Possessions can bring joy and ease to a person’s life, but for some people they can become a nightmare and can make a normal life very difficult.

Definition of Hoarding

1. The acquisition of, and failure to discard a large number of objects that are useless or of limited value;
2. Living spaces sufficiently cluttered so as to preclude activities for which those spaces were designed;
3. Significant distress or impairment in functioning caused by this behavior

(Frost & Hertl, 1996).

Hoarding has until recently been considered a subset of Obsessive Compulsive Disorder (OCD). More recently, hoarding has been seen as not usually a subset of OCD.

Frost and Steketee are researchers and clinicians who have treated many hoarders over the years. They have noted that hoarders are usually very perfectionistic and this characteristic makes decision-making difficult. Problems with making decisions leads to the problems with organizing items or discarding them. Additionally, there are often problems with categorizing and organizing due to difficulties in determining the relative importance of objects. When categorizing, hoarders often have too many and too complicated categories. When going through piles of stuff, hoarders “churn”; that is, they pick up something, put it back into the pile, and go pick it up later, and then again and again. This churning is obviously discouraging.

Hoarders also lack confidence in their memory and generally want to keep things visible because they think they will forget where something is. Of course, this leads to piles and to not being able to function effectively.

Renae Reinardy, Psy.D. has talked about the excessive emotional attachment of hoarders. They often see possessions as extensions of themselves. They may have a grief reaction when letting go of something or when not acquiring something. They may think that everything they have has a purpose or it would not have been saved, even if it has long ago become worthless. 

Treatment of Hoarding

There is no medication which is effective for hoarding. If the hoarder is depressed or has Attention Deficit Disorder with Hyperactivity (ADHD) or another disorder, medication may be helpful for those disorders and the person then might be better able to handle the hard work of treatment for hoarding. 

Treatment is not fast and a professional organizer might be helpful as an adjunct to treatment. However, if all of the work at home is done by an organizer, the hoarder has not learned what needs to be learned and the stuff will quickly return and “take over” again. The hoarder needs to be praised for progress, even if it seems minimal. This is hard work!

The hoarder needs to be ready for a change in what is acquired and how things are kept, and this takes a lot of motivation. When I work with hoarders, I work on :

• Building motivation,
• Identifying dysfunctional thoughts specific to hoarding
• Disputing these thoughts and replacing them       with thoughts that are more functional
• Selecting small target areas which are very visible
• Assessing types of possessions in the target area
• Determining what actions are needed to get the area returned to the use for which it is intended
• Making plans to use the cleared space (for example, eating at the kitchen table)
• Making plans on how to prevent clutter from returning to the space
• Planning for regular maintenance

Some clinicians have found that groups for hoarders build motivation and can be fun as well as effective. Feel free to call me to schedule an intake for a hoarding group. These groups are 8 sessions of 2 hrs each. 

Therapy Group for Hoarding/Cluttering

• Before & after photos
• Homework assignments
• Compulsive buying targeted
• Awareness of impact on quality of life
• Enhanced motivation & support
• Referrals to organizers if needed