My guest this week is Dr. David Tolin, a clinical psychologist, researcher, author, and expert on effective treatments for many psychological conditions.

In this conversation we focused on hoarding disorder, and then segued into a more general discussion about cognitive behavioral therapy (CBT) and other treatment approaches.

Topics we discussed included:

• The continuum of hoarding
• The diagnostic criteria for when hoarding is considered a disorder
• Instances of needing to buy a second home due to hoarding
• The prevalence of hoarding disorder
• The causes of hoarding
• How those who are at risk for hoarding disorder can minimize the risk of developing it
• The limits of reason and logic in treating hoarding
• Effective hoarding treatment
• The possibility that the medications atomoxetine and venlafaxine might be effective
• The role of distress tolerance in treatment
• Prioritizing living better over feeling better
• The value of strategies from motivational interviewing
• Effectiveness of the best treatments
• The effects on hoarding of general talk therapy
• Whether cognitive behavioral therapy (CBT) is the best treatment for every condition
• How to harness the placebo effect in therapy
• Finding mutual respect across therapy traditions
• The need for more effective psychological treatment
• Doing higher quality research studies
• What to do when the best-tested treatments aren’t helpful
• Historical advancements in CBT for panic disorder
• The textbook that David wrote calling Doing CBT

David Tolin, PhD, ABPP, is the Founder and Director of the Anxiety Disorders Center at the Institute of Living, and an Adjunct Professor of Psychiatry at Yale University School of Medicine.

He is the Past-President of the Association for Behavioral and Cognitive Therapies, the Past-President of the Clinical Psychology Division of the American Psychological Association, and a principal investigator for the National Institutes of Health.

He received the Awards for Distinguished Contribution to the Science of Psychology, Distinguished Contribution to the Practice of Psychology, and Lifetime Contribution to Psychology from the Connecticut Psychological Association.

David is the author of over 200 scientific journal articles, as well as several books, including (affiliate links):

• Doing CBT: A Comprehensive Guide to Working with Behaviors, Thoughts, and Emotions
• Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding
• Face Your Fears: A Proven Plan to Beat Anxiety, Panic, Phobias, and Obsessions.

He has been featured on the reality TV series Hoarders and The OCD Project, and has been a recurring guest on The Oprah Winfrey Show.

Find David online at his website and at the Institute of Living.