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Home Health

Understanding and Treating Hoarding Disorder

Terrence ShulmanbyTerrence Shulman
05/17/2015
in Health, Mental Health
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Understanding and Treating Hoarding Disorder
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You can’t take it with you.—Kaufman and Hart

Unless you’ve been living on another planet, you’ve probably noticed the ever-increasing media coverage over the last few years around the “latest” disorder hoarding. Several cable programs on hoarding have garnered big ratings and endless fascination: A&E’s “Hoarders,” TLC’s “Hoarding: Buried Alive” and “Storage Wars,” Animal Planet’s “Animal Hoarders,” and OWN’s “Enough Already!” And you thought you or someone you know was the only one with this “secret.” Of course, these TV programs tend to highlight the more extreme cases of hoarding, but hoarding is either on the rise or we’re finally starting to come to terms with it. While statistics and prevalence are still sketchy, here’s what the latest research shows:

  • Hoarding affects about 6-15 million Americans.—2010, Time magazine
  • There are over 75 U.S. National Hoarding Taskforces.—2010, Time magazine
  • Personal consumption expenditures and storage unit rentals increased over 20% since 1980.—U.S. Chamber of Commerce

hoarderI became interested in studying and treating hoarding disorder several years ago when many of my counseling clients divulged their struggles with clutter and stuff—especially my clients who were compulsive shoppers or shoplifters. I also recognized several family members and friends who were “packrats” and, bit-by-bit, even found my office getting disorganized. Then, it occurred to me: my father had been a hoarder, too! And for every hoarder still “hiding” behind closed doors, more public faces of this disorder are “coming out,” including Micahaele Salahi, Heidi Montag and Spencer Pratt, Lisa Kudrow, Mariah Carey, Kevin Federline, Celine Dion, Marie Osmond and Paris Hilton (17 dogs might qualify as animal hoarding).

Looking at the bigger picture, society has encouraged super-consumerism; hoarding often is its byproduct. When everyone bought a home before the housing bubble burst, we had to fill those homes up, didn’t we? And if there wasn’t enough room in your McMansion, have we got a storage unit for you! Or two, or three or four!

But what, actually, is hoarding? Compulsive hoarding (a.k.a. pathological hoarding or disposophobia) is a hard condition to pin down. While no clear clinical definition or set of diagnostic criteria exist, certain defining features have been identified by researchers in dealing with chronic hoarders.  These criteria include:

  • The acquisition of and failure to discard a large number of possessions that appear to be useless or of limited value;
  • Living spaces sufficiently cluttered so as to preclude activities for which those spaces were designed;
  • Significant distress or impairment in function by hoarding; and
  • Reluctance or inability to return borrowed items; as boundaries blur, impulsive acquisitiveness could sometimes lead to stealing or kleptomania.

One man’s hoard is another man’s collection.—Anonymous

There are different degrees of hoarding—from a Level I to a Level V—and there are different things that people hoard, including:

  • New purchased items;
  • Used purchased items (from garage sales, flea markets, discount stores);
  • Freebies and junk (picked out of garbage, the side of the road, etc…);
  • Food;
  • Animals;
  • Newspapers, magazines, bills, other papers;
  • Scraps or parts for artistic or utilitarian projects; and
  • Intangibles (email, DVR recordings, etc…)

Hoarding can lead to many negative consequences, including:

  • Loss of money;
  • Loss of time;
  • Loss of relationships;
  • Shame and embarrassment and isolation;
  • Arguments with loved ones;
  • Germs and disease;
  • Accidents and injuries;
  • Loss of freedom and movement; and
  • Increased mental illness (especially depression, anxiety and OCD)

Beauty is Nature’s coin, must not be hoarded, must be current.—John Milton

Why Do People Hoard?

While pioneers and experts in the field of hoarding are still unlocking the puzzle of what causes hoarding, it’s believed that hoarding has both genetic and socialized components (nature and nurture). Hoarding has been related to obsessive-compulsive disorder and anxiety disorder but it is distinct in itself. Theories about what causes hoarding include:

  • Getting a high from accumulating and feel pain/anxiety when discarding;
  • Reaction to change, trauma, loss, stress—control over little things;
  • Social anxiety/phobia, isolation/protection;
  • Shaky sense of self and over-identification with objects;
  • Problems with attention/organization
  • Problems processing information/categorizing;
  • Problems making decisions;
  • Problems with memory (too much/too little); and
  • Attempts to experience safety, security, control

If you or someone you know may have a hoarding problem, take The Shulman Center 20-Question assessment below:

  1. Are some living areas in your home cluttered?
  2. Do you have trouble controlling urges to acquire things?
  3. Does the clutter in your home prevent you from using some of your living space?
  4. Do you have trouble controlling your urges to save things?
  5. Do you have trouble walking through areas of your house because of clutter?
  6. Do you have trouble throwing away or discarding things?
  7. Do you experience distress throwing away or discarding possessions?
  8. Do you feel distressed or uncomfortable when I can not acquire something you want?
  9. Does the clutter in your home interfere with your social, work or everyday functioning?
  10. Do you have strong urges to buy/acquire things for which you have no immediate use?
  11. Does the clutter in my home causes you distress?
  12. Do you have strong urges to save things you know you may never use?
  13. Do you feel upset/distressed about your acquiring habits?
  14. Do you feel unable to control the clutter in your home?
  15. Has compulsive buying resulted in financial difficulties?
  16. Do you avoid trying to discard possessions because it’s too stressful/time consuming?
  17. Do you often decide to keep things you do not need and have little space for?
  18. Does the clutter in your home prevent you from inviting people to visit?
  19. Do you often buy or acquire free things for which you have no immediate use/need?
  20. Do you often feel unable to discard possessions you would like to get rid of?

Most hoarders will answer “yes” to at least 7 of these questions.

We are hoarding potentials so great they are just about unimaginable.—Jack Schwartz

TIPS for Dealing with Hoarding… Admit you have a problem and need help:

  • Seek professional, specialized counseling/therapy;
  • Read books/watch TV programs on this subject;
  • Visit the websites www.hoardingtherapy.com and www.hoardersanonymous.org;
  • See support groups (Messies Anonymous, Clutterers Anonymous);
  • Hire a professional organizer;
  • Set a timer to clean a certain amount of time per day;
  • If you are trying to help a hoarder, don’t move or throw out their possessions;
  • Seek help categorizing things: trash, keepers, recycling, gifts, for sale; and
  • Maintain order and cleanliness through ongoing support/accountability

Case Study:

Cathy, a 50ish married mother of three started overshopping and hoarding around the time her first daughter became very ill at age 3. Her husband, Don, was an overspender, too, but eventually became a penny-pinching workaholic. He became increasingly angry and controlling and threw out some of Cathy’s things without asking her. “It’s me or the stuff!” he’d yell. Through several months of counseling, Cathy began to understand what triggered her hoarding and found the skills and support to de-clutter her home, improve her self-esteem and confidence, and confront the underlying issues in her marriage.

[youtube]https://www.youtube.com/watch?v=tqK6y8TBto0[/youtube]

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Tags: Compulsive hoardingHealthhoarderKevin FederlineMcMansionMental HealthObsessive–compulsive disorderTelevision program
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