What is Compulsive Hoarding?
Hoarding is the compulsive acquisition or saving of items that are perceived by the individual to have some intrinsic value or importance. Hoarding can be a symptom associated either another disorder such as OCD or can occur all by itself. Individuals who hoard may experience obsessions, cognitive distortions, and or compulsions about their possessions.
Common hoarding obsessions and cognitive distortions include:
- Thoughts about the importance and/or necessity of objects
- Fear of running out of objects
- Fear of discarding an object and then needing it
- Fear of losing control of saved objects
- Fear of missing a sale
- Fear of discarding items with emotional value
- Fear of losing sight of an item
- Fear of being irresponsible
- Fear of making a mistake regarding a choice of discarding or savings an item
Common hoarding compulsions include:
- Inspecting possessions
- Purchasing more items
- Counting items
- Checking garbage (own and others) for objects
- Looking through circulars for sales
- Maintaining clutter
- Making piles/clutter visible
- Making "discard piles" without actually discarding
- Calling others to check on items
Individuals who hoard also experience functional impairment and/or subjective distress either directly or indirectly because of their hoarding. This might include limited functional space at home, becoming isolated due to feelings of shame about others seeing the disorganization and clutter in their home, family and marital discord, and physical, health, or safety concerns due to the clutter. Many individuals who hoard also demonstrate marked impairment in organizational skills such as difficulty categorizing and organizing objects in a meaningful fashion, poor decision making skills, and extreme anxiety at attempts to organize or to decide to "save or discard".
How is compulsive hoarding treated?
There is a cognitive behavioral treatment specifically designed to treat hoarding. The goal of the treatment is to clean up and organize the clutter and improve decision making and organizational skills, thereby allowing patients to once again use their space functionally and improve their quality of life.
Treatment sessions for hoarding begin with education about the problem and the treatment. Then the patient and the therapist establish goals together and the patient is taught basic organizational and decluttering rules. Cognitive therapy is used to challenge those beliefs that support the hoarding and help the patient prepare themselves for the decluttering phase of treatment. With the therapist's support, and at a pace that is comfortable for the patient, the patient begins to sort through their possessions and clean their home. Only a small area is worked on at a time and the patient makes all decisions (with the therapist's assistance) about what to keep, throw out or donate. As cleaning progresses, before and after pictures are taken as positive reinforcement, so that the patient can see their accomplishments as they progress. Once an area is cleared, treatment will focus on maintenance and relapse prevention so that the patient can maintain their treatment gains.
Hoarding Links
To purchase a video tape of a lecture given by Dr. Rabinowitz about Hoarding, visit www.njocf.org/VideoTapes.htm (all proceeds go to the NJ Obsessive-Compulsive Foundation chapter). To read a review of the talk, visit www.njocf.org/Documents/june04.pdf
Understanding Obsessive Compulsive Hoarding Site
Obsessive Compulsion Foundation Hoarding Site
"Overcoming Compulsive Hoarding: Why You Save & How You Can Stop" by: Fugen Neziroglu, Ph.D., Jerome Bubrick, Ph.D.& Jose Yaryura-Tobias, M.D. - Hoarding Self Help Book
