Hoarding Q & A

Written by Michelle Silverman

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Q: What is hoarding?
A: Hoarding, also known as "compulsive hoarding," is a psychiatric illness characterized by excessive collection of objects and an inability to relinquish these possessions. The result is disorganization and clutter that causes significant distress or interference in daily activities, and in many cases, poses a serious health or safety risk. A person who engages in hoarding usually has at least one designated space (e.g. room, house, storage space, office, car, etc.) filled with so much clutter that it is completely unlivable.  
 
Q: How do you know when hoarding has become a problem?
A: There are several warning signs that indicate hoarding:
  • Impulsively purchasing or collecting items in excess
  • Struggling to dispose of items and becoming upset when others try to do so.
  • Interference with daily activities (e.g. going to school/work, socializing, etc.)
  • Difficulty maneuvering or finding things amidst the clutter
  • Unsafe or unhygienic conditions (e.g. fire hazards, rotten food, vermin, etc.) that may result in eviction or intervention from social services
  • Embarrassment and/or refusal to allow visitors into the house.
 
Q: Someone I care about suffers from hoarding. How can I help?
A: There are tons of resources out there for sufferers of hoarding and their family members. Check out the links below or call our clinic at (617) 726-6766 for more information. 
 
Remember that unless there is a safety issue, you can not force someone to de-clutter his/her home; the person needs to be willing to take action and get help. The best thing to do is offer your support and provide resources for professional help. 
 
Q: Why do people hoard?
A: Whereas most people are capable of throwing out, donating, selling, or recycling things they no longer want, those who hoard struggle with all forms of disposal. The most common reasons for hoarding are: difficulty with organization, desire to prevent waste, fear that the object will be needed at a later point, a strong emotional attachment to and feeling of responsibility toward the items, positive emotions associated with acquiring new items, and anxiety, anger or guilt associated with disposing of the items. 
 
Q: What kinds of things do people hoard?
A: Individuals can hoard anything including food, receipts, and mail. The most commonly hoarded items, however, are clothes, newspapers, and books. Despite its recent attention in the media and on television, animal hoarding is actually quite rare. 
 
Q: What causes hoarding?
A: There are a number of factors thought to contribute to hoarding behaviors, including:
  • maladaptive patters in thinking (e.g. forming firm beliefs about not wasting objects or needing them later)
  • impulsive behaviors (e.g. impulsive purchasing/collection of items)
  • emotional attachment issues (e.g. giving objects human-like qualities leading to difficulty parting with those objects)
  • neurological impairments (e.g. difficulty with information processing, memory, categorization, and decision-making) resulting from abnormalities in key brain structures. 
Q: How is hoarding treated?
A: It is important to understand that hoarding is a mental illness and can not be effectively treated by forcing someone to get rid of their stuff or removing it without their consent. Successful treatment requires the individual to be motivated to change and willing to accept outside help. An effective treatment team involves professional help (a behavioral therapist, hoarding coach, etc) along with sympathy, patience, and support from family and friends.
 
Cognitive and/or behavioral therapy is currently the treatment of choice for individuals who hoard. The highlights of cognitive behavioral therapy (CBT) are described below:
  • Practicing disposing of the hoarded items first with the help of a trained professional and then independently.
  • Teaching the individual to question, challenge and eventually modify their thought patterns (e.g. challenging the notion that items need to be kept on hand or considering the negative consequences of hoarding on marriage or friendships)
  • With the help of a clinician, learning how to go out without purchasing unnecessary items.
  • Accepting that relapse might happen and creating a plan to prevent future clutter.
There are also support groups available for both sufferers of hoarding, as well as their friends and family. Check out our resources list below to find a support group near you. 
 
Q: How are hoarding and OCD related?
A: Currently, hoarding is considered a sub-type of OCD. This is because many people suffer from both disorders and the hoarding is often considering the compulsive behavior or ritual associated with the OCD (the "C" in OCD).  
There are many people who suffer from hoarding who do not have OCD, just as there are many people with OCD who do not hoard. Furthermore, the typical treatments for OCD do not always work for hoarding. As a result, hoarding will soon gain its own unique diagnosis. 
 
If you suspect that you or someone you know may be suffering from hoarding, we strongly encourage you to call our clinic at (617) 726-6766 or e-mail ocdclinic@partners.org
 
For further information on hoarding:
 
Reference:
 
 
©2011 Massachusetts General Hospital OCD and Related Disorders Program | Reprint only with permission