Hoarding

Once again the subject of hoarding has captivated the public’s attention. Every week the A&E show “Hoarders” spotlights the clean up of two different cases of extreme hoarding with the assistance of a professional organizer and a crew. Despite the unpleasantness of the deep clutter, rodents, insects and squalor our attention is held by the need to know why someone lives this way. What is clear from watching the program is the intensity and magnitude of emotional pain caused by hoarding for both the hoarder and his family.

No one willingly chooses to hoard. Psychological and emotional factors underlie hoarding behavior. Mental health workers have traditionally considered hoarding as a sub-type of Obsessive Compulsive Disorder; however, recent research seems to indicate that hoarding is a feature of many psychiatric disorders. While the research on hoarding has been fruitful, there is still a lot that is unknown.
The show’s opening displays the statistic that three million people in the United States are hoarders; however, the exact number is unknown. I have seen estimates as low as two million and as high as 20% of the population – about 61,528,000 people. Shame, embarrassment and fear contribute to the social isolation of hoarders and the difficulty in identifying them.

People who suffer with extreme hoarding behavior are adept at hiding. Friends, family, repairmen, utility workers – anyone wanting entry - are typically barred from the house. Such isolation can lead to further degeneration of behavior and of the home. In the most extreme cases, doors and windows blocked by clutter trap the occupants from escaping during a fire.

It is important to point out that hoarding, like many behaviors, follows a continuum. The National Study Group on Chronic Disorganization (www.nsgcd.org) created the Clutter Hoarding Scale that is used to objectively describe clutter in place. The scale uses four factors to assess the level of clutter on a scale from one to five. The examined factors look at the integrity of the home’s structure, the pets and vermin present, household functions and cleanliness. Most lay people would describe a Level I home as messy and a Level V home as uninhabitable.

If someone you know and love hoards it is important to seek help. There are several organizations that provide information and forums. Children of Hoarders (www.childrenofhoarders.com), Messies Anonymous (www.messiesanonymous.com), and Squalor Survivors (www.squalorsurvivors.com) are very good websites to visit. When speaking to someone about his hoarding use neutral and supportive language. Sometimes good-meaning friends and family decide to do a surprise cleanup of the cluttered house. Such gestures are usually not a good idea. How would you feel if a group of people came into your home and threw out things without your knowledge or permission? Respect and dignity are always important and appropriate when dealing with anyone, and provide the foundation for taking the first steps towards recovery from hoarding.