What is hoarding?
Hoarding has been recognised as a distinct mental health issue on its own and the following are its main symptoms, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):
- Persistent difficulty with discarding objects or possessions, regardless of their actual value.
- The difficulty is due to a perceived need to save the possessions and they will feel stressed when discarding.
- Accumulation of clutter that congests living areas and compromises the functioning of the living area.
- Presence of clinically significant psychological, emotional distress, impairment to social or work functioning (or any other area).
Items that are often hoarded include clothes, books, newspapers, bills and receipts, containers, household supplies, animals or electronic data and emails.
What’s the difference between hoarding and collecting?
The main difference concerns how the objects are stored: collectors, in fact, are very organised and their objects are very well-ordered. They are able to discard by trading to improve their collection and they have low levels of emotional distress.
People who suffer from hoarding, unlike the collectors, don’t share their interest with others and feel ashamed and humiliated by the chaotic display of the items.
How hoarding can effect people’s lives?
Hoarding affects people’s lives physically, socially and psychologically. People with severe hoarding difficulties are likely to be at risk of neglecting their own physical health care – hygienic standards are very poor, access to the sink or the bathroom may be obstructed and there can be insects or even rats in the house. Not to mention the risk of trips, falls, house fires and gas leaks due to unstable piles of belongings and lack of maintenance of gas/electric services.
This can also have an impact on their social and family life. People with hoarding difficulties tend to be reluctant or unable to have visitors, which can cause isolation and loneliness. If they do have a family, it’s actually shattered and the quality of life is very poor. Family members report high level of stress and children of someone who hoards can be severely compromised.
Hoarding can also have elevated financial costs since people may be unable to maintain attendance at work, and at the same time they may spend a lot of money to hoard items.
How to treat hoarding?
Individual therapy can help improving the quality of life of people who have hoarding difficulties. The first contact is usually made by the family, exasperated by the hoarding behavior; relatives and partners may also benefit from meeting a therapist themselves because of the passive hoarding they were forced to deal with and because they have high level of suffering.
Those who hoard also experience a great deal of suffering and this is something that needs to be understood by the therapist, who should remain non-judgmental and create a solid working alliance.
The key to help people who hoard is understanding what makes it difficult to throw things away and the reasons why the clutter has built up. Therapists can explore what kind of wall is the person building. Why? For whom? Why does the person need such boundaries or protections? What does the wall represent? What is the person try to communicate, is it a cry for help?