Compulsive hoarding: when collection becomes an addiction

Resource post for June:  Compulsive Hoarding Syndrome

Are you a collector? Do you feel reluctant to throw away anything? Do you always get the feeling you will need something later? Are you an enthusiast who collects coins, stamps, or baseball cards? It is normal to keep things that we identify ourselves with – photos, letters, etc. It is also normal to collect things we are passionate about. But when collection becomes addictive, even compulsive and turns into hoarding, then we are talking about a serious problem.

What is compulsive hoarding?

Compulsive hoarding syndrome is defined as (source: Obsessive Compulsive Foundation) the acquisition of, and inability to discard worthless items even though they appear (to others) to have no value. Aside from hoarding, other symptoms are associated with this disorder are indecisiveness, procrastination, and avoidance.

What is the difference between simple collection and compulsive hoarding?

Dr. Randy Frost and his colleagues give the following criteria to distinguish compulsive hoarding from normal collecting behavior:

• The acquisition of, and failure to discard, possessions that appear to be useless or of limited value.
• Living spaces sufficiently cluttered so as to preclude activities for which those spaces were originally designed.
• Significant distress or impairment in functioning is caused by the hoarding.

What are the risks and dangers of hoarding?

Compulsive hoarding comes with risks and dangers that are not only confined to the ones afflicted. Hoarders have a strong influence on their immediate environment and this is wheere the risks and dangers come in.

Safety. When a place is cluttered with so many things, it can have some safety issues. For example, objects on the floor can be falling or tripping hazards. Others (e.g. paper, cardboard, etc.) can become fire hazards. Piles can literarily fall over and cause serious injury. Escape routes in case of fire and other emergencies may be blocked or inacessible.

Sanitation. When a place is cluttered or overfull, it is not easy to clean it thoroughly. It can become a nesting place for pests  and other types of vermine. Rats, cockroaches, and snakes are just a few examples of animals that you may find in a

Mental health. It was only recently that compulsive hoarding has been identified as a mental disorder. According to Dr. James Abelson, a psychiatrist the University of Michigan Health System

“Hoarders succumb to forces within their brains such that the overflowing garbage in their homes isn’t seen or isn’t experienced as distressing. Whatever they see in terms of clutter doesn’t seem to matter to them. What matters is the fact that these things have importance to them and the loss of these things would trigger distress.”

Family tensions. It is estimated that up to 1.5 million Americans may suffer from this condition. Like other addictions and disorders, family members who are not afflicted are still badly affected by the problem.

How does compulsive hoarding affect family life?

The home environment of a hoarder is cluttered, chaotic, and  well – overfull. It is no wonder that this kind of disorder, which some might consider harmless, can lead to serious tensions within the family. In the home environment, functional living space such as the kitchen, living room, etc. ends up unusable. This affects the family’s eating habits and physical acitvity. This leads to health problems and family stress.  There are anecdotes of children, for example, running away from home to avoid the chaos and clutter. Marriages easily end up broken.

Is there a treatment for hoarding?

In many cases, hoarding as treated just like other obsessive compulsive disorders through pharmacotherapy (e.g. drugs) and cognitive-behavioral therapy.

Behavioral therapy. In the latter, group behavioral treatments seem to be especially effective and includes hands-on exercises of sorting and discarding. In addition, patients are also trained to resist acquiring new items, thus avoiding a vicious circle of clutter coming in as fast as it is going out.

Alternative behavior. Behavioral therapy also includes giving patienst “homework” Simple tasks such as cooking, clearing the kitchen and emptying the rubbish bin, also help patients get used to the act of discarding and give structure to their daily routine. In addition, alternative activities such as physical exercise or engagement in hobbies that do not involve hoarding (e.g. gardening, dancing, etc.).

According to Dr. Abelson

“There are no simple drugs that have an impact on it. Therapy is helpful but challenging because it requires the person who needs treatment to be highly motivated…We basically set up a program of practice so that they can become desensitized to reduce the amount of pain they experience when they let go of objects. If we make sufficient progress with that, we can help them ultimately clean out their homes, but it’s a very challenging process.”

The key to the treatment of compulsive hoarding, however, is the willingness of the patient to cooperate.

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