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#195 Why is it so hard to deal with uncertainty in hoarding disorder? With Dr Jan Eppingstall
That Hoarder: Overcome Compulsive Hoarding
1 hour 1 minute 30 seconds
3 months ago
#195 Why is it so hard to deal with uncertainty in hoarding disorder? With Dr Jan Eppingstall
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Podcast show notes, links and transcript: http://www.overcomecompulsivehoarding.co.uk/
Why is it so hard to deal with uncertainty, and what does that have to do with hoarding? This week I’m joined by Dr Jan Eppingstall to unpack how our brains handle ambiguity, why fear of making mistakes can keep us stuck, and how intolerance of uncertainty feeds into hoarding behaviours. We break down practical ways to build up your tolerance for not knowing and share some strategies that might actually make a difference.
Uncertainty and Its Challenges
Definition and context of uncertainty
Evolutionary reasons for discomfort with uncertainty (Selfish Brain Theory)
Contrast between historical resource scarcity and modern abundance
Our minds’ outdated ways of managing uncertainty
Cognitive Closure
What is cognitive closure?
Difference between cognitive closure (psychological need for definite answers) and “closure” in pop culture (emotional resolution)
How it relates to need for certainty in present/future, not just past events
The creation of cognitive closure measurement scales by researchers
Factors influencing need for cognitive closure:
Personality traits: Conscientiousness, neuroticism (now called emotionality), openness to experience, extroversion
Trauma history and its effects on the nervous system
Neurodivergence (with emphasis on autism and “sticky thinking”)
Combination of personality, trauma, and neurodivergence
Intolerance of Uncertainty
Psychological definition of intolerance of uncertainty
Negative cognitive bias: How it affects perception and response
Manifestations in people experiencing uncertainty as distress
Its direct relevance to hoarding behaviours
The Link Between Hoarding Disorder and Intolerance of Uncertainty
Research findings: intolerance of uncertainty as a predictor of hoarding symptom severity
Usefulness in early intervention strategies
intolerance of uncertainty as a transdiagnostic factor (across anxiety, some depression, and other mental health conditions)
How heightened anxiety sensitivity in hoarding perpetuates avoidance
Experiential avoidance in hoarding (saving and acquiring behaviours)
Connection between maladaptive behaviours and intolerance of uncertainty
Fear of Making Mistakes and Perfectionism
Common fears of mistakes in hoarding (disposing, acquiring, putting things away)
Perfectionism’s role (fear of failure, not wasting)
All-or-nothing thinking and rigid decision-making rules
Paralysing effect of avoidance due to fear of mistakes
Not making a decision as a potential mistake itself
Interaction and reinforcement between perfectionism and intolerance of uncertainty
Comorbidity and Severity
Research on multiple diagnoses: More than half of psychiatric patients have more than one diagnosis
Diagnostic challenges and overlapping criteria
How comorbidity compounds issues: More symptoms and more complexity
Higher intolerance of uncertainty linked with more severe hoarding, especially when other conditions are present
Impact on treatment difficulty
intolerance of uncertainty’s Impact on Acquiring and Discarding Behaviours
How acquiring reduces fear of missing out and future needs
Difficulty discarding as protection against future regret
Shame around mistake-making
Common inner questions: Future use, responsibility, relationships
More complexity leading to more avoidance
Nuances in intolerance of uncertainty and Hoarding
Study on sub-factors of uncertainty:
Factor 1: Negative self-referential implications (linked to hoarding severity)
Factor 2: Perception of uncertainty as unfair (not linked)
Internal vs. external perspectives on uncertainty
Relevance of anxiety-driven self-criticism
Changing Relationship to Uncertainty: Curiosity and Reframing
Rilke’s quote on “loving the questions”
Transforming approach from fe