We rarely heard people talk of hoarding a decade ago. Now this bizarre behavior has captured our attention in a major way; it’s the subject of at least three cable television shows: “Hoarders” (A&E), “Hoarding: Buried Alive” (TLC) and “Confessions: Animal Hoarding” (Animal Planet). Hoarders have appeared on the most popular talk shows, including “Oprah,” “Dr. Phil” and “The Dr. Oz Show.”
Homer and Langley, a popular 2009 book by E.L. Doctorow, was a fictionalized look at the Collyer brothers, New York City hoarders who lived in a 5th Avenue brownstone in the 1940s. The Collyers also had inspired a bestselling 1954 novel, My Brother’s Keeper, by Marcia Davenport.
So why all the buzz about hoarding?
“It’s because everyone has stuff,” says Gail Steketee, Ph.D., author of Stuff: Compulsive Hoarding and the Meaning of Things. “We all have a relationship with our stuff, and we can see ourselves in the issues of hoarders.” The social climate, too, encourages Americans to accumulate: “There’s a lot of pressure to purchase things, to own things.”
Hoarding, the compulsion to collect and save large quantities of things, takes personal ownership to the extreme. Typical symptoms include:
* Saving broken or useless items
* Excessively buying and keeping far more than one would expect to use in the near future
* Being unable to throw things away because the person might need them someday, or because they were once owned by a friend or family member
* Collecting certain items and not being able to stop acquiring them
People can hoard anything—old greeting cards, newspapers, lists, computers, even animals. The mountains of clutter and filth sometimes seem not to affect the hoarders themselves, though the condition can isolate families from their friends and relatives, causing great distress and shame. Hoarding can eventually create safety and health hazards as insects and rodents invade the stacks of paper, clothing and trash.
The current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) classifies hoarding as a diagnostic criterion for obsessive-compulsive personality disorder (OCPD) and obsessive-compulsive disorder (OCD)—meaning, when therapists see that a patient is a hoarder, they should consider a diagnosis of OCD or OCPD. It’s estimated that hoarding affects between 2 and 5 percent of adults in this country.
And anyone can be a hoarder—even children, though their hoarding happens on a small scale: they may save old scribbles or candy wrappers, filling a box under their bed or their school desk with the trash. Often their hoarding habits grow when they are old enough to leave their parents’ home and can control their own stuff without hiding it.
So, when does a person have too much stuff? When do we cross the line from collecting to hoarding?
“When our stuff seriously impairs our ability to use a room for its intended purpose,” Steketee says. “If the bed is full of clutter so no one can sleep in it. If the dining room table is covered with stuff and people no longer eat there. If it’s uncomfortable to invite people over because you live with so many piles of stuff, that’s hoarding.”
The good news is, hoarding can be treated. The treatment of choice is cognitive behavior therapy (CBT), an approach used with a number of mental illnesses that helps patients to change their thought patterns—in the case of hoarding, to change the way they think about their stuff. The person eventually overcomes his fear of making decisions and letting go of things. “There’s no more saving ‘just in case,’” Steketee says. “That’s the best outcome—the person can look at clutter for what it is, and get it out of the house with less avoidance and anxiety.” When it succeeds, CBT actually enables people to change their beliefs, opening up possibilities for its application in treating other illnesses such as eating disorders.
But there is still work to be done. “We need to understand hoarding among the elderly better,” Steketee says. “Researchers are starting to see that some of their treatment strategies might need to adapt for those patients because as we age, we lose a bit of our cognitive abilities.”
Steketee is optimistic. “Hoarding will always be a human issue,” she says. “We will develop more efficient, effective treatments, and we’ll learn to catch it early.”
CONNECT THE DOTS
The best way to cope with hoarding is to get a diagnosis from a licensed treatment provider. You can get help in locating a therapist from the International OCD Foundation. If you believe a child you know could have hoarding tendencies, the Foundation’s new website for kids and their families can help. They also provide advice on early signs of hoarding, how to help a family member who hoards, support groups and other information. For more mental health related news, check out these Healthy Outlook Blog articles: “Journaling for Health and Peace of Mind,” “Deep Brain Stimulation for Depression,” and “Transcranial Magnetic Stimulation May Offer New Hope for Severe Depression.”
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