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Compulsive Hoarding Syndrome

Compulsive Hoarding Syndrome is often associated with obsessive compulsive disorder (OCD). It is a complex disorder, however – many hoarders suffer from other comorbid problems such as chronic depression, attention deficit/hyperactivity disorder (ADD/ADHD), dementia, generalized anxiety disorder (GAD), social phobia, or schizophrenia/paranoia.¹‚ ²

Hoarding is neither simple, nor benign. As we talked about in an earlier installment, “Hoarding: Time to clean out the house,” hoarding can kill.

Ole Bert’s place down the road, six old tractors, a few car carcasses, a refrigerator, rusty stove, lamp skeletons, disemboweled sofas and chairs, a bathtub, heaps of parts for whatever a body could ever want, a few dogs, feral cats around the house and throughout the yard of knee-high grasses and weeds. The shades always drawn. The porch falling off. No one knew what the inside looked like. Bert wasn’t one to socialize at home. No one called it hoarding. When yards were measured in acres, it was just ole Bert’s place.

Not many people live on acres of land now. In the metro Washington DC area as around the country, they’re closer, share walls, small yards abut. Ole Bert isn’t the eccentric living out on the edge of town. He’s next store, and the odors and vermin from his place are invading his neighbors’ homes. Slowly we’re realizing that Ole Bert isn’t just cluttered, isn’t just a collector, doesn’t just have excessive accumulations, isn’t just chronically disorganized, isn’t just a pack rat – he has a serious problem. And ole Bert is our parents, sister or brother, spouse, child, neighbor…ourselves.

Regardless of the causes, individuals with hoarding disorder share four fundamentals:

  1. Difficulty processing information;
  2. Problems in forming emotional attachments;
  3. Behavioral avoidance; and
  4. Erroneous beliefs about the nature and value of possessions.

    Unsanitary, unusable kitchen.

Compulsive Hoarding Syndrome severely limits the use of living spaces and poses safety and/or health risks. Equally important, it interferes with work, social, and everyday functioning.  Often, hoarders cannot cook in the kitchen, wash the dishes, sit in a chair, sleep in their beds, bathe in their bathrooms, launder their clothes – because every surface is buried in clutter. Utilities – plumbing, electricity, heat, air conditioning – usually don’t function well, or at all. Rodent and/or insect infestation is common. Frequently, hoarders have rented storage spaces – nothing more can be shoved into the home.

Hoarders don’t have friends or family in. They’ll meet at a restaurant, a coffee shop, someone else’s home. Or they don’t go out socially. If they work, they go in early, stay late, pick up take-out on the way home. Or they don’t go out at all. They stay secluded inside, behind darkened windows and locked doors.

Hoarding Disorder – What’s Going On?

Although some cases are less severe than others, hoarders are reluctant – often unable – to acknowledge the problem, much less fix it. While they may acknowledge that their collections have gotten out of control, they seem to be powerless to whittle them down or stop collecting. They have no problem, others do. They will tidy it up tonight, tomorrow, or next week, but tomorrow never comes.

While hoarders can be charming, intelligent, educated, personally well-groomed and employed, in their homes they’re unable to get rid of anything. They may need it, it was on sale, it can be fixed and used…. Saving money, recycling, reusing is good – until you have hundreds of 48-roll packages of toilet paper, thousands of canned goods dating back twenty years, mounds of boxes from catalogue orders that haven’t been opened, walls of stacked newspapers, fast food containers and junk mail, and keep on saving, scavenging, compulsively shopping. Yard sales, alley finds and dumpsters can become irresistible, with lots of good (hey, with a little work, it could be good) stuff, for nothing, practically! Napkins, condiment packets from restaurants – no one will care if you take a few…they’re free…you can never have enough!

When someone tries to touch their things – to sort, organize, throw out useless, dirty, dangerous things – the individual will use every “weapon” to make them stop. Stealing is a common charge. The individual will scream, curse, weep, withdraw, become ill, throw things, urinate, defecate, manipulate, bribe, hide, not be at home, refuse to answer the door or phone…run guilt trips that Shakespeare would envy for variety and creativity.

Researchers know the behavior generally begins in childhood or adolescence and that it tends to run in families. Hoarders are likely to be unmarried or divorced, frequently isolated and without family. They may have difficulty meeting and interacting with others, so they surround themselves with things. Later, they experience shame at others seeing the mess they live in, so don’t go out or invite others in.

If family members are not close by, the problem can go unnoticed for years. Yet for the family, dealing with hoarding is tough. Children of hoarders are especially torn – they can feel like the red meat in a dog fight, between what the folks say and coming to the realization that the folks are in real trouble, and they – the folks and the children – need help. If you are a caregiver grappling with this issue, please read our earlier post Caring for the Caregiver.

1 Frost, R.O.,  Department of Psychology, Smith College, Northampton, MA

²Steketee, G., PhD, School of Social Work, Boston University, Boston, MA

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