IN A LAND where citizens are implored to shop as an expression of patriotism, where little girls can attend summer camp cruising the stores of a mall, and where the average credit-card holder is $1,673 behind in payments, buying things in the United States is more than a hunt for daily provisions. It's a national pastime, a form of therapy, a means of self-expression.

But for more than 1 in 20 Americans, shopping is something darker. A study published in the October 2006 issue of the American Journal of Psychiatry found that at some point in the lives of an estimated 5.8% of the U.S. population, shopping will become a source of shame, a cry for help, the cause of job losses and broken relationships, a road to financial ruin. They are "compulsive buyers" -- troubled by intrusive impulses to shop, prone to lose track of time while doing so, plagued by post-purchase remorse, guilt and financial woes and sometimes given up on by loved ones.