Help for Hoarding Behavior

Dr. Purushothaman
October 7, 2013

Hoarding, which is considered a mental illness, expresses itself with an obsessive inability to discard anything, and the uncontrolled acquisition and retention of unnecessary items. It is not unusual that the hoarder becomes displaced from parts or all of his or her living space by virtue of the sheer amount of accumulated junk.

Hoarding is more than having clutter around. It’s more than simple messiness, or an inclination to collect, or to save. Hoarding is manifested by an irrational but compelling attachment to all items within one’s possession and a corresponding inability to discard any of them for fear that such action will put the hoarder in jeopardy. Unfortunately, it can often also result in unsanitary and even diseased or infested living environments which can easily become nuisances and even dangerous to the point of being life-threatening.

Dr. David Tolin, Director of the Anxiety Disorders Center at the Institute of Living at Hartford Hospital, says that the reason why some people hoard is linked to their ideas about perfection and about how impossible it is to achieve. Accordingly, when faced with a task like cleaning out a closet, some hoarders will avoid it, concluding that “if they can’t do it right, they won’t do it at all.” Here, in this thinking, we can see how the possibility of a failure to achieve perfection is so threatening that it contributes to hoarding behavior, since the fear of making a mistake is so great that paralysis sets in, allowing clutter to accumulate.

But there are also a number of additional reasons why people hoard. For many, it’s linked to fear—presumably fear that they will accidentally throw away something they might need later. "People with hoarding problems will often think of ways they can use something, or they think of people who might want a particular object, so they keep it," Dr. Tolin says. "The irony, however, is that in most cases, the hoarding individual never uses the object in the way he or she thought they would. And, they also rarely give the object away.” Accordingly, while hoarding behavior is linked to fear, the fear appears to be something other than the literal fear of not having the object anymore. The fear appears to be linked to the unbearable consequences of being ‘without’ or of ‘not having’ something. This feeling or emotional state—emptiness—is so frightening that nothing can be thrown away for fear of bringing on that emptiness.

Hoarding has further been explained by describing a sense of emotional attachment to the objects of clutter. "All of us get attached to things some of the time," Dr. Tolin explains. "We have things that remind us of people we love, or of happy times. But for people with hoarding problems, the attachment to objects becomes very intense—sometimes more intense than the attachment to actual people. And instead of feeling attached to one thing, like a scrapbook or a favorite sweater, the hoarding individual becomes attached to hundreds, even thousands, of things. Some people have told me that all of the things in their homes feel like their friends or family members, so they can't bear to throw them out.”

Psychotherapy and in-home counseling are effective ways to treat hoarding issues since treatment can help to fill in the emptiness and loss that is the feared consequence of resolving the hoarding. Dr. Tolin also suggests that you can try to do the following:

1. Question your motives: Ask yourself why you are saving something and use the one-year rule: If you haven’t used it in a year, get rid of it.

2. More is not necessarily better, so don’t duplicate things unnecessarily, like toaster ovens, refrigerators, etc.

3. Categorize items into piles of what to keep, what can be donated and what to give away. Keep the piles down to a minimum.

4. Don't over think it. "If you have to go through a long and complicated decision-making process for each and every item before you get rid of it, you'll never get free of the clutter," Dr. Tolin says. "Most decisions are not that complicated. If you find that the decision takes you more than a couple of minutes for a particular object, you are probably making it too complicated."

5. Mistakes are normal. "You don't have to do a perfect job," Dr. Tolin says. "Just a good enough job."

6. Follow the "OHIO" rule: Only handle it once.

7. Be brave. Beating compulsive hoarding requires you to face things that are very scary," Dr. Tolin says. "I can't tell you not to be scared, because you can't really control that. But you can be brave. Be willing to face your fears. Be willing to risk making the wrong decision. The people who gain the most are usually the people who are willing to risk the most."

8. Understand what you're afraid of, and recognize when your fears are irrational.
"Ask yourself: What's the worst that can happen if I throw this out? And how bad would that really be? If you're not sure whether your fear is irrational, try an experiment. Try making a specific prediction about what will happen if you discard an object. Then discard it, and really look to see whether that bad thing happened."

9. Be patient. “No one is going to overcome compulsive hoarding overnight. This is a time-consuming process," Dr. Tolin says. "So people with hoarding problems, and their friends and family members too, need to focus on small victories. If you cleaned a room out, congratulate yourself, rather than get down on yourself for the rooms you haven't cleaned yet."

10. Stay current with yourself and your stuff: Clean things as they come along, before they become overwhelming problems. "Once you've started, don't stop, even for a day," Dr. Tolin says. "If all you can do is five minutes a day, fine. But do it."

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