by Kimberly Allen, RN
Do you still have those drawings and little projects your child made when he/she started school? Well, if you do don’t panic, there’s a difference between being a “packrat” and a hoarder. While both collect and hang on to things packrats and collectors have order and organization. What separates hoarding from the others is that it interferes with the persons ability to function. Many of us collect knick knacks and/or some items of our children’s childhood, however, most of us have them neatly tucked away in boxes and out of the way except for the collections that we enjoy displaying. Not only is there no order and organization in a hoarders home, they are unable to safely live in their home.
This year, hoarding becomes an official diagnosis in the DSM-V (diagnostic and statistic manual). This gives many new hope in the diagnosis and treatment of hoarding. Hoarding is more common than people think. In the US, tens of millions of people are affected by hoarding but not much has gone into discovering the underlying cause, now with it becoming an official diagnosis many experts believe that will change. In the past hoarding was felt to be a form of OCD, however experts report that the percent of hoarders affected with OCD is only 2% or less, while approximately 1% suffer from panic disorder. There have been studies that showed the area of the brain responsible for decision making and rationalization work differently in hoarders than non-hoarders. One of the things that makes hoarding such a concern is because it’s affects are long reaching. Not only does it affect every other member of the family but friends and neighbors as well.
Most hoarders don’t realize they have a problem and they don’t seek help without being pushed by someone that is trying to help them. Hoarding can become a significant health hazard and even dangerous for people entering the home. Hoarders have things stacked everywhere, from floor to ceiling with only barely visible pathways to walk through. If something were to unsettle one of those stacks and it tumbled down someone could be seriously injured. There is also a significant fire risk as well as other concerns. Eventually most hoarders will isolate themselves especially if they think someone wants them to get rid of their stuff. This can cause significant concern and stress among family members and friends.
Treating hoarding requires more than a box of garbage bags and/or a dumpster. People that hoard hve an emotional attachment to their belongings that is all consuming and throwing it away creates a feeling of significant loss. They also believe that each item has an essential value and that they will need them someday in the future. Usually it’s a family member that pressures a hoarder to get help. However, there are also cases where landlords or city ordinances have forced hoarders to seek treatment and get rid of some of their stuff.
Most experts agree that using cognitive behavioral therapy or CBT. With CBT hoarders can improve their ability to make more reasonable decisions when trying to let go of things as well as being able to make them quicker. In CBT hoarders practice throwing out things while they process the fierce emotions that are triggered by them. Because most hoarders have significant difficulty with change many experts also focus on “harm reduction” especially in the beginning of treatment. In hoarding harm reduction works under the assumption that the behavior will continue. However, the therapist works with the hoarder to become organized and more sanitary. The main objective is to reduce vermin, bacteria, and fire hazards as well as other threats to the health and safety of the hoarder and their family.
Helping a hoarder to learn to let go of even the smallest, what we would consider trivial, thing can be a long and time consuming process. Experts say that teaming a professional organizer with a mental health professional can be very beneficial.