It is estimated that 1 to 2 million people in North America are living in so much clutter that they can barely walk through their homes, or find a place to sit or a surface to rest a plate. Although it is not classified as a separate disorder in the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), compulsive hoarding is a debilitating condition that can destroy relationships and tear families apart. Statistics show that 15-30% of individuals diagnosed with obsessive-compulsive disorder (OCD) also exhibit hoarding tendencies. Recently, studies have also shown that individuals who have both OCD and exhibit hoarding symptoms were more likely to have experienced at least one traumatic life event in comparison to those with OCD alone, suggesting that the act of compulsive shopping and the obsessive need to collect and keep material objects may serve as a coping mechanism for grief, loss or posttraumatic stress.
Jessica Grisham of the University of New South Wales has found that the link between hoarding behaviour and traumatic events, such as losing a spouse or child is especially important to consider in individuals exhibiting a late onset of hoarding symptoms, especially if those symptoms first appeared at the time of the event or shortly thereafter. Accumulating “stuff” fills the emotional hole left by the trauma and allows individuals to avoid dealing with the pain. Later removal of these items can trigger high levels of anxiety, especially if someone else gets rid of these items without the hoarder’s permission. When discussing their behaviours, many hoarders describe the “rush” they experience when purchasing new items, especially if the item is free or on sale, and they go to great lengths to justify purchases when questioned by friends or family members.
Hoarding often results in unhealthy attachments and an inability to form meaningful relationships with others. The attachment that hoarders assign to their possessions often takes on greater value than the attachment assigned to people. When given an ultimatum, hoarders will often choose possessions over friends and family. Some hoarders describe the intense emotion experienced when throwing out possessions as comparable to the emotion experienced when a loved one is lost. Jamie Feusner at UCLA’s School of Medicine has stated that most hoarders are single, either because their behaviour has driven away those around them or has prevented them from forming meaningful relationships.
Treating a hoarding problem is far more complicated than simply cleaning the individual’s house and throwing the offending possessions away. If the underlying issue is not properly treated, the hoarder will simply begin accumulating new possessions and quickly refilling the cleared space. In cases where the hoarding behaviour is linked to a traumatic event, therapies such as cognitive-behaviour therapy (CBT) can be quite effective. CBT teaches the person to cope with emotions related to the triggering traumatic event and to manage the grief in a healthy and functional way. It can also be helpful to have hoarders practice going to stores and resisting the need to purchase triggering items while being supervised by a mental health professional who can provide coaching and support.
Television and other popular media have brought hoarding into view, hopefully sparking further research into the underlying causes of the behaviour. Hoarding literally creates a mess so visible to others, that the disorder is extremely difficult, if not impossible, to disguise. Such disarray leads to very serious health and safety hazards, causing hoarding to carry a great deal of stigma. Without proper education, it is easy for people to assume that hoarders are merely “dirty” or “lazy.” In fact, these individuals may be suffering from trauma-related psychological pain and may require treatment by a mental health professional. Fortunately, there are a growing number of practitioners who now specialize in treating the condition and helping to reduce its stigma. Common signs of hoarding include acquiring more than can be used, keeping useless items such as newspapers, old containers, and trash; and then restricting others from using, touching or borrowing those items. Symptoms may be paired with procrastination, a lack of organization, and poor decision making that may result in the impairment of typical functioning, for example, frequent absence from work.
It is important to recognize that the individual will need to be approached with empathy and understanding. Hoarding is a serious, complex disorder, one that takes time and the assistance of professionals to be treated. If you or someone you know needs help with this, you can visit complusivehoarding.org for more information.
–Contributing Writer: Crystal Slanzi, The Trauma & Mental Health Report; Chief Editor: Robert T. Muller, The Trauma & Mental Health Report
This also appears on "The Trauma & Mental Health Report."