April 05, 2020
What is Hoarding?
Until 2013, hoarding was characterized under the diagnosis of Obsessive-Compulsive Disorder. In the new Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-5, the pattern of hoarding is now its own diagnosis, called Hoarding Disorder.
A person with Hoarding Disorder has difficulty getting rid of possessions, and experiences significant distress when forced to do so. This often leads to excessive storage of items in their home, which then leads to clutter and disorganization that interferes with normal living. In extreme cases, home appliances might be covered and unable to be used or sanitation and safety of the home might be compromised.
- Hoarding behaviors can start in childhood, with children trying to obtain and keep various items. Typically, parents or guardians interfere with this behavior to help keep homes tidy. However, these behaviors typically worsen with each decade of life if they are not dealt with.
- Most people who hoard have a pattern of indecisiveness.
- Traumatic and stressful events might contribute to hoarding behaviors.
- Items collected can range from newspapers, free pamphlets, clothes, or books to sentimental items or garbage. Some people hoard animals, and can have dozens to hundreds of animals in their home for which they are unable to provide proper care.
- People who hoard normally do so because they find significance in the items. They might:
- think an item will be helpful in the future
- have a strong emotional attachment to an item
- not want to waste anything
- feel safe when surrounded by their possessions.
- Hoarding is distinguished from collecting or having messy storage areas by noting that people who hoard:
- obtain many different types of items
- do not plan to acquire an item, yet end up holding on to any free or purchased item they get
- live in homes where items are disorganized and take over normal living areas, interfering with daily tasks such as cooking, bathing, and storing food.
- experience distress when asked to get rid of an item, and their hoarding behaviors are often a source of conflict in their relationships with others including family, friends, and landlords/neighbors
- have homes that can be dangerous, presenting an increased risk of fire, falling, and being buried by items. These homes can also be unsanitary, possibly putting neighbors and visitors at risk.
How to Help a Person Who Hoards
Getting help for someone who hoards can be difficult. Most people do not seek treatment for hoarding, but for other issues, such as Anxiety and Depression, that are bothering them. While it might seem like cleaning out the home for this person would be a quick fix, it will not stop the hoarding behaviors. It might actually increase their tendency to hoard, and put them further from a healthy living environment and lifestyle.
Instead, begin by educating yourself about hoarding, and ask yourself how hoarding is benefiting the person. It can be helpful to speak with a mental health professional to come up with a plan of how to engage your loved one who hoards, into treatment. There are tools available, like the Clutter Image Rating Scale, that can help with this process. This tool can help them identify what their home looks like. And evaluate if their perspective is accurate. As with any mental health condition, true change will only be accomplished if the person has an internal desire to learn, understand, and try.
Participating in counseling – also called psychotherapy, therapy, or talk therapy – is one of the primary methods of treating Hoarding Disorder. Counseling might include:
- Motivational Interviewing – This method helps to increase a person’s desire to change by looking at values, motivation, and small steps to achieve change.
- Cognitive Behavioral Therapy – This form of therapy helps people identify how their thoughts influence their behaviors, and how to effectively challenge and change the problematic thoughts and behaviors.
- Psychoeducation and skills training – Taking this approach includes educating people who hoard about Hoarding Disorder, and helps them to gain skills to understand and prevent problematic behaviors.
- Structured Cleaning – Strategically cleaning out the home can be part of treatment. This should be done at specific times, with support offered to the individual to prevent relapse and increase of behaviors.
- Medication – While there is no medication specifically for the treatment of Hoarding Disorder, some psychiatrists recommend different medications to help treat Anxiety and Depression that often occur along with it.
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Hoarding: How to help a hoarder, how to get help