Hoarding: Treatment, symptoms, and personal impact/costs

Posted by in Hoarding The topic of hoarding is rarely met with disinterest.  Maybe that’s because nearly all of us can relate to hoarding on one level or another. Perhaps you yourself have been touched personally by hoarding.  You may have a strong emotional attachment to objects, or you may have a loved one who inexplicably continues to add to an already existing surplus of items.  This surplus may be small, or it  may be quickly exhausting all remaining living space. Perhaps you don’t have issues with surplus, but you consider yourself a “pack rat” or a “collector”.  Maybe you have a nice collection of art or knickknacks, and you can relate to the urge to over-acquire. Perhaps you are “organizationally challenged” and have struggled with how to best categorize and store your possessions.  Maybe you have difficulties with throwing out your newspapers before you’ve read them, or you hold onto your old college textbooks just in case you might need them one day.  Maybe your counters are overflowing with unopened or unfiled mail, receipts, and to-do lists. Perhaps you are a viewer of one of the recent television shows devoted to various aspects of hoarding.  Maybe you watch Hoarders on A&E, Hoarding: Buried Alive on TLC, or Confessions: Animal Hoarding on Animal Planet, and you’re fascinated with the how’s and why’s of hoarding.  Although these shows often do justice to illustrating the real impact of hoarding on individuals’ lives, they sometimes paint a rather scattered and/or confusing perspective on the condition.  Oftentimes, these shows fail to accurately depict the grueling work and intensive therapy that support long-term recovery, because the time and energy supporting these changes simply cannot be conveyed in before and after pictures. Perhaps you’ve just stumbled on this blog, and despite not fitting any of the above descriptions, you’ve continued to read. Hoarding, as a phenomenon, draws us in and is intriguing from an evolutionary standpoint.  Control of resources has been (and continues to be) a determining factor in individual and group survival.  There are many good reasons to conserve, to avoid waste, and to safeguard oneself and one’s family against the negative effects of resource depletion.  In many ways, to smartly stockpile is to survive.  Considered in this light, characteristics associated with hoarding may be intrinsically adaptive but, in the case of pathological hoarding, these positive qualities come to be overshadowed by the negative sequelae of the condition. Regardless of who you are and your...
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Hoarding treatment: Choosing the right therapist

Posted by in Hoarding If you are an individual who struggles with hoarding, you might have been frustrated by negative treatment experiences in the past.  For most individuals who hoard, treatment can be challenging.  However, it is an essential ingredient for regaining control and reclaiming your life. When selecting a therapist to help you address your hoarding, make sure that your potential therapist practices cognitive behavioral therapy for hoarding (or CBT for hoarding).  Based on research studies, this type of treatment is most likely to be effective in supporting long-term positive changes and leaving you less vulnerable to relapse.  In South Florida, there are very few psychologists who have formal experience with hoarding treatment.  Make sure that when you interview your potential psychologist, you ask them about their experience in treating hoarding.  A CBT orientation alone is not sufficient; make sure that they’ve treated other patients who hoard and can explain how cognitive behavioral therapy can be tailored to specifically address hoarding in the context of acquiring, organizing, and discarding objects.  Good CBT therapists will also explain how exposure and response prevention (a CBT component most frequently discussed in the context of obsessive-compulsive disorder) will be integrated into your treatment.  Fortunately, there are resources that make choosing a qualified therapist slightly easier; check out the IOCDF’s database of treatment providers with hoarding experience.  Although this database is largely focused on OCD therapists, it also contains information about providers who treat clinical hoarding. Sadly, even in today’s society in which there are multiple popular television shows focused on  hoarding, quality scientific knowledge about hoarding is limited to a relatively small group of treatment providers.  Interestingly, one reason why hoarding had a delayed entry into the limelight has been nosological.  Nosology refers to the study of how different disorders relate to each other and are classified.  In the DSM-IV, which is the manual that psychiatrists and psychologists use when making diagnoses, hoarding is currently not recognized as a formal diagnostic category.  Instead, it is described briefly in a side note within a section that pertains to obsessive-compulsive personality disorder.  Given this peripheral placement, it is not uncommon for trained clinicians to open up their DSMs and fail to be able to find hoarding listed at all.  Fortunately, it is likely that the upcoming DSM-V will finally rectify this in May 2013 and will recognize hoarding as a distinct OC-spectrum diagnosis. Here’s some interesting additional background on this subject:...
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