Monday, February 04, 2008

Help for Hoarders

There has been an increase in awareness among professional communities and the public that Compulsive Hoarding is a more common problem then once thought. A frequently cited estimate places the number of Americans suffering with hoarding between one and two million. However, it is suspected that this estimate is too low. Hoarders exist all over the world. They come from every economic and educational background. Your neighbor, your aunt, or your best friend could be a hoarder.

According to David F. Tolin, Ph.D., Randy O. Frost, Ph.D. and Gail Steketee , Ph.D. (2007) there are three major characteristics of hoarding:
1) Acquiring, saving, and great difficulty discarding items that seem to be useless or have limited value;
2) Enough clutter so that living spaces cannot be used as intended;
3) Significant stress or impairment of everyday activities caused by the clutter.

Frequently a hoarder may deny or minimize the hoarding problem, much to the exasperation of a loved one. The family and friends of a hoarder may watch aghast as a hoarder continues to add to an already dangerously cluttered house. Well-meaning family and friends might go so far as to clear out the clutter for the hoarder. Their actions are understandable. Hoarders may live in dangerous situations brought on by their hoarding behavior: clutter stacked precariously, unhygienic conditions, structural damage to the living quarters, and obstructed exits. But instead of thanks and relief, the hoarder’s response to their efforts is a bewildering mix of anger and anxiety. Worse, the hoarder may rebound with more clutter than was present before the cleanup.

Why can’t the hoarder just stop collecting and start disposing of the clutter? According to mental health professionals the explanation may lay neurobiology. Compulsive Hoarding is considered part of a psychiatric disorder. But, recently disagreement has risen among professionals as to how to classify Compulsive Hoarding behaviors. Traditionally Compulsive Hoarding has been considered a form of obsessive-compulsive disorder (OCD). Some professionals are rethinking this classification because there are aspects of hoarding that do not seem to fit into the characteristics of OCD. Depression, social anxiety disorder and attention-deficit/hyperactivity disorder are often associated with hoarding. Regardless of how Compulsive Hoarding is classified the question remains: how to treat it?

Seeking the help of a counselor can be the first step toward recovery. Be sure that the counselor is knowledgeable about Compulsive Hoarding – not every counselor is. Some studies indicate that traditional talk therapy is not effective in treating hoarding. But preliminary studies have demonstrated success with Cognitive Behavioral Therapy (CBT). CBT focuses on changing the faulty thoughts associated with Compulsive Hoarding while simultaneously modifying the hoarding behaviors, which should lead to a change in how a person feels.

Medications may provide some relief for the depression or anxiety that sometimes exists with hoarding; however, in some cases medications are ineffective. Although any physician can prescribe medications Tolin, Frost, and Steketee recommend the hoarder consult a psychiatrist or advanced practice nurse who is an expert in psychiatric medications.

Professional organizers who have special training and expertise in dealing with Compulsive Hoarding can provide hands-on assistance, support and can work collaboratively with a counselor; however, they are not a substitute for a counselor.

The Internet may provide resources in finding help for Compulsive Hoarding.

The National Study Group on Chronic Disorganization ( and the National Association of Professional Organizers ( can help you find professional organizers who specialize in Compulsive Hoarding.

Squalor Survivors ( has stories of those who are dealing with hoarding either personally or within the family. You can also find information on Compulsive Hoarding and resources.

Children of Hoarders ( is a website for the adult children of hoarders. You will find support, information and additional resources there.

The Obsessive Compulsive Foundation’s website on Compulsive Hoarding ( provides information and assistance to those dealing with hoarding.

St. Louis Behavioral Medicine Institute ( has professional counselors who understand Compulsive Hoarding.

There are several good books on the subject of hoarding which you may find useful. In 2007 Tolin, Frost and Steketee published Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding. David F. Tolin, Ph.D., Randy O. Frost, Ph.D and Gail Steketee, Ph.D. have published many excellent books on the subject of hoarding previously. The Messies Manual by Sandra Felton has provided help for many people. Overcoming Compulsive Hoarding: Why You Save and How You Can Stop by Fugen Neziroglu, Ph.D., Jerome Bubrick, Ph.D., and Jose A. Yaryura-Tobias, Ph.D. is another highly regarded book on the subject.

Dealing with Compulsive Hoarding may feel lonely and overwhelming. The good news is that it is treatable. Whether you personally are dealing with Compulsive Hoarding or are involved in a relationship affected by it, there is hope.