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"Help, I have too much stuff!": extreme possession attachment and professional organizers.

Compulsive hoarding is a serious problem for consumers, their families, and the communities in which they live. Consumers naturally form attachments to their possessions. However, at the extreme end of the attachment spectrum, these attachments can undermine a consumer's well-being. This study describes attachment styles exhibited by consumers who sought help from trained professional organizers (POs) to help them achieve their de-cluttering goals. Narrative case descriptions were compiled from 28 trained POs across the United States using an Internet survey with mostly open-ended questions. Interpretive analysis demonstrates how POs craft strategies to help clients let go of meaningful goods by considering the client's unique attachment profile and the temporal relevance of possessions to self. This study illustrates how POs help consumers improve their well-being by unraveling possession attachments that threaten consumers' quality of life.

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Consumer researchers have explored deep emotional attachments to goods and have related possession attachment and sources of possession meaning to the maintenance and perpetuation of self- or family-identity structures (e.g., Belk 1988; Curasi, Price, and Arnould 2004; Epp and Price 2010; Furby 1978; Kleine, Kleine, and Allen 1995; Richins 1994; Schultz, Kleine, and Keman 1989; Wallendorf and Arnould 1988). For the most part, possession attachment research has focused on the positive aspects of attachment and how possessions fortify a person's self-identity. Research has also shown how self-identity structures are disrupted and possibly re-constructed in transformative ways through dispossession practices (Cherrier 2009; Cherrier and Murray 2007; Lastovicka and Fernandez 2005; Roster 2014). However, little to no consumer research has explored attachment styles and possession beliefs at the negative end of the spectrum, as is the case when consumers' ties to possessions threaten to undermine their well-being. Nor have studies examined how these strong emotional ties to possessions relate to the work of service providers, such as professional organizers (POs), who are often called upon to work with consumers whose hoard of special possessions threatens their ability to remain in their homes.

It is no wonder that consumers are often reluctant to part with their possessions, especially those that are particularly meaningful for self-identity. However, for chronic packrats and compulsive hoarders, nearly everything they own is associated with highly charged meanings, making disposition a difficult and painful process (Frost and Gross 1993; Frost and Hard 1996; Frost et al. 1995, 2007; Steketee, Frost, and Kyrios 2003). The perversity is that an overwhelming inventory of "special" objects prevents packrats and hoarders from extracting the super-charged meanings they associate with these goods, and creates a life situation where the accumulation of special possessions threatens, rather than promotes, the maintenance and development of self-identity.

Hoarding Disorder is a remarkably common but often hidden mental disorder characterized by the acquisition and saving of a large number of possessions, creating excessive clutter that can pose serious threats to the health, safety, and well-being of the affected person and those who live with or near them (Frost and Hard 1996; Frost, Steketee, and Tolin 2012). Recent epidemiological studies estimate that clinically significant hoarding disorder affects between 2% and 5% of the adult population, which in the United States alone equates to 6-15 million adults (Iervolino et al. 2009; Mueller et al. 2009; Samuels et al. 2008). Hoarding, when severe, causes significant impairments to a person's ability to execute basic life functions in their spaces, such as cooking, cleaning, personal hygiene, moving through the house, and sleeping, which can put a person at substantial risk for falling, fire, poor sanitation, or other health concerns (Frost, Steketee, and Williams 2000; Steketee, Frost, and Kim 2001). In their study of elderly hoarders, Steketee, Frost, and Kim (2001) report that 4% of cases involved protective services and nearly 13% resulted in eviction or threat of eviction. Compulsive hoarding was previously classified as a suborder condition within the spectrum of obsessive-compulsive disorder (OCD) in the DSM diagnostic manual, but substantial empirical evidence recently led to its classification as a stand-alone mental disorder in the revised 2013 DSM-5 (American Psychiatric Association 2013). Clinically significant hoarding is typically diagnosed in mid- to late adulthood (Steketee, Frost, and Kim 2001), although precipitating behaviors such as "pathological collecting" can sometimes be observed in late childhood or early adolescence (Samuels et al. 2008). Individuals with hoarding behaviors often exhibit a number of comorbid conditions, including OCD, depression, anxiety, and attention-deficit hyperactivity disorder (Hall et al. 2013). Support has been shown for a genetic component, as hoarding tends to run in families (Iervolino et al. 2009; Samuels et al. 2008). Hoarders are significantly less likely than friends or family members to view their living situations as a problem and are resistant to treatment efforts, which can create frustration and escalate tensions among family members who attempt to intervene (Tolin et al. 2008).

Compulsive hoarding also poses a significant financial burden on communities and service providers. In 2009, the San Francisco Task Force on Compulsive Hoarding (2009) estimated that public and private service providers, including community health officials and landlords, spend nearly six million dollars each year on hoarding cases in that city alone. The health risks associated with hoarding involve multiple service providers, including public health departments, protective services for older adults or children, animal welfare agencies, and fire departments. A survey of health department officials (Frost, Steketee, and Williams 2000) found that 79% of severe hoarding cases involved public service providers of some kind. Consumers with serious clutter issues often seek services from private agencies, including POs, who are not therapists or mental health professionals, but rather in-home service providers trained to assist consumers with the clearing-out process (Bratiotis et al. 2013).

To date, no studies have examined the strategies used by POs to assist consumers who have developed unproductive attachments to many or all of their possessions. This paper describes a study based on case reports obtained from 28 trained POs across the United States. The primary objectives of this study were to describe the attachment styles exhibited by consumers who seek help from trained POs and to understand more fully how POs incorporate clients' attachment styles as they develop tailored strategies to help over-extended clients achieve their de-cluttering goals. The discussion section highlights opportunities for researchers to examine more deeply the role of transformative service providers and the role they play in addressing complex over-consumption problems and their ramifications on consumers, families, and communities in which they live.

BACKGROUND

Furby (1978) concludes that possessions are meaningful primarily because they enable possessors to use the power of goods to maintain control over their environment. The power of possessions to fortify self is further classified by Furby as either "instrumental" or "sentimental." The instrumental power of goods lies in their ability to enable effective responses to basic life needs, and the sentimental power of goods lies in their ability to maintain and perpetuate a continuous sense of self as self-identity changes and evolves in response to environmental factors that naturally occur throughout the course of people's life span.

Therefore, it is no wonder that people develop strong emotional attachments to objects that strike at the heart of these basic fundamental needs. The basic premise that possessions play a vital role in developing, defining, communicating, and maintaining a sense of self-identity has been well-established in the consumer behavior literature (e.g., Belk 1988; Csikszentmihalyi and Rochberg-Halton 1981; Richins 1994; Solomon 1983; Wallendorf and Amould 1988). Research shows that one of the primary reasons that consumers develop strong attachments to the things they own is that possessions represent extensions of self (Ball and Tasaki 1992; Belk 1988; Kleine, Kleine, and Allen 1995). Belk (1988) asserts that possessions can become extensions of one's core self-concept through normative patterns of attachment cultivated by ownership of possessions. Possessions represent not only who we are today but also who we once were and who we might become in the future (Belk 1990; Kleine, Kleine, and Allen 1995). That worn-out teddy bear we tightly held in childhood photographs, grandma's hutch, a child's tiny baby shoes and his/her art projects from kindergarten, the award plaque we received years ago from an esteemed career, that box of old college t-shirts we intend to fashion into a quilt one day, and the treadmill we just bought are important because these possessions embody the story of our lives and enable us to achieve future goals and aspirations.

Kleine, Kleine, and Allen's (1995) research on the construct of possession attachment (see also Kleine and Baker 2004; Schultz, Kleine, and Keman 1989) defines material possession attachment as a multifaceted and emotionally complex construct that can be understood by orienting possession meaning in a multidimensional space that reflects temporal orientation (i.e., past, present, and future) and two distinct types of attachment, affiliation, and/or autonomy-seeking. Attachment-seeking motives align with an individual's need to retain possessions because they represent important connections with others, one's heritage or tradition, or memories that make one feel connected to and cared for by others (Kleine, Kleine, and Allen 1995; Schultz, Kleine, and Kernan 1989). Autonomy-seeking motives align with an individual's need to retain possessions because they represent independence, uniqueness, individual accomplishments, self-control, or enable an individual to achieve self-oriented goals (Kleine, Kleine, and Allen 1995; Schultz, Kleine, and Kernan 1989). These researchers also point out that possession attachment can vary in terms of strength and intensity, and importantly, that attachment to possessions is not always associated with positive emotions or positive outcomes for the consumer. Kleine, Kleine, and Allen's (1995) study of material possession attachment and possessions' role in reflecting consumers' life narratives reveals that consumers can be emotionally attached to possessions with negatively charged emotions. Kleine and Baker (2004) note that studies exploring the downsides of material possession attachment are rare and under-investigated.

Compulsive hoarding represents an extreme manifestation of possession attachment. A hallmark of compulsive hoarding is strong emotional attachments to possessions (Frost and Gross 1993; Frost and Haiti 1996; Frost et al. 2007; Steketee, Frost, and Kyrios 2003). Hoarders experience strong emotional attachments to many or all of their possessions, to the degree that these attachments impede productive use of possessions in the quest for self-identity and result in an accumulation of goods that threaten their quality of life. Steketee, Frost, and Kyrios (2003) have identified four fundamental possession meanings, that while common to all consumers, if experienced at extreme levels and across multiple possessions tend to differentiate consumers who experience symptoms of compulsive hoarding from those who do not. These include (1) "hyper-attachment" to goods as sources of self-identity; (2) reliance upon possessions to embody and enable memory of past events or to serve as information repositories that retain and keep safe information that might be lost or forgotten; (3) a strong need and desire to maintain control over possessions; and (4) heightened sense of responsibility for possessions. Most consumers form strong emotional bonds with possessions that are closely associated with self-identity, such as gifts, heirlooms, and momentos kept to remind one of important places, events, and people in one's life (Belk 1990). Consumers also can become attached to objects that enable them to complete life tasks and aspirations, ranging from seemingly mundane utilitarian objects, like a timeworn baking pan that produces "just right" muffins every time to book or magazine collections that provide inspiration and knowledge. Increasingly, baby-boomers feel the burden of responsibility to keep and honor objects they inherit from family estates (Curasi, Price, and Arnould 2004). These normal possession meanings, if taken to extreme, can become maladaptive, especially when consumers form "hyper-attachment" to objects and the overall volume of goods to which consumers harbor attachments threatens to interfere with normal life functions (Frost et al. 1995).

These close meanings make disposition of possessions with important ties to self-identity an emotionally painful and difficult process for consumers (Cherrier and Murray 2007; Price, Arnould, and Curasi 2000; Roster 2001; Young and Wallendorf 1989). Letting go of possessions with deep meanings implies severing ties with important aspects of self imbued in possessions. Dispossession research has identified how possession meanings align with disposition practices, and how social mores affect consumer disposal decisions. For example, "inalienable objects," implying those with attachments most close to self (Lucas 2002), should be retained by individuals or family units (Curasi, Price, and Arnould 2004) and not sold as marketable commodities (Belk, Wallendorf, and Sherry 1989). Alternatively, Lastovicka and Fernandez (2005) show how "shared selves" can be discovered during market exchanges, providing sellers with reassurance that object meanings will be respected and protected. Researchers have also explored how giving up possessions without hope of material or financial gains fulfills consumers' philanthropic motives or desire to live a less materially oriented life (Albinsson and Perera 2009).

What is not understood is how possession meanings influence the strategies utilized by POs who are paid to help consumers achieve their goals for downsizing or clearing out spaces. The role of the PO is especially critical when consumers have formed strong attachments to many possessions, such that these attachments hinder rather than further consumers' life goals, and perhaps even their well-being. How do these consumers' attachment styles and possession beliefs influence a PO's tailored approach toward the letting-go process for these consumers? This central question drove the objectives for this study, stated below:

1. to describe the attachment profile and sources of possession meaning among consumers who experience chronic difficulty discarding possessions; and

2. to describe the strategies used by trained POs to alleviate distress associated with the dispossession process.

The following sections describe a narrative case study of chronic packrats and hoarders viewed through the lens of POs, who are often first on the scene to deal with the disorganization, chaos, and sometimes life-threatening conditions that can arise when clients' strong attachments to possessions impede their ability to function effectively in their life spaces (Belk, Seo, and Li 2007). A content analysis of PO's case accounts supports classification according to the two primary attachment styles identified by Kleine. Kleine, and Allen (1995), which can be further contextualized by the four possession beliefs identified by Steketee, Frost, and Kyrios (2003). Identification of strong tensions between temporal life spaces, along with the client's attachment profile, proved critical in the development of successful letting-go strategies devised by POs.

METHODS

This study was based on narrative case descriptions compiled from 28 POs across the United States, all of them were members of the Institute for Challenging Disorganization (ICD). ICD is a nonprofit 501(c)(3) educational organization whose mission is to benefit people challenged by chronic disorganization. The term "chronically disorganized" was coined by ICD's founder, Judith Kolberg, to describe individuals who exhibit "a past history of disorganization in which self-help efforts to change have failed, an undermining of current quality of life due to disorganization, and the expectation of future disorganization" (Kolberg 1998). The sample frame consisted of ICD members seeking to earn ICD certification as a Certified Professional Organizer in Chronic Disorganization, or CPO-CD[R]. POs who desire to achieve CPO-CD[R] status must first complete coursework to become a Certified Professional Organizer, then complete further coursework and a mentorship program specifically designed to enable them to work effectively with clients who have chronic disorganization. Chronic disorganization is typically associated with a myriad of contributing factors, which include compulsive hoarding, compulsive buying, ADHD, traumatic brain disorders, aging, and major life transitions. ICD members can also earn certificates in specialized areas as part of their overall educational program. More information about ICD's education and certificate programs can be found at the Institute's webpage, http://challenging disorganization.org.

The data collection method is best described as a narrative survey case approach. In narrative inquiries, respondents are asked to relate a "story," or a "connected series" of life events (Lieblich, Tuval-Mashiach, and Zilber 1998; Shkedi 2004). Narrative inquiries typically involve qualitative data collection methods, usually personal interviews. However, for researchers seeking to collect a large number of cases, an option is to use traditionally quantitative methods, such as a survey with mostly open-ended essay-type questions. That was the approach used here. This study utilized an Internet survey to collect detailed case accounts from POs. An invitation to participate in the study was sent to 126 POs across the United States who had either already attended or were seeking CPO-CD[R] certification from ICD. After completing the consent form, respondents were asked to "think about a past or current client who experienced great difficulty parting with their possessions" and respond to five open-ended questions with this client in mind. The five questions were as follows: (1) describe the client's background; (2) describe the central possession meanings and attachments that the client associated with possessions that were most hard to let go of; (3) describe the strategies you used to help this client let go of these objects and to relieve the distress associated with the process; (4) describe the outcomes; and (5) describe any obstacles that impeded successful outcomes with this client, if applicable. The survey concluded with basic demographic information. A non-monetary incentive to participate in the survey was sharing the study results with ICD members. A follow-up reminder was sent one week later.

Complete case descriptions were obtained from 28 POs for a response rate of 22%. All respondents were female, which reflects the population of ICD POs. Forty-one percent indicated that they had between four and seven years of experience as a PO, 17% had 8-10 years of experience in the profession, and 24% had 10 or more years of experience as PO. Thirty-five percent had already attained certification as a Certified Professional Organizer from ICD and 24% of respondents had already obtained CPO-CD[R] status, but were working on coursework to achieve ICD certificates in specialized areas related to chronic disorganization.

Participant responses to the five open-ended questions were quite detailed, averaging two to three pages of single-spaced text per case account, which resulted in approximately 86 pages of single-spaced textual data used in the analysis. Analysis of cases was guided by guidelines for interpretative analysis within and cross-cases as described by Corbin and Strauss (2007). Each case represented a unique account of circumstances surrounding the client and the PO's experiences. Therefore, analysis began with a close reading to classify each case according to one or more of the dominant attachment styles previously identified in the possession attachment literature, either affiliation-seeking or autonomy-seeking (Kleine, Kleine, and Allen 1995). Next, each of the 28 cases was categorized according to the four primary possession meanings described by Steketee, Frost, and Kyrios (2003) associated with compulsive hoarding and distress when contemplating dispossession of possessions. A cross-case analysis confirmed that the primary attachments and possession beliefs were consistent with those already identified in the literature. However, the cases exhibited variation in their unique combined expression of attachment styles and primary possession meanings. The strategies utilized by POs were categorized individually and then across cases to identify commonalities in the match between attachment profiles and dispossession strategies. This analysis indicated that effective strategies used by POs were those that considered the client's unique attachment profile and the temporal relevance of possessions to self.

FINDINGS

This analysis revealed that primary attachments and possession meanings did not vary significantly from those described by prior research (Kleine, Kleine, and Allen 1995; Steketee, Frost, and Kyrios 2003). The narrative case descriptions of chronic packrats and hoarders emphasize the strong attachments these consumers form with their possessions, both affiliation- and autonomy-seeking (Kleine, Kleine, and Allen 1995; Schultz, Kleine, and Kernan 1989). In some cases, one of these attachment styles appeared primary, while in other cases, both attachment styles were present in fairly equal strength across possessions that were extremely difficult to discard. The analysis also supported the presence of one or more of the four possession meanings identified by Steketee, Frost, and Kyrios (2003) that are commonly associated with compulsive hoarding. The coding of cases according to these primary attachment and possession meanings resulted in distinctive attachment profiles. Figure 1 summarizes the four possession meanings and beliefs driving these attachments and the strategies used by POs that proved most effective when working with hoarding clients exhibiting one or both attachment styles. The findings present cases that fell into one or the other of two primary attachment styles, or both, along with dominant possession meanings associated with those possessions that were particularly difficult for clients to discard. The strategies used by POs to help the client let go of possessions are also described for each case.

Affiliation-Seeking Attachment Styles

One of the strongest attachments that compulsive hoarders form with possessions is an emotional attachment tied to the belief that possessions represent important interpersonal connections with others (Frost et al. 1995, 2007; Steketee, Frost, and Kyrios 2003). Affiliation attachments tap the ability of possessions to represent "we-ness" or the integration of self with others (Kleine, Kleine, and Allen 1995; Schultz, Kleine, and Kernan 1989), or one's "social self' (Csikszentmihalyi and Rochberg-Halton 1981). The fear is that by disposing of these possessions, the possessor signals that these past memories or relationships are not treasured and that the meanings invested in these goods will be lost forever.

The case of Gloria exemplifies an attachment style that reflects a primary affiliation attachment style along with a hyper-attachment to objects that fortify her self-identity as a mother. Gloria and her daughter were very active in Girl Scouts together, and these shared activities bonded mother and daughter. Below is an excerpt from the PO's description of Gloria and the meanings behind the many possessions she found difficult to let go of:

   Gloria had an extremely large Beanie Baby collection, at least 100
   sets of children's books, and dozens of boxes of various Girl Scout
   craft kits. She said she loved her Beanie Babies and they made her
   feel warm, loved and happy. Crafts were the key to Gloria's happy
   memories with Girl Scouts and her daughter. Gloria's daughter is
   [now] a woman in her early twenties who lives in another city. She
   is independent and rarely visits home ... Gloria misses the
   closeness she had with her daughter, and finds it difficult to
   believe her daughter is grown-up.


Gloria's affiliation attachment to the possessions that were crowding her living space was rooted in the ability of these possessions to evoke memories of shared times together when she and her daughter were closer, both emotionally and physically. By keeping these objects close to her, Gloria was able to transcend geographical and emotional barriers between her and her grown daughter. Psychologically, these objects filled a void in her current life and helped her feel more connected to her daughter.

Gloria's PO utilized a number of organizer strategies designed to appeal to Gloria's emotional and affiliation-seeking possession meanings during the dispossession process. First, her PO utilized a strategy described as "friends, acquaintances, and strangers" (Kolberg 1998) to help Gloria sort through her large collection of Beanie Babies. This sorting strategy, in which possessions are classified in terms of their affiliation to self, can appeal to hoarders' tendency to anthropomorphize their possessions (Grisham and Barlow 2005). Afterwards, the PO asked Gloria to select only the 20 "best friends" to keep publicly displayed in a shrine-like bookcase. Creating "shrines," or special displays, is helpful during the sorting process as it helps the PO and client to pare down large assortments of momentos to manageable displays that truly honor these objects. After Gloria and her PO determined which items were worthy of public display, the rest were carefully bagged and placed into temporary storage. While these emotionally charged objects were being sorted, the PO made sure to retain physical control over the objects, holding each up for the client to review and relate its "story." This organizing strategy, called "avoiding tactile sympathy" (Kolberg 1998), increases the likelihood clients will let go by assuring that deep emotional connections are not rekindled by allowing clients to hold or caress treasured possessions. For clients with a strong desire to control possessions, relinquishing physical control to the PO aroused anxiety, but created opportunities for the client and the PO to discuss the object's value and importance more objectively. Finally, the organizer arranged for Gloria to donate the majority of her large craft collection to the Girl Scouts. Meaning-matched disposition strategies helped POs to align clients' attachment styles with corresponding disposition choices, thus alleviating their concerns over responsibility for objects. This strategy helped Gloria to reconcile her past memories with her current self-identity as revealed in the following excerpt submitted by her PO:

   Relinquishing the crafts was tantamount to relinquishing her
   memories of and hope for the relationship she shared with her
   daughter years ago ... After we discussed her dreams and goals for
   them we went through an exercise where we pulled out the items that
   were seen as distracting to her dreams and goals. Two-thirds of the
   crafts were seen as distracting. These were boxed up and personally
   presented to the local Girl Scout council by my client. This
   presentation made her feel very helpful and important. My client
   really was treated like quite a hero by the scouts and that had a
   wonderful affirming affect for her.


Another example of a primarily affiliation-seeking attachment style is represented by the case of Jane, which is described in the excerpt below by her PO:

   Jane and a nephew are the only survivors of what was once a very
   large family. She had never married and was beyond child-bearing
   years. Jane could not let go of any family photos or mementos. She
   felt that keeping the boxes and boxes of photos and items was
   preventing her from being happy but she had really had a hard time
   releasing these things--to the point of panic and tears. I believe
   she felt duty-bound to keep the family things because it was a way
   of keeping the family alive.


As with Gloria, the possessions Jane feels most distressed about relinquishing are those that represent her connections with others. However, not only does Jane feel deep emotional connections to these possessions but also she feels a strong responsibility for them because they represent her family's legacy units (Curasi, Price, and Amould 2004; Epp and Price 2010). She understands that being the keeper of these mementos is detracting from her current life goals and well-being, but the sense of responsibility is a burden she feels duty-bound to honor as the elder of two remaining family members.

Jane's PO utilized a collection of strategies to enable her to negotiate the letting-go process while honoring her commitment and deep emotional connection to family members represented by these possessions. First, Jane's PO encouraged her to relive the past through storytelling, which allows clients to relate the history of objects during the sorting process, similar to that described by Lastovicka and Fernandez (2005) in their study of meaning-transfer rituals observed between possessors and strangers during the transference of ownership of possessions sold at garage sales. Second, the PO arranged for those objects with historical value to be donated to a local museum, which is another example of meaning-matched disposition, as Jane wanted to honor the historical value of these objects. Throughout the dispossession process, Jane's PO encouraged her to balance the temporal relevance of possessions with her current life circumstances and future goals. Those objects that failed to contribute to Jane's current or future life goals and could not be meaningfully placed in the care of others were given an honorary good-bye in the form of a disposition ritual described below by Jane's PO:

   The "burial" was a ritual of lighting candles, wrapping the items
   in paper, sprinkling it [sic] with holy water, and saying prayers
   for the ancestors who were represented in the items. The items were
   then discarded. The ritual was done with a level of respect and
   really did represent a burial of sorts. Jane felt that she had let
   go of these things with honor. Jane was also encouraged by her
   therapist to journal throughout the weeks we worked together.


Emotion-based strategies, such as storytelling, avoiding tactile sympathy, creating shrines, and engaging in dispossession rituals, were effective strategies for many clients with primarily affiliation-seeking attachment styles. In several cases, these strategies were used to help clients honor affiliations that extended to social selves beyond family. For example, Margie had difficulty disposing of old clothes that she had not worn in years and could no longer wear. Her PO says: "Clothing is her downfall. She remembers where she wore each piece of clothing, when, and the friends she was with when she wore them. Everything she owns has a story. They capture events and the people in her life." Margie's PO challenged her to go on a "treasure hunt" for outfits she was positive she no longer needed, but had sentimental value. The treasure hunting strategy helps POs turn the negative act of identifying unneeded objects with strong self-identity and memory attachments into a positive act that affirms clients' ties to these objects and their inherent value (Kolberg 1998). After listening to the stories behind each item, Margie's PO asked, "Are you attached to the memory or the outfit?" After reflecting, Margie realized her attachments were rooted in the memories and she was quickly able to get rid of 12 large bags of clothing.

Likewise, Delores, who once had a very successful career in the medical field, had difficulty getting rid of decades-old personal correspondence with patients. Understanding that Delores experienced tactile sympathy, her PO gained her trust to sort through papers and held each as Delores told the story of these patients. After reliving the cases, the PO appealed to Delores's professional ethics regarding patient privacy, which prompted Delores herself to shred these documents. Respect proved to be the key to unlocking Delores's ability to dispose. A devout Christian, Delores also had trouble disposing of an old and worn Bible, but agreed to burn it because this seemed a more "respectful" way to dispose of this item than simply throwing it in the trash in a disposition ritual.

Affiliations also extended to broader social networks. Mark's PO created shrines to display his collections, which included militia artifacts and a vast collection of pipes (over 300), which were important to him because of the social stature he had cultivated within the collector community while procuring these collectibles. It was extremely difficult for Mark to let go of his collectibles, but he eventually sold many of his treasured collectibles, mostly through his connections. With the help of his PO, he came to relish his expertise through the sale of these items and treasure even more those very important objects that he kept back as "unsalable" to display in his shrine.

Emotional attachments rooted in close connections to others were not always positive, and sometimes disposition rituals acknowledged ambivalent emotions. For example, Phyllis felt a need to be the responsible steward of possessions she inherited from a relative toward whom she had very negative feelings. Phyllis's PO describes how her client's disposition ritual helped to acknowledge negative feelings and lighten the mood: "When she determined she could let some of these objects go, I wrapped them carefully, even if they went to the curb, and we made it a point to wave 'bye-bye' to them as they were taken away. This provided emotional relief as well as a welcome break from making decisions about more beloved possessions."

Last, another PO strategy commonly used by POs when dealing with clients whose attachments were primarily affiliation-based is that described by Lastovicka and Fernandez (2005) as "iconic transfer," in which meanings invested in goods are transferred to an object that is more easily retained, such as photos or collages. Many organizer cases described taking photos of objects before they were disposed to help clients retain the memories, if not the objects themselves. For affiliation-seeking clients, the need to keep physical relics was important and organizers were creative in transforming these memories into tangible objects clients could retain. One example is the case of Bob and Doris, an elderly couple in their 80s forced to downsize from assisted living quarters into a nursing home. Their PO reported that clearing out their possessions was made difficult because "everything they owned had 'deep sentimental meaning' even if it was broken."

   Most of the items were given to them for their wedding or were
   gifts from their children. These items, even if they had not been
   used (sometimes they were even in the original box), or had been
   stored away for 40+ years, the client had the need to keep the item
   because it showed that the person who gave it to them LOVED them.
   An important strategy was reliving the stories behind the people
   that had given them these object ... In most cases, they agreed to
   take photos in order to remember the item. This allowed them to
   release about 90% of the items in question. During the last move to
   the nursing home, I made a photo quilt with pictures of the most
   special items. The wife hung this above her bed, so she could look
   at her special things.


Another example is Maggie, who had an intense emotional reaction to the idea of letting go of her extensive collection of t-shirts or clothing belonging to her deceased mother. In addition to creating a shrine to give homage to these very special objects, Maggie's PO helped her create a quilt using remnants from special clothing articles to iconically transfer this meanings into a tangible form she could keep, which helped Maggie to relinquish most of the remaining usable clothing to charitable organizations.

Autonomy-Seeking Attachment Styles

Both affiliation- and autonomy-seeking motivations are fundamental aspects of the self-identity development process as it occurs throughout the life span (Kegan 1982). Accordingly, the role that possessions play may emphasize one of these life-development motivations over the other as individuals negotiate self-identity throughout the life span (Furby 1978; Kegan 1982; Kleine, Kleine, and Allen 1995). While affiliation-seeking motivations emphasize our social connections to others, autonomy-seeking motivations emphasize an individual's uniqueness, personal accomplishments, passions, and control over their environment (Kleine, Kleine, and Allen 1995; Schultz, Kleine, and Kernan 1989).

The case of Michele is an example of a primarily autonomy-seeking attachment style fortified by a need to control possessions and an over-reliance upon them as memory cues. Michele gave up a successful career as an optometrist to become a stay-at-home mom to her three young children. This excerpt from her PO illustrates how Michele's desire to be the "perfect mom" fueled her fear of letting go of anything that might ever be needed by her family:

   Michele is a very caring mother who is devoted to her children. She
   feels that she needs to keep everything that anyone could ever
   need--"you never know when you'll need it for a school project" is
   her mantra. When we began working together, her paperwork was out
   of control, including subscriptions to at least 75 different
   catalogs and hundreds of emails in her inbox. She is afraid of not
   having information at her fingertips in case she needs it. Her home
   was cluttered with piles--very visual, needing things to be in
   front of her to remember them but then lost in the clutter. She
   also is a perfectionist to the point of wasting time by picking
   pieces of paper from her shredder. Her perfection comes at a
   cost--she is constantly stressed that she is not providing
   everything her children need and runs around in circles trying to
   accomplish everything needed for them and her husband. She also is
   a shopoholic--buying items that don't fit or work and not returning
   them in a timely manner.


Ironically, Michele's strong need to have objects and information visually accessible, along with her continual purchases, have created a mass of clutter and chaos that is disruptive to her family and impedes her ability to be the perfect mother she aspires to be.

Michele's PO astutely understood that tactics appealing to sentimental and emotional attachments embodied by the possessions Michele felt compelled to keep was not the best way to help this client. Instead, the PO employed traditional professional organizing strategies, including bins and storage spaces, throughout the home to address the piles and help the family create appropriate spaces for objects important to have easily accessible, while storing or discarding others. The PO created a "memory bin," one for each child, and attained Michele's agreement on a set of disposal rules governing what objects were allowed to be kept in each bin, such as: (1) limiting the number of items to be kept in each child's bin; (2) agreeing nothing could be added to the bin unless it was "truly special" and could not be retained in an alternative fashion, such as taking a picture of the object; (3) school papers with no names on them were not allowed to go in the memory bin or be kept. Michele's PO also created a family organization center that included spaces for each family member to store important items, which helped to relieve Michele's felt need to be in control of everything and distribute this responsibility across the family.

Autonomy-seeking motivations can be distinctly different from affiliation-seeking motivations, especially when rooted in possession beliefs strongly aligned with a desire to retain control over possessions that could be useful to self or others. These meanings can become wildly exaggerated by traumatic life experiences. Onset of compulsive hoarding has been associated with traumatic or stressful events (Cromer, Schmidt, and Murphy 2007). Several cases gathered in this investigation support the notion that life experiences involving deprivation contribute to an extreme need for control over possessions. The case of David is an example, as described below in this excerpt submitted by his PO:

   David is a middle-aged divorced man, son of Holocaust survivors,
   and a successful attorney. He had trouble disposing of everything:
   old food, old newspapers, empty bottles, old clothing, etc. The
   items represented comfort--the fear of disposal represented fear of
   going hungry or being naked, etc.


After working with him and understanding his past and possession meanings, David's PO came to understand that the key to reducing his extreme anxiety when faced with disposal decisions regarding primary goods, such as clothing and food, was to create for him a comfortable visual of "fullness" when he looked into his closet, pantry, or refrigerator. After sorting through piles of old clothing and disposing of old non-perishables that were past their expiration date, the PO worked with David to restock closets and pantries at "density" levels he felt comfortable with and establish guidelines for replenishing objects.

David's PO used visualization strategies effectively to create a sense of abundance and security, but other organizers utilized the same strategy to make clients visually aware of an "overfull" situation and the irrationality behind their extreme stockpiling of goods. Hoarders often exhibit information processing deficits, including visual learning disabilities, that make it difficult for them to "see clutter" as do others (Tolin et al. 2010), until they are confronted with a visual display of their hoard. Clients were often shocked when their organizer bagged or displayed their vast collections for them to see categorized in one place, apart from their natural habitats and hiding places. An example is Andrew, described by his PO as "a highly-educated male who is not overtly sentimental or emotional ... He is practical and conscientious." Andrew's PO compiled his enormous collection of reading materials into a single space, which consumed most of his large basement, to visualize for him the problem. Then, she appealed to the self-esteem motivations behind his "infoholic" tendencies, which were driven by his desire to be "the most knowledgeable, especially in technology" by confronting him with a mathematical problem--how much available time did he have in a typical day/week to read these materials? After calculating his available reading time, Andrew was forced to admit that he did not have enough hours in the day to read all of the materials he collected. Faced with this visual, Andrew and his PO established various containment strategies to mark available spaces in his home as progressive storage areas, including "holding areas" for reading materials he planned to read in the near future and a "discard area" for outdated materials defined as one year or older. Andrews's PO also established for him a "tossing log" to create a visual digital archive he could access on the Internet should he need to refer to these materials in the future.

Combined Affiliation- and Autonomy-Seeking Attachment Styles

Both affiliation- and autonomy-seeking may be equally competing motives for keeping possessions, especially for consumers who experience strong attachments to many or most of their possessions. These complex attachments may be accompanied by a complex web of possession meanings regarding the ability of these possessions to fortify a person's self-identity goals, as was the case with Deborah:

   Deborah is a widow in her late 50's, a former librarian, and very
   attached to her late husband who died over 3 years ago. She lives
   alone in a rented apartment and knows she eventually wants to move.
   She lives in a very crowded space, filled with excess clothes,
   books, and other stuff. She seems to have a more than adequate
   income and is a compulsive buyer. She has trouble letting go of
   books because they have knowledge, and her background as a
   librarian reflects her reverence for knowledge. She has difficulty
   disposing of anything belonging to late husband, for whom she had a
   great love and many memories. She also has trouble letting go of
   her vast collection of pigs (ceramic, etc.).


Deborah has strong affiliation attachments to her deceased husband's belongings, as well as her books because books were a passion they shared. She also associates the books with her former career as a librarian, which aligns with an autonomy-seeking attachment style. Her collective tendencies and compulsive shopping signify independence, uniqueness, and other expressions of individual self. Her affiliation- and autonomy-seeking attachments are fortified by strong emotional attachments, a need to control possessions, and a strongly felt responsibility for these possessions.

These meanings have made it challenging for Deborah's PO to help her achieve her goal of downsizing so that she could move into a smaller apartment that better suits her current life circumstances. When clients have strong responsibility beliefs, meaning-matched disposition strategies help to match these meanings with disposition outlets that are tailor-made to clients' specific meanings. For instance, Deborah's husband was Brazilian, so her PO arranged for her to ship boxes of his books to an organization in Brazil. However, these match-making activities can be very time-consuming when there are many possessions to dispose of in a short time, and the client chooses very specific disposition channels that require research and coordination between parties. Deborah's need for control over possessions also slowed progress, as she insisted on reviewing every object and dictating specific instructions for how each should be handled. Deborah's PO found it useful to cater to her strong need for control, and allowed her to be "the boss" over the clearing-out process. Allowing client control over decisions in the disposition process is critical, but when clients have strong needs for control, it can impede progress. Deborah's PO managed to channel her client's need for control over her possessions and the disposition process into desired outcomes by continually reinforcing Deborah's expressed goal of moving into the smaller apartment to reinforce progress. Her PO often heard her muttering to herself, "I have to let go of this. I have to let go of this" as Deborah reviewed her possessions, and she encouraged this self-talk.

Iconic transfer, or transforming objects into alternative formats more easily retained by clients, was also commonly observed among clients with mixed attachment styles, but its use varied depending on possession meanings. As previously described, objects with close affiliation ties were often transformed into alternative physical forms, such as photo collages, scrapbooks, quilts, or other material objects that could be held and displayed. Objects retained to support autonomy needs and control over information, such as collections of papers, magazine clippings, newspaper articles, and music collections, were frequently dematerialized into digital formats. For example, Linda, a compulsive collector of 33-1/3 records, despite the fact "she no longer has a working player on which to play these records," was willing to relinquish her collection only after her PO suggested they compile a list of her vast music collection. After compiling the list, Linda happily donated most of her record collection to a library for music students. "Special" CDs were placed in plastic CD holders and stored above her CD player. Linda's PO says that the outcome was very positive and the client has not expressed any regrets:

   I think the key was we took our time; we discussed the project; we
   had a plan in place, and we contacted a good resource to make the
   donation. The gentleman from the library who came to pick up the
   records was courteous and pleasant and told my client about the
   students using the library often and how much they appreciated such
   a donation. Also, we still had a written record of the music she
   could refer to as a remnant of the actual items, although I think
   after compiling the list that she rarely refers to it. I think, in
   some way, it gave her comfort to know she had the listing available
   to her in case she wanted to refer to it.


DISCUSSION

The types of attachments and possession meanings exhibited by consumers in this study are no different from those experienced by most consumers. These are natural consequences of possession ownership that are typically associated with positive mental health and successful execution of life goals. However, when consumers become overly attached to many or all of their possessions and develop exaggerated or unrealistic expectations about the power of possessions to fortify self that are not substantiated by current life circumstances, continued retention of these possessions can create an "over-extended" self. In such cases, attachments to possessions cease being productive and can become perverse in the sense that they stifle the maintenance and continued development of self-identity.

The accumulation of possessions had reached the point of an "overextended" self for all 28 cases analyzed in this study. These consumers sought help from a PO, who is not a mental health professional, but rather a service provider hired to assist clients experiencing issues with clutter and disorganization in their lives (Belk, Seo, and Li 2007; Bratiotis et al. 2013). The task of a PO becomes one of moving backwards from the current situation to uncover the deep meanings and beliefs that created these consumers' desire to retain these objects and why they feel so anxious about letting go of them. Only then can they devise strategies that successfully allow their clients to engage in dispossession activities designed to help them achieve their goals.

Overall, affiliation attachments emphasized "we-ness" and exhibited strong emotional undercurrents. The most effective strategies for these clients were those that incorporated an appreciation of these strong emotions and clients' almost human-like relationship with these objects, including sorting by "friends, acquaintances, and strangers," storytelling, "treasure hunting," creating shrines, avoiding tactile sympathy, and engaging in disposition rituals. On the other hand, autonomy attachments emphasized "me-ness" and were often associated with irrational belief systems or concerns related to the power of objects to achieve self-identity goals. Emotion-based strategies were not nearly as effective as rationality-based appeals in these cases. Some POs remarked that emotion-based strategies such as "friends, acquaintances, and strangers" frustrated clients with a primarily autonomy-seeking attachment style. Instead, learning and visual organizing strategies such as creating bin systems, establishing disposal rules, and helping clients to visualize their accumulation of goods in juxtaposition to their current needs and goals proved most effective. Across cases, some strategies appeared universally effective, especially when POs tailored their approach to address mixed attachment styles and meanings associated with particular objects. These universally effective strategies included meaning-matched disposal, in which organizers sought to recirculate goods in appropriate secondary markets or to particular benefactors, and iconic transfer, in which meanings invested in goods were transferred to alternative materialized or dematerialized forms that were easier for clients to retain. Allowing clients to maintain control over decision-making also proved helpful in alleviating the extreme anxiety these consumers experienced during the clearing out process.

This research reveals the importance of linking attachment styles to sources of meaning and subsequent disposition methods and strategies, especially for emotionally charged objects that are important to one's self-identity. Meaning-matched disposal strategies, in which POs sought appropriate placements for goods, varied widely based on the client's attachment style and depended on the PO's understanding of exactly what perceived values the client wished to acknowledge and honor. Donating goods was the favored disposal option, but it was extremely important for these consumers to know how benefactors would honor or value their prized possessions. Future research could explore more deeply how dispossession strategies, like storytelling, can be used to increase the emotional "pay-off" for consumers who donate goods to charitable organizations (Merchant, Ford and Sargeant 2010). Future research could also explore more deeply the relationship between personal agency, recycling values, and secondary retail channels that link charitable donations to profits that benefit social concerns (Derksen and Gartrell 1993; Hibbert, Home, and Tagg 2005).

Another very interesting and important insight that surfaced from this research was how the concept of extended self is realized in an increasingly digital world (Belk 2013). Iconic transfer was a strategy frequently used by POs to transform material objects into other forms more easily retained by clients, but its successful use as a dispossession strategy was dependent on singularized meanings attached to these goods and the consumer's primary attachment style. Belk suggests that "while digital possessions can be objects of self-extension, they may not be as effective as material possessions" (Belk 2013, 481). Hoarders with primarily affiliation-seeking styles and strong emotional connections to possessions seemed satisfied with iconic transfers that re-embodied these close meanings into alternative physical forms that they could still touch and view daily. Hoarders with primarily autonomy-seeking styles and strong memory and control needs seemed satisfied with digital re-embodiments, yet they often rarely accessed them in their digital formats. Future research is needed to understand how attachment styles differ between tangible and digital extensions of self.

The ability of trained POs to "match meaning with matter," which is a phrase coined by ICD Founder Kolberg (1998) to describe organizing and clearing out strategies that match possession meanings with possessors' motivations, suggests that the ability of a PO to help his or her clients achieve transformational life outcomes is facilitated by the PO's level of emotional intelligence (EI). Mayer and Salovey (1997) (see also Salovey and Grewal 2005) define EI as the ability to perceive, use, understand, and manage emotions of both oneself and others to achieve goals. Although the construct of El has generated controversy among behavioral researchers in terms of its definition, conceptualization and measurement, and even its scientific validity (c.f. Zeidner, Roberts, and Matthews 2008), a growing body of research has linked EI with job success and customer satisfaction in careers that have elevated interpersonal and emotional demands, such as managers, service providers, and health care practitioners (e.g., Barlow and Maul 2000; Kernbach and Schutte 2005; Lemmink and Mattsson 2002; Price, Arnould, and Deibler 1995; Walker 1995).

POs provide in-home services to help clients make emotionally difficult disposal decisions that can improve their well-being. The work done by POs possesses transformational qualities that have not been investigated by service researchers. In their agenda for transformative service research, Rosenbaum et al. (2011) cite the need for research that focuses on services with the potential to improve not only the well-being of consumers but also the communities in which they live and society in general. Future research is needed to understand more fully the role and demands placed upon POs, and factors that contribute to both positive and negative outcomes for their clients, families, and communities.

CONCLUSION

Hoarding and excessive accumulation of possessions is a serious problem for consumers, families, and the communities in which they live. Hoarding is also easily hidden by consumers because it involves acquisition and possession attachment behaviors that are remarkably common among consumers, until these become so extreme that they pose serious threats to the well-being, health, and safety of the person and those living around them. Compelling empirical evidence gathered over the past two decades about the nature of compulsive hoarding and its unique characteristics recently led to hoarding becoming a distinct classification in the DSM-5 as opposed to a sub-classification of OCD behavior. This change could have a significant impact on the ability of consumers to utilize insurance to pay for in-home services such as those provided by POs. A capable and trained PO can make a positive impact by working productively with clients and other involved parties to address these potentially life-threatening situations; however, without proper training, the PO may do more harm than good. It is important that future research examine how personal service providers can improve or impede the potential welfare of consumers through their interactions, based on factors such as the service provider's training, preparedness to deal with difficult and emotionally demanding service encounters, and perhaps the service provider's level of El.

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Catherine A. Roster (roster@unm.edu) is Associate Professor of Marketing at the University of New Mexico. The author wishes to thank volunteers from the Institute for Challenging Disorganization for their participation in this study and two anonymous reviewers for their helpful suggestions to earlier versions of this article.

DOI: 10.1111/joca.12052
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