This week I answer a letter from a reader, Mary, who has a problem with hoarding, which is having a huge effect on her life.
Dear Dr Eddie,
I would like help with my house. It began to fill with items when I was in my early thirties. I now have very little room to live.
My kitchen is almost entirely full, so I use a mini-fridge and a toaster oven that I had wedged between piles of paper in the hallway. I eat my meals on a chair.
At night, I move pile of papers from the bed onto that chair so I can sleep. I buy items from charity shops and pick up daily free newspapers that I plan to read in the future, which of course I don’t.
I am deeply ashamed by the state of my house. I am in no relationship, and my sisters don’t visit me anymore. I avoid gatherings and dating, despite being friendly and very lonely, as I could not invite anyone to my house.
A picture of my house would show furniture, papers, boxes and clothes piles from floor to ceiling.
Any advice would be appreciated.
Dr Eddie replies:
Hoarding is so hard and raises many different and complex emotions including anxiety, shame, guilt etc.
Psychologists have begun to think differently about hoarding now than they did before.
Hoarding is defined as a persistent difficulty discarding or parting with possessions because of a perceived need to save them.
A person who is hoarding experiences distress at the thought of getting rid of the items. Excessive accumulation of items, regardless of actual value, occurs.
Hoarding for many, including you, often creates such cramped living conditions that homes may be filled to capacity, with only narrow pathways winding through stacks of clutter.
Countertops, sinks, stoves, desks, stairways and virtually all other surfaces are usually piled with stuff. And when there's no more room inside, the clutter may spread to the garage, vehicles, yard and other storage facilities.
Hoarding ranges from mild to severe. In some cases, hoarding may not have much impact on your life — while in other cases it seriously affects your functioning on a daily basis.
People with hoarding may not see it as a problem, making treatment challenging. But intensive treatment can help people with hoarding understand how their beliefs and behaviors can be changed so that they can live safer, more enjoyable lives.
Getting and saving an excessive number of items, the gradual buildup of clutter in living spaces and difficulty discarding things are usually the first signs and symptoms of hoarding, which often surfaces during the teenage to early adult years.
Problems with hoarding gradually develop over time and tend to be a private behavior. Often, significant clutter has developed by the time it reaches the attention of others.
Signs and symptoms may include:
l Excessively acquiring items that are not needed or for which there's no space
l Persistent difficulty throwing out or parting with your things, regardless of actual value
l Feeling a need to save these items, and being upset by the thought of discarding them
l Building up of clutter to the point where rooms become unusable
l Having a tendency toward indecisiveness, perfectionism, avoidance, procrastination, and problems with planning and organizing.
Excessive acquiring and refusing to discard items results in:
l Disorganized piles or stacks of items, such as newspapers, clothes, paperwork, books or sentimental items
l Possessions that crowd and clutter your walking spaces and living areas and make the space unusable for the intended purpose, such as not being able to cook in the kitchen or use the bathroom to bathe
l Buildup of food or trash to unusually excessive, unsanitary levels
l Significant distress or problems functioning or keeping yourself and others safe in your home
l Conflict with others who try to reduce or remove clutter from your home
l Difficulty organizing items, sometimes losing important items in the clutter.
People with hoarding disorder typically save items because:
l They believe these items are unique or will be needed at some point in the future
l The items have important emotional significance — serving as a reminder of happier times or representing beloved people or pets
l They feel safer when surrounded by the things they save
l They don't want to waste anything
Hoarding disorder is different from collecting. People who have collections, such as stamps or model cars, deliberately search out specific items, categorize them and carefully display their collections. Although collections can be large, they aren't usually cluttered and they don't cause the distress and impairments that are part of hoarding disorder.
Presently, the treatment pathway is going to your GP and referral to community mental health services. Previously hoarding was seen a subtype of Obsessive Compulsive Disorder but now is seen as a discrete problem in of itself. What we are also looking at is that, for some individuals who hoard, there may have been significant trauma in their lives, such that the “creation” of hoarding as a problem is to avoid the hurt of the original trauma.
Myth of the cleanout
Big cleanouts are often seen as the cure for hoarding. In fact, often these can lead to further distress as the root cause and trauma and loss is not addressed.
What we really need when it comes to addressing hoarding behaviours are regional teams that encompass health professionals, housing and compassionate declutterers working as a team.
Unfortunately at present they don’t exist but I believe that they would both make economic sense and more significantly support individuals with hoarding issues to improve their quality of life.
Dr Eddie Murphy runs a psychological and counselling service in Portarlington, Co Laois. If you are organising a speaker or training for school, community, voluntary, sporting or work groups, call Dr Eddie on 087 1302899 or go to www.facebook.com/ dr.eddie.murphy.psychologist
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