Kleptomania: when compulsive stealing takes over your life

Australia Broadcast Center

2 days ago

Sana Qadar: What comes to mind when you hear the term kleptomania? Maybe it's celebrities like Winona Ryder, Farrah Fawcett and Lindsay Lohan.
Archival news audio: A jury at the trial of actress Winona Ryder has heard she was preparing for an acting role when she was first detained last December on suspicion of shoplifting at a store in Hollywood.
Sana Qadar: Or depictions in popular culture, like Breaking Bad.
Sana Qadar: What might not come to mind is fear, anxiety and pain.
Lynn: I've often felt like a very bad human for it. I felt like the worst human on earth because of it.
Dr Sam Chamberlain: Obviously there's a lot of stigma around the condition and also a lot of people aren't aware that it's a recognized mental health condition.
Sana Qadar: This week on Criminal Psychology, our four-part series for All in the Mind, we're going somewhere a little different. Because while on face value, a person with kleptomania is doing something criminal...
Lynn: Almost everywhere I go right now, I have to steal something.
Sana Qadar: There's a whole lot more to it than that.
Dr Sam Chamberlain: Often people with these conditions think they're the only person affected, but actually lots of people across the globe are affected by kleptomania.
Sana Qadar: I'm Sana Qadar. Today, what it's like to live with kleptomania. Plus, what we know about treating it and what's still a mystery.
Lynn: I've never been caught and I hope to let it stay that way, but I'm not sure how long I'll be able to.
Sana Qadar: All in the Mind's senior producer James Bullen is our reporter for this one.
Sana Qadar: James, hey.
James Bullen: Hey, Sana.
Sana Qadar: What are we going to hear today?
James Bullen: Today we're going to hear the story of one woman who was diagnosed with kleptomania, a little bit about how she got to that point and how it's affected her life.
Sana Qadar: We speak to a lot of people who have lived experience in various mental health conditions. I don't think we've ever spoken to someone who has kleptomania before.
James Bullen: Finding someone who's both diagnosed with kleptomania and happy to chat to us, you know, that was hard, but we found Lynn and she was really generous in sharing what life is like for her and kind of her journey.
Sana Qadar: And she's not from Australia, though, is she?
James Bullen: She's not from Australia. She's from Western Europe, but she was understandably really concerned about being identified. So the voice you'll hear for this episode is an actor. We did the interview with Lynn and then it's being voiced by someone else.
Sana Qadar: And so when did it all start for Lynn? When did she start stealing?
James Bullen: Earlier than you might expect in some ways. So she says her first memories of stealing were when she was seven years old.
Lynn: I was at a friend's house with my parents and out of nowhere, actually, I took some of the toys, like the Playmobil toys of the kid. And I didn't really know why. I didn't really realize it either. But I just put it in my pocket and left. And there was a small toy that fell out of my pocket. And my dad asked me, like jokingly, oh, are you stealing something from there? And I was like, what? No, what are you saying? But I didn't realize yet, I think. And like years following from there, I took small things sometimes. Like when I saw a pencil laying somewhere, I took it. But not, no big things.
Sana Qadar: So wait, I have to stop us there because this feels like very familiar behavior. I have a preschooler. He definitely has nicked things from daycare from time to time. Do I need to be worried about, you know, him?
James Bullen: That's a good point. And if you are listening and worrying, this is my kid, this is my child. This is a normal thing that kids do. It doesn't mean that they have kleptomania.
Sana Qadar: Okay, thank goodness. Why do they do it then?
James Bullen: A whole heap of reasons. If they're really young, like if they're two through even to about five years old, they might still be developing their sense of ownership and that other people own things and they're taking someone else's stuff. It can be because they're bored, they want attention from their friends, their parents, a bit of peer pressure.
Sana Qadar: That's the attention one is definitely probably my kid.
James Bullen: Yeah, a whole heap of things. And there's an article we'll put on the show notes that kind of goes into more detail on this if people want to dig into it. But for Lynn, particularly, that early stealing did continue on through her teenage years and got worse over time. And by the time she was about 17, those urges were getting much stronger.
Lynn: I started stealing more often. I was in my second year of university when it all really went down. I stole an umbrella at the university once. I started stealing in shops too. Like it was a camping shop that I took a thing with just hair ties, I think, from the shop. And from then on, I started stealing regularly. Almost everywhere I go right now, I have to steal something, which is really disabling for me.
James Bullen: The urges Lynn experiences have pretty much taken over.
Lynn: Almost everywhere I go, I have the feeling that I need to take something. I don't always take something because sometimes it's simply not possible because there are too many people around. But I do take things very often from friends, from family, from shops, from, I don't know, the people I babysit.
James Bullen: And at the age of 22, Lynn says that these urges are just about impossible to resist.
Lynn: It feels like I'm being pulled towards a certain object. I see something and I'm like, I have to take it. It feels like there's no way of not taking it. And there's, those are not things that I need or that I want. Often it's like things I would totally not even buy. Like if I have the money, I have enough money to buy stuff and it's things like, let me think. Like the umbrella. I have five umbrellas at home. I really didn't need another one. And I just took it because there was just an urge. Yeah, just, I felt like I was being pulled towards the object and I had to take it. And yeah, it's really difficult to explain it because it's just really an urge. I don't really think about it too much. It's a bit of a compulsion maybe.
James Bullen: And once she's taken the object, even if it's something totally trivial.
Lynn: At first it's like big euphoria. Yes, I did it. And it worked out and I didn't get caught. But afterwards, after a minute already, I feel so very guilty about it. And I feel like a terrible human being. And yeah, I just feel really bad about it actually. But there's two kinds of feelings at the same time. Like the euphoria is still there. And I'm very happy with being able to have taken the object. But also the guilt is there very strongly from the beginning too. I've seen many videos online. Oh, I have kleptomania, but I only take from big shops so people are not disadvantaged by it. But that's not how it works. It's really an urge. And it's not like I can stop it because it's a small shop or because it's a friend. People often think that. And they think that like I choose to do it. But it's, yeah, really not that way. I had some mental health issues. I was also diagnosed with OCD at age 16. But I had symptoms of it way earlier as well. And I actually went to the psychologist at age 13, I think. At first I purely talked about OCD and self-harm and depressive symptoms and stuff like that.
James Bullen: But when she was about 18, she started to feel more comfortable bringing up these stealing urges. She told a psychologist that she'd looked up the symptoms online and it sounded a lot like kleptomania.
Lynn: I was feeling very ashamed of it. At first I didn't want to admit it. It took a lot of trust to be able to open up about it. But eventually I did. And at age 20, I went to a psychiatrist for other things as well. But the psychiatrist was in the same office as the psychologist. So they knew about my stuff. I went, I'm pretty sure that I have kleptomania. Could I get an official diagnosis? She just went over the symptoms with me, the criteria. And she was like, yeah, it's very clearly kleptomania. And that's how I got diagnosed. It's less people who have kleptomania, but it's still a lot of people who have it. But it's so difficult to find people with it. And it's very lonely and very stigmatised.
Sana Qadar: This is All in the Mind. I'm Sana Qadar. Today, kleptomania, a compulsive and consuming urge to steal. It's a condition that's rare, often misunderstood and debilitating. And James, it strikes me that Lynn was also diagnosed with OCD and depressive symptoms. What do we know about the links between all of those?
James Bullen: There is a little bit of research out there. And what it finds is that more severe symptoms of kleptomania are linked to having a current diagnosis of OCD. And they're also linked to having an eating disorder. And in that same study that made those findings, they found that this group of people who were diagnosed with kleptomania, they typically stole once or twice a week and almost two thirds of them had been arrested for shoplifting at some point.
Speaker 6: Oh, wow.
Dr Sam Chamberlain: Kleptomania is a mental health condition, but it's not really been very well studied. And it's quite different to normal stealing.
James Bullen: This is Sam Chamberlain. He's a professor of psychiatry at the University of Southampton in the UK.
Dr Sam Chamberlain: Based on the evidence so far, we think it affects around three people in every thousand. So in terms of other mental health conditions that would make it relatively uncommon, for example, if we compare that to something like depression, which could affect, say, 10% of the population at some point in life, then kleptomania is relatively rarer.
James Bullen: Sam says what makes kleptomania different to stealing is essentially what Lynn described. People steal not because they need or want something. They have an urge to steal, an impulse that's impossible to resist.
Dr Sam Chamberlain: Often beforehand, they describe a sense of tension. And then after the stealing, they often will describe a sense of pleasure or gratification or relief from doing it. But then at the same time, often they might regret it and feel that they weren't able to control it. So that's the important thing to emphasize, is it's an impulse control disorder rather than a person stealing for their own kind of benefit or gain.
James Bullen: It can affect people of any age, but Lynn's experience is a common one.
Dr Sam Chamberlain: I would expect it to emerge during teenage years and early adulthood, because that's the time when the brain is undergoing a lot of rewiring, a lot of development, and people tend to be a little bit more impulsive when they're younger as well. At the same time, I've known some people who develop this later in life out of the blue, so it's really variable.
James Bullen: In terms of what causes kleptomania at this stage, we're still not really sure. But there may be clues in how it links to conditions that involve impulsivity.
Dr Sam Chamberlain: What we do know is we find associations with particular factors, for example, in terms of a person's personality and their cognitive function. And this is true of other conditions that are related to kleptomania, like obsessive compulsive disorder, but also other impulsive conditions like attention deficit hyperactivity disorder. So what we often see in people with kleptomania is that they have high trait impulsivity. This means that in terms of their personality, they have a tendency towards doing things in the spur of the moment, maybe in response to reward, and perhaps not planning things through to the extent that a less impulsive person would. So that's quite a common feature that we see. And we can also link that to some kind of subtle changes in what's going on in the brain as well.
James Bullen: There are only a handful of studies in this area, but what they do is recruit people with kleptomania and then a similar group of people who are the controls, who don't have the condition.
Dr Sam Chamberlain: What the study would tend to do is put people in brain scanner, so we can look at the structure of the brain, so how it looks. But also we can look at the function of the brain, so how activities, for example, when people are looking at pictures on a computer screen. And there's been just a handful, just a couple of imaging studies in people with kleptomania. What the work of Professor John Grant has shown, who's based in Chicago, is some subtle differences in parts of the brain that are involved in connecting, for example, the frontal lobes to other parts of the brain. So what we call the white matter tracts seem to be subtly different. Now, it's important that I explain here that this isn't a change in the brain that you would see physically. If you looked at a person's scan, these are subtle differences between groups of people with the condition, with kleptomania and match controls.
James Bullen: And while kleptomania hasn't been compared directly to other conditions that involve difficulties with impulse control, it's the same parts of the brain that seem to be affected.
Dr Sam Chamberlain: We also see changes in the white matter tracts connecting these key brain regions in people with other conditions such as attention deficit hyperactivity disorder or obsessive compulsive disorder. So probably there's some kind of common brain processes contributing to these different conditions.
Sana Qadar: So James, what else fits under this impulse control umbrella?
James Bullen: Yeah, it's a whole set of disorders under the DSM. And these are a class of disorders that typically involve difficulty in resisting temptations or urges, that kind of thing. They do tend to be fairly rare. So pyromania is another one.
Sana Qadar: Right, last week's episode.
James Bullen: Yes, yes.
Sana Qadar: Yeah. And so why is it important to kind of understand where this fits into that framework?
James Bullen: So Sam Chamberlain says that it influences how we will treat the disorder. So understanding what it relates to and how it kind of fits into our broader kind of understanding of psychology influences what treatments people will get.
Lynn: I have never been caught and I hope to let it stay that way. But I'm not sure how long that I'll be able to because I've been in a university home since this year. And I've stolen from the local shop every time I go there every week. I'm not sure how long I'll be able to keep doing that without getting caught. This week, I've not been to the shop because I was just too scared. And I just, I made sure that I didn't eat bread this week, which I would have bought at the shop. I just ate other things because I was too scared to go. Because I was like, oh no, I'm going to steal something and I'll get caught and that will become an issue. And my parents will know and I'll be arrested and convicted and the anxiety starts going up from there.
James Bullen: Lynn wants to become a clinical psychologist, but she's scared she'll one day have a criminal record and not be able to follow that dream.
Lynn: I think the anxiety is the biggest thing. And not everyone with kleptomania will experience this kind of anxiety, but I do. And I think it's just a strain on your relationships. Because I'm very scared to tell my parents, for example, I don't want them to worry about me too much. I really want to talk about it with them, but I won't because I don't want them to be scared for my future and I don't want them to be worried about me. But yeah, I can also be afraid to go to a friend's house, for example, because I'm like, maybe I'm going to steal there and maybe they're going to see it and be mad at me and don't understand. So it's just a lot of anxiety, I think. That's the main thing.
James Bullen: She has told a few friends, but that's about it.
Lynn: And I've often felt like a very bad human for it. I felt like the worst human on earth because of it, which I know I'm not, but it makes you feel so guilty. And I've told a few friends of mine quite recently, actually. I've told them they were very kind about it, but I've only told the friends that I'm very sure about the would-be kind. I have other friends that I wouldn't tell because I know that their response could be questionable or could be more difficult.
James Bullen: Psychiatrist Sam Chamberlain says it's typical that a person with kleptomania will conceal the condition from mostly everyone in their life. And he says the anxiety Lynn describes is all too common.
Dr Sam Chamberlain: We often see that people develop anxiety and depressive disorders and other addictions such as alcohol use disorder. Sometimes these can be a direct consequence of the kleptomania and other times they can sort of be happening in parallel. It can be really hard as well, like if family and loved ones find out about it for them to understand and so that can lead to relationship difficulties. We also know that people with kleptomania have a worse quality of life on average than people that don't have that condition.
James Bullen: So once someone is diagnosed with kleptomania, how is it treated? Broadly speaking, the kind of treatments that have evidence are certain types of talking therapy and a particular medication.
Dr Sam Chamberlain: So the talking therapy tends to be forms of cognitive behaviour therapy or CBT that have been adapted to help people with kleptomania. Usually it would be working with a trained clinical psychologist, say for an hour and working with them, meeting them at say an hour a week over a couple of months.
James Bullen: And with that psychologist, you look at the triggers for the stealing, the emotions surrounding it and whether there are other things that might replace the stealing itself.
Dr Sam Chamberlain: Helping the person sort of train themselves to be able to resist those urges. There's also some evidence that kind of relaxation techniques and mindfulness can be useful too.
James Bullen: So that's the therapy side of things.
Dr Sam Chamberlain: And then in terms of the medication, the main evidence to date is for a medication called Naltrexone.
James Bullen: You might have heard of Naltrexone already. It's a medication used for some types of addiction like alcohol use disorder.
Dr Sam Chamberlain: So we know from a randomised controlled trial that Naltrexone was better than placebo pill at improving symptoms of people with kleptomania. It was a relatively small trial, but it was a good quality study. And so Naltrexone is often a useful choice, but obviously as with any medication, there are side effects for some people. Naltrexone is not officially licensed for kleptomania and that's because nothing is in any part of the world as far as I'm aware. And that's to do with a lack of interest in the condition, I suppose. So it doesn't mean there's no treatment that works. It's just a sort of political and practical thing that means that it doesn't have a particular license.
James Bullen: And just on that addiction thing before we go back to Lynn, because it's kind of interesting in a nerdy psychology way, Sam says how you look at kleptomania and what cluster of conditions it's counted under could be important too.
Dr Sam Chamberlain: There's different ways of conceptualising these conditions. I think that thinking about kleptomania as an addiction could be useful because it shows the sort of parallels with some other conditions. So what you see is that tension beforehand and a kind of relief or gratification from doing the act in a similar way that, for example, someone might get some tension, have a drink of alcohol, and then that provides a sense of relief. As with other addictions, it can be triggered by stress or particular exposure to things in the environment. So obviously for someone with kleptomania, that could be being physically around shops. For someone with alcohol, that could be seeing an advert on TV for alcohol or seeing the bottle up on their shelves. Naltrexone as a medication treatment, really, that was chosen because of these parallels between kleptomania and addiction, because we knew that naltrexone can be useful for some of the other addictions. At the same time, that doesn't necessarily mean that that's the only way of viewing it. And so at the moment in one of our diagnostic systems, kleptomania is an impulse control disorder, so it's not in the same category as addictions. Yet we have something like gambling disorder is in that addictions category, but that's a little bit arbitrary. So there's other ways of trying to understand it as well, but I think the addiction model can be a useful way of thinking about it.
James Bullen: Metaconversation about how we define and organise these disorders aside, there's Lynn's real life experience of treatment, and it's been mixed.
Lynn: So I did have therapy still for OCD and self-harm, but kleptomania was also added to the things that I got therapy for. So I learnt tricks, for example, I had to do tricks like not bring a bag with me to the shop or have a card with me digitally on my phone that showed the reasons why I shouldn't steal. The police or my parents or my friends, the anxiety of losing them, stuff like that on a card on my phone, which I could look at when I felt bad, like when I felt the urge to steal. But that hasn't really worked out for me, so that's one thing I tried. It was also the recommendation of my therapist to, when I stole something, to do something that I don't really like, like doing certain sports or something that I didn't really like but that was good for me. Eating more food, for example, doing certain sport or stuff like that, but it also didn't really work. And right now with my therapist, we're trying out having a recording of my friends who say stuff like, try not to steal, I believe in you, you're so strong for not stealing, stuff like that in the recording, which I can listen to on my headphones when I'm at the shop or something.
James Bullen: Along with that, there's the medications.
Lynn: I tried one kind already, an anti-opioid, which is actually for alcohol abuse, but yeah, it's also been experimented with for kleptomania. I've tried it for a month and it didn't really do anything. So now I'm just starting a new medication, an SSRI, which also could help with it, but I don't really know if it will help or not because I haven't tried it long enough yet. So that's a bit how I went further with it. So like therapy with medication, but so far nothing has really helped enough to stop it or to really lessen it. It's difficult because it makes me feel hopeless a bit. Yeah. Will I ever get over this? Will it ever stop? Because I really don't want to live my whole life with this condition. And I also don't want to get arrested and have no future because of it. I don't want to end up in prison and yeah, it sucks that it's, that the research isn't there yet.
James Bullen: You might think it's a bit odd we've included this story as part of a series on criminal psychology, but for as long as the condition remains difficult to treat and stigmatised and hidden, people will be committing criminal acts and they will be at risk. If this is you.
Dr Sam Chamberlain: First step is I would say, go and speak with your family doctor, with your GP. That's confidential. You know, you don't need to be concerned about legal consequences because in most parts of the world that conversation with the doctor would be confidential and the doctor wouldn't disclose if someone's been stealing except in particular circumstances, you know. So I think just acknowledging and coming forward for help is a really positive first step.
James Bullen: He says people might also try and seek out support groups on the internet.
Dr Sam Chamberlain: There are some support groups out there. I'd say in some parts of the world, kind of kleptomania anonymous type groups. And that's not an evidence based treatment for kleptomania, but sometimes people can find it useful discussing with other individuals who have similar problems that can help a person sort of appreciate they're not alone. Often people with these conditions think they're the only person affected, but actually, you know, lots of people across the globe are affected by kleptomania.
Lynn: You don't know what battles people are fighting and kleptomania happens more often than you would expect. If you look at it people wise, it's still a lot of people and it could be your loved one who's experiencing this without you knowing. So just to be open for talks, for conversations about difficult things and to show that you're non-judgmental and just react kindly and help us like it can help for me. For example, I have a friend who sometimes goes with me to the store and they take a bag so I don't need to take it because I know that the urge will be bigger if I'm able to take things. Just ask us how you can support us.
Sana Qadar: That is Lynn, who was diagnosed and is being treated for kleptomania. You also heard from Dr. Sam Chamberlain. He's a professor of psychiatry at the University of Southampton in the UK, and he runs a treatment service for people with impulsive and compulsive problems. Thanks to producer Rose Kerr, senior producer James Bullen, and sound engineer Emrys Cronin. I'm Sana Qadar. Oh, and next time on our series...
Future episode: The other personality trait you find more commonly in people who commit serial murder and sexual murder is obsessionality. And obsessionality is to do with the need to control people and have things the way that you want it. And again, when you think about people who commit serial murder, many of them are extremely controlling and meticulous individuals. So that probably relates to why they want to control other people, but also to how they can actually plan and do their crimes in a meticulous way because there are people that do lots of things in meticulous ways.