“The price of anything is the amount of life you exchange for it.” -Henry David Thoreau
Many of us hold onto things that we don’t need. Even the most organized person might have a drawer full of expiring coupons, another full of little shampoo bottles from hotels, a basement full of souvenirs from childhood or notes from university.
Keeping items like these may be based on not wanting to waste, thinking of future use or for sentimental reasons. Yet, if these piles grow and start to overtake your home and you are can’t get rid of them, you may be hoarding.
Compulsive hoarding is a pattern of behavior that is characterized by the excessive acquisition of and an inability or unwillingness to discard large amounts of objects that cover the living areas of the home and cause significant distress or impairment.
The recently revised Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-V) has distinguished hoarding a category separate from Obsessive Compulsive Disorder (OCD) because people who hoard have treatment needs that are different from typical OCD treatments.
According to the DSM-V, approximately two to five per cent of the population has a hoarding disorder. It may start during childhood or in teen years but doesn’t usually become severe until adulthood.
While hoarders may find comfort in their piles of things, hoarding can be detrimental to health and safety and cause distress in relationships. Family members who live in homes full of stuff can be affected and others, such as landlords, can also be negatively impacted. Hoarders can become more attached to their stuff than to the people around them.
One investigation found that in the homes of hoarders 45 per cent could not use their refrigerators, 42 per cent couldn’t use their kitchen sink or bathtub, 20 per cent could not use their bathroom sink and 10 per cent couldn’t use their toilet.
James hated going home after work. He tried to avoid being in the same room as his mother because it made him feel sick to be around her.
James couldn’t afford his own place yet, but was desperate to move out as soon as he had enough money.
James’ mother was a hoarder. Every room in the house was filled with stuff – James called it junk – and even the corners had junk piled up to the ceiling. It had been this way all his life growing up in that house where he was too embarrassed to ask friends over after school, so James just kept to himself most of the time.
James’ mother never cooked since the kitchen was too crowded and the counters were piled up with stuff that didn’t belong in a kitchen at all. They usually ate take-out or had pizza delivered. Sometimes he lost his appetite as soon as he got home and didn’t eat at all.
James’ mother and father didn’t’ have lives either. James and his father usually watched TV together during the evenings since there was no room for another person to sit down because of all the clutter. James and his father felt hopeless that things would ever change.
The last time they had cleared out all the junk when James’ mother was out of town visiting her sister. But within 3 months, James’ mother had gone shopping, visited flea markets and garage sales, and the rooms were soon piled up with clutter all over again.
The reasons why people hoard are varied. Hoarding often runs in families and frequently accompanies other mental health disorders like OCD, depression, social anxiety or bipolar disorder.
Hoarding is often about fear and perfection. Many hoarders are terrified that they will make the wrong decision about what to keep or throw out, so to avoid regret they will keep everything. The anxiety that comes with throwing things out can be paralysing.
In some cases hoarding can be in response to a traumatic event such as losing a spouse or child, found Dr. Jessica Grisham of the University of New South Whales. This is especially relevant if symptoms of hoarding appeared around the time of the event. This behaviour then becomes more about filling an emotional void with lots of stuff.
While parting with junk is a very emotional, anxious-ridden process for hoarders, there is treatment available. However, it is not as simple as getting rid of all their stuff because they could easily revert to old patterns.
Cognitive Behavioural Therapy has been found to work, although more so for middle aged hoarders than older ones. It can teach the person to deal with their emotions, understand why they do what they do and teach them how to deal with their emotions in a healthier way. This therapy has to be focused for the person’s specific needs and tends to use techniques of exposure and response prevention.
Medication can also be effective in dealing with hoarding, usually SSRIs in combination with Cognitive Behavioural Therapy.
If you or someone you know is hoarding, the first step is to see a psychologist.
If you are interested in learning more, The New York Times recently produced a short video about a hoarder being evicted from his house.
 Frost, R., & Hartl, T. (1996). A cognitive-behavioral model of compulsive hoarding. Behavior Research and Therapy, 34
 Ayers, Catherine R. “Types of Hoarding,” http://www.ocfoundation.org/hoarding/types.aspx
Patients in this story are a fictional composite of people who have sought help for this issue. Any resemblance to real persons, living or dead is purely coincidental.
Dr. Eva Fisher is an Ottawa psychologist who has been providing psychotherapy for a variety of issues for over 20 years. Follow her on Twitter @drevafisher, Facebook or Instagram @dr_evafisher. Blog writing assisted by freelance journalist Alyssa McMurtry.
Written by Dr. Eva Fisher C Psych
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