Redefining Crazy Conference 2022 Keynote Interview with Dr. Michael Tompkins

This Fall [October 12th-14th, 12-5 PM] MHASF’s premiere virtual conference returns for Redefining Crazy 2022. The goal of this virtual conference is to convene peers, experts, stakeholders, policy leaders, providers, researchers, and community advocates in a collaborative learning environment to advance innovation and highlight the values of diverse leaders across sectors to discuss the state of mental health work. This year’s online event features tracks on Hoarding & Cluttering, and Communities Reclaiming Wellness. 

MHASF sat down with keynote speaker, Dr. Michael Tompkins, to discuss his experience with hoarding and cluttering ahead of his presentation, Sorting and Decision Making: Two Key Skills for Effective Decluttering.

What led you to your work in de-cluttering?

I started my practice, and I was specializing a lot in obsessive compulsive disorder [OCD]. What I started to notice is that some of some of the people who are seeking help for OCD had a lot of saving and keeping behaviors. It is really quite different than people with what we think of as more of a hoarding condition. I started meeting people like this where the cluttering, saving, and the acquiring was much more than I’d ever observed in my other clients. So, I started researching the topic, which led me to some fantastic researchers like Dr. Randy Frost & Dr. David Tolin [Buried In Treasure], Dr. Jordana Muroff, and Dr. Christiana Bratiotis—just amazing researchers in this area. When I started to learn more about it, I was looking for ways to actually help people. I started working with people who are looking for some help with their saving and acquiring behaviors. I got into the field because I had tried a number of different things, and none of those were very rewarding to me, and I really wanted to help people.

How has your lived experience shaped your view of mental health over time?

I do have relatives who have had their mental health challenges like major depression and anxiety, of one sort or another, but I’ve never really had more than what I would characterize as periods of worry but not something that I would call disabling in any way. I really do think I can empathize with and be compassionate towards someone who is suffering regardless of what that suffering is and I bring a great deal of privilege and fortune into my life. I think that’s part of why I really have tried to give back a little bit—use it for good.

What can someone who has experienced Hoarding & Cluttering take away from your presentation this October?

This training is going to be an experiential training. I want the people to come prepared to grow around this. The cool thing about this being virtual is that many of the individuals will already be in their living environment. We’re going to collect a box of representative items, put them in the box in preparation for the training and then we’ll focus on two skills—we’re going to do a little skill building. The first skill is sorting, and the second skill is decision making. Both those skills are difficult for people who struggle with hoarding and cluttering.Sorting just means to organize our environment, our living environment. It requires us to be able to sort our items—our possessions—into categories. Not just like categories like ‘Keep’ or ‘Let Go’, but other categories like importance, unimportant, relatively important, etc.One of the things for people who struggle with hoarding and cluttering behaviors is that sorting is hard do, in part because the idea of putting things into categories brings up a lot of anxiety. Part of that anxiety is because they’re worried about putting it in the wrong category, so the result is no sorting, categorizing, no decision-making. I want to give people the opportunity to practice that with me, and then pay attention to what comes up for them while they do that. What feelings come up for them, what thoughts come up? Because what we know is that the more you sort, the easier the sorting becomes, and the faster you become in sorting.The second skill is making decisions effectively. People who struggle with hoarding and cluttering behaviors have a lot of trouble making decisions quickly. When you have trouble making decisions quickly, the default is not to make a decision. So you put it aside and decide what to do with it later. Regardless of what gets in the way of the decision, you’re actually not making a decision. We’re going to spend some time on decision-making rules and questions that you’ve asked yourself to help make decisions a little faster. And again, just like with sorting, the more you apply that skill, and more you ask yourself those questions, the faster your ability to make decisions [becomes].Now there are lots of other skills that help people receiving treatment, there are a lot of other skills you can learn. We’re going to focus on those two [at Redefining Crazy Conference 2022].

Do you find that by naming the internalized process of sorting and decision making, helpful habits begin to build?

Self-awareness is the key to any change. Saying, ‘this is a problem, and this problem has a name’. Alright, but also to be aware of the pieces of that problem. When we’re trying to help people in their recovery, we’re trying to teach them skills that are focused on factors that perpetuate the problem.One of the things that people who struggle with hoarding and cluttering behaviors have trouble with is categorizing. They look at their possessions, they label all their possessions as important. When you place all your possessions in one category, important, then the obvious thing that comes from that is to keep [the possessions]. Sorting into relative importance helps you learn that not every possession is of equal importance. With a gradient of importance, it gives you more agency, it gives you more capacity to make decisions about what to keep and what to let go of and how to let go of it.

Do you notice a change in importance for someone’s relationship with a belonging over time?

When you struggle with hoarding and cluttering behaviors, the importance you attach to possession is not for lack of a better term, rational. Meaning that it’s not something that you can step back from without emotion. Importance is a feeling; it’s a felt importance. With time, the importance of a possession changes as our feeling about the possession changes, so something that initially might feel very, very important, if we let go of it, we would discover it will feel less important 24 hours later. 48 hours later it will feel even less important. 72 hours later, because the importance is really a felt importance, not rational importance. I use that word [rational] cautiously. Does it make sense in my head, versus, does it feel true in my gut and feeling true in my gut… it’s a felt belief, right? So, the felt belief is the belief about important, even though it may not make sense in my head, but in my gut, when I think about letting it go, it feels really important.

Why is community important for mental health support?

Community is enormously helpful in mental health. The primary reason it can be so helpful is supportive, caring compassion. In this country, unfortunately, there still exists a very high level of stigmatization [around] mental health issues. Stigmatization of a mental health issue results in shame and embarrassment, resulting in an unwillingness to seek help, mean[ing] people are trapped in the problem. This is where the Mental Health Association of San Francisco is so vital to people in recovery, regardless of what the recovery entails. The mission to destigmatize mental health issues, so that people are more willing to seek mental health services is vital, absolutely critical, regardless of the problem. How people enter that space can influence their recovery dramatically. Through the Mental Health Association of San Francisco, those who have entered through either support groups or education, and have then been able to take that and enter more active recovery—maybe move into treatment, or any other opportunity that influences their recovery. But it all started with a willingness to dip their toe in recovery. Feeling that support and acceptance comes from being within a community of people with lived experience, and that cannot be re-created. It is a natural space that only people with lived experience occupy, and it’s a very powerful space that they inhabit. It has done remarkable things, helping people regardless of the struggle. So, it’s vital.

In ten words or less, what can you say to someone experiencing rock bottom with their mental health? 

 Any point you enter your recovery is a good point.

What gives you hope for the future of Hoarding & Cluttering? 

What gives me hope for the future of hoarding and cluttering is twofold. One is that there are people. There are scientists, researchers, and mental health advocates who are continuing to work in the field to understand the conditions. Through that understanding, we’ll be able to develop resources and treatments that reach more people and help more people. There are super smart people working in that area.And then I think the second thing that it gives me hope is organizations like the Mental Health Association of San Francisco. Continuing to advocate and educate the public. Not just about hoarding and cluttering behavior as it stands, but mental health issues in general. The advocacy is needed so badly. I am very hopeful, as I watch what is going on in the world and within our communities, that there are young, passionate people who are working that space. I’m very hopeful that as mental health is destigmatized, that more people are going to be reaching out and getting more help. Then, people will suffer less, which is the goal: less suffering. I hope to be a part of that future, and I hope it comes to fruition.

Thank you so much for sitting down for this talk, Dr. Michael Tompkins. Please check out Dr. Michael Tompkins presentation for the Redefining Crazy Conference 2022 in October [10.12-10.14] . His presentation is called Sorting and Decision-Making: Two Key Skills for Effective Decluttering. Thank you so much, Doctor Tompkins