Compulsive shopping is finally coming out of the closet. First described by Bleuler in 1915 and then Kraepelin in 1924 (they labeled it oneomania from the Greek oneomai, to buy, and included it among other pathological and reactive impulses), it went largely ignored for the next sixty years. Only in the last decade have we seen specific and persistent inquiry into the disorder-in the psychiatric literature, in studies of consumer behavior and marketing, and in the popular press. And although the study of compulsive buying is still in relative infancy compared with some of its psychological siblings-alcoholism, for example, or eating disorders or drug abuse-there is more and more evidence, both research and anecdotal, that it poses a serious and worsening problem, one with significant emotional, social, occupational, and financial consequences.
How many people are we talking about? Estimates vary. According to Faber and O'Guinn (1992), somewhere between one and six percent of the population may be full-fledged compulsive buyers. The American Psychological Association's Monitor (Mjoseth 1997) agrees, reporting that perhaps fifteen million Americans have little control over how much they spend or what they buy. Estimates in the popular literature go higher; they see a full ten percent of the population, perhaps twenty-eight million Americans, as problem buyers (Trachtenberg 1988). And nonpathological compulsive buying-a compelling need to purchase that is not self-destructive, but may become so-could exist in as many as a quarter of us (Nataraajan and Goff 1991). Richard Elliot (1994), who has written about the relationship between addictive consumption and the postmodern condition, suggests that as incomes rise and shopping becomes a leisure pursuit, more and more addictive shoppers will emerge. The same possibility is envisaged by Scherhorn (l990). No surprise, then, that diagnostic criteria for compulsive buying are being proposed to the American Psychiatric Association for possible inclusion in the next revision of the Diagnostic and Statistical Manual.
As you will read, most shopaholics try to counteract feelings of low self-esteem through the emotional lift and momentary euphoria provided by compulsive shopping. These shoppers, who also experience a higher than normal rate of associated disorders-depression, anxiety, substance abuse, eating disorders, and impulse-control disorders may be using their symptom to self-medicate.
Underlying (or at least intensifying) the deeply felt need of problem shoppers is our nationwide outbreak of "affluenza," the modern American plague of materialism and overconsumption. This addiction to affluence and all its trappings underscores the reality that for every voice echoing Thoreau's famous plea, "Simplify, simplify," a hundred others cry, "Amplify, amplify!" (Sanders 1998). And amplify we do. The kind and number of shopping sites proliferates, and the gap between what we have and what we want grows ever wider. In addition to stores, still the most frequent sites by far, catalogue shopping, television shopping, cybershopping, and perhaps even online trading are becoming fertile grounds for the growth of compulsive purchase.
A particular media focus has been the fetching eye candy displayed by Internet auction sites, yet the newest temptation in the compulsive buyer's Garden of Eden. USA Today summed up the attraction: "Take the thrill of gambling, the excitement of computer games, the enjoyment of collecting, and the desire to get a good deal, and sprinkle it with a little of the old hunter-gatherer instinct. Suddenly, you've got several million people hooked on on-line auctions. (Weise 1999)" Although mental health professionals, addiction support groups, and researchers are just beginning to see cases of what might be called auction addiction, we can expect the numbers to increase sharply. For the susceptible shopper or buyer, these sites have a hypnotic pull.
As always, shopping jokes and bumper stickers are ubiquitous. Thus, the "smiled upon addiction," as Catalano and Sonnenberg have called it (1993), is smiled upon in two senses: it is at once a source of wry humor and at the same time a behavior much inflamed by our ever present marketing machinery. As a result, compulsive shopping may be an even greater source of guilt and shame than alcoholism or drug abuse. Those disorders are commonly thought of as diseases, or at least recognized as serious problems requiring treatment. Compulsive buyers, who are often quite secretive about their habit, worry that they will be considered simply materialistic and vacuous-judgments that likely reflect their self-perceptions.
In my clinical experience and that of most of my colleagues, it is still unusual for a patient to refer him- or herself for treatment for a compulsive buying problem. If compulsive shopping is a presenting problem, the patient has typically been referred by a financial counselor, lawyer, law enforcement officer, family member, or spouse. Much more frequently, a compulsive buying problem reveals itself in the course of ongoing psychotherapy. As treatment progresses, some patients begin to talk openly about the problem; with others, it emerges in the context of financial independence and responsibility issues, relationship problems, difficulties at work, or parenting problems. Compulsive buying may also present itself indirectly in therapy: a patient might wear something new or different to every session, or arrive with shopping bags week after week, or repeatedly give gifts to the therapist, or fall behind in paying the bill. Often a patient will enact several of these behaviors simultaneously.
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