardrobe, to help other women make better use of what they have. RESOURCES For more information on getting control of

compulsive spending, see: "Virtually You: The Dangerous Powers of the E-Personality," by Elias Aboujaoude "To Buy or Not to Buy: Why We Overshop and How to Stop," by April Lane Benson "Stuff: Compulsive Hoarding and the Meaning of Things," by Gail Steketee and Randy Frost "Minimalism: Live a Meaningful Life" by Joshua Fields Millburn and Ryan Nicodemus "Cluttered Lives, Empty Souls: Compulsive Stealing, Spending and Hoarding" by Terrence Shulman Write to Melinda Beck at HealthJournal@wsj.com Corrections & Amplifications Terrence Shulman is director of the Shulman Center for Compulsive Theft, Spending and Hoarding in Franklin, Mich. An earlier version of this article omitted "hoarding" from the title.

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