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Impulse to Shoplift Treatable, Experts Say

November 07, 2002|Benedict Carey | Times Staff Writer

Actress Winona Ryder has not said what prompted her to take more than $5,500 in clothes and accessories from Saks Fifth Avenue last year. But psychiatrists say people who shoplift to serve a compulsive urge may suffer from a treatable mental disorder.

For people who repeatedly take things they don't need, a condition known as kleptomania, the inner struggle can be extremely difficult to overcome: the breathless thrill of walking past the cashier with stolen goods against the stinging shame of having broken the law.

"Kleptomaniacs are people who usually see themselves as having a serious moral failing," said Dr. Jon Grant, who runs the Impulse Control Disorder program at the University of Minnesota Medical School in Minneapolis. "The key is to get them to see the problem as an illness, as a problem in the brain."

Like compulsive gambling, experts say, kleptomania is an impulse problem rooted in chemical cravings as real as any for alcohol or tobacco -- and the habit is as hard to break as drug addiction.

Researchers in the past year, however, have discovered several promising treatments.

In one study, Stanford University researchers studied compulsive shoppers, whose impulse control problems are similar to those of kleptomaniacs. Using a Prozac-like antidepressant, citalopram, the researchers reduced urges significantly in 17 of 22 of the patients.

In another study, Grant reported that naltrexone, a medication used to treat alcoholism, reduced the urge to steal, as well as the thrill that comes with stealing, in 13 kleptomaniacs. In an ongoing follow-up involving 30 compulsive shoplifters, Grant said, the drug has reduced cravings 60% to 70% of the time, "sometimes down to zero."

Medication by itself rarely turns people's lives around, psychiatrists say. Most compulsive shoplifters also need to identify and avoid the situations that get them into trouble, such as fancy display cases, jewelry counters or shopping after a stressful workday. Instead, experts say, they must learn to distract themselves when they feel the urge. Weekly therapy sessions can help; so can supportive friends and family members.

"With some of my patients, I have to tell them they simply cannot go into a store again, unless they have someone with them," said Dr. Donald Black, a professor of psychiatry at the University of Iowa who studies impulse control problems. "If you've got someone with you who knows about the problem, you're much less likely to take anything."

Will Cupchik, a Toronto psychologist who has studied and treated what he calls "atypical theft offenders" for 30 years, said most kleptomaniacs begin to break the law in response to some personal crisis: divorce, the death of a loved one or job loss. Sometimes discovering the underlying crisis helps to resolve the problem, he has found.

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