Social worker backs concept of shopping addiction

At a time when some are questioning whether the definition of addiction has become too broad, the prospect that compulsive shopping could soon become an officially classified disorder would appear unlikely. But a licensed social worker in New York City who has conducted numerous groups with individuals who cannot control their spending has no qualms about using the addiction construct to describe what she sees.

“Absolutely I would call it an addiction,” says Laura MacLeod. “All the things are there,” from prominent triggers such as resentment and boredom to the patterns of repeated actions despite negative consequences, such as financial hardship and impaired relations with loved ones.

MacLeod believes in the healing power of groups in general, and says she is seeing how people affected by compulsive shopping benefit when they come to realize that others have experienced similar problems. A common element among those who join these groups, she says, is that up to that point, they generally have told no one else about their problem. MacLeod says some of that stems from fear that people won't take the issue seriously, and might instead say something like, “What do you mean you can't go into a store and not spend $5,000?”

Intersection with other problems

In her observation of this issue, MacLeod says she has seen it more frequently in women than in men, although she also describes recently working with a male client in Ireland through video technology. She says the participants in her groups tend to be middle-aged, and have engaged in problematic shopping behavior for some time. Today's home and online shopping options, along with easy access to credit and constant reminders of sales and deals everywhere, certainly enhance the opportunities for these behaviors.

MacLeod says that when there are co-occurring issues present, compulsive shopping will most likely intersect with an eating disorder. Of course, since shopping addiction is not recognized in the DSM, this problem occurring in isolation cannot be treated under insurance billing.

She sees variation in levels of severity among the individuals with whom she has worked. One woman simply feared that the time she spent shopping online was taking too much energy away from her job. Others talk of the anxiety and guilt around having to hide purchases from their loved ones. Another person might describe the “high” around having just landed the perfect designer handbag, only to realize on the drive home that maybe it's not so perfect and the ideal purchase is still out there somewhere.

In the most extreme cases, MacLeod says, someone may have mortgaged the family home several times over and is about to face foreclosure, unbeknownst to the person with whom they share the home.

Although the DSM does not officially list shopping addiction as a disorder, many consumer health websites freely use the term. In addition, the Illinois Institute for Addiction Recovery describes the problem, attributing the information to the American Psychiatric Association, in part by stating, “It is defined as an impulse control disorder and has features similar to other addictive disorders without involving the use of an intoxicating drug.”

MacLeod sees feelings of resentment over anything from a bad day at the office to an unhappy relationship as the most prominent trigger for compulsive shopping behavior. The feeling becomes one of, “I deserve something,” she says. “It's almost like a child saying, 'I want that candy. I should have it.' They feel entitled.”

Inroads in groups

Making a connection with others in group has been an important first step for many of the people MacLeod has encountered. Once the individual feels accepted, he/she can begin to explore the origins of the behaviors, ultimately identifying triggers and creating an action plan to cope with them—one that doesn't involve going on the next shopping binge.

“Then they can step aside and work to stay in the discomfort,” she says. They also will ultimately have to learn healthier patterns of shopping, since it is not realistic for them to be able to avoid ever setting foot in a store again (this is another common element between an eating disorder and compulsive shopping).

For therapists who work with a variety of issues, it might be difficult to uncover a shopping problem in a patient, as the shame that is involved often keeps these issues well hidden. MacLeod believes therapists should look out for any off-the-cuff comments from clients about buying, or money, especially if they recur. Even something such as “My spouse doesn't know how much I spend” could serve as a warning sign.

Of course, therapist-client conversations about money can be uncomfortable, and generally have been frowned upon. “We don't generally address money,” MacLeod says. “We're not supposed to care about that, because we're here to help people.”