When People Hoard

Last Editorial Review: 1/31/2005

Has clutter created chaos in your life? Are you unwilling to throw anything away? What you call collecting may actually be hoarding.

By Richard Trubo
WebMD Feature

Reviewed By Brunilda Nazario

Is your apartment cluttered with stacks of newspapers up to your chin and towers of unread magazines that have reached almost nosebleed heights? Just to get from the living room to the bedroom, do you have to tiptoe over Christmas wrapping paper from the 1980s, junk mail from your college days, and a broken TV that hasn't worked since the final episode of M*A*S*H?

You might call yourself a "collector" or maybe even a "pack rat." But for the psychologists who study people like you, they'd probably label you a "hoarder."

When your junkaholic behaviors involve acquiring and keeping objects that appear to have limited if any value, and they begin to take over your living space, you meet the definition of a hoarder. Such people can't make a decision about the worth of anything, from food tins to tattered receipts, and over a period of years, they may accumulate mountains of "stuff" that can eventually leave them isolated and almost incapacitated in their own homes. Their possessions may cover their floors, couches, chairs, tables, and beds. They may have to wade through knee-deep piles of debris just to get to the bathroom.

At its worst, hoarding can become a health and safety hazard, with the clutter posing a fire risk, and making it almost impossible for repairmen to enter their homes to fix a leaky faucet or a refrigerator on the blink. Yet hoarders continue to add to their "collections" with no willingness to discard any of it.

"These are people who can no longer use entire rooms in their homes because of all of their possessions," says Gail Steketee, PhD, professor at the Boston University School of Social Work. "They may lose their medications in the piles and have to repurchase them. They may file their taxes late, if at all, because they can't find the paperwork they need."

Trash or Treasure?

When it comes to hoarding, one man's junk is another man's treasure. "Most of us are attached to things we inherited from our parents or grandparents, or we're attached to photographs or special items that we've bought," says Steketee. "But people with hoarding problems often become emotionally attached to items that strike the rest of us as junk, or to pieces of paper that aren't particularly interesting."

Hoarders may become anxious and angry at the mere suggestion of getting rid of items that they've held onto for years. They often say that if they throw something away, they may need it someday when it will be impossible to retrieve.

So they collect scraps of paper with shopping lists from years ago. They may hold on to old clothing, extra furniture, used envelopes, clothing price tags, soda cans, string, leaves, even cigarette ashes, burned-out light bulbs, used tea bags, and toilet paper cores. One woman saved wishbones from chickens because "one day they will be used for making wishes." Another collected clothes that weren't her size because she "might run into someone who needs them someday."

When confronted with their behavior, hoarders often claim that it isn't a problem at all. At the same time, they are often embarrassed to have visitors to their home.

Most experts report that hoarding doesn't seem to play favorites with rich or poor, young or old, although the middle-aged and the elderly have had more years to squirrel away the stuff that might drive others crazy. There are no good statistics on the number of hoarders, although some estimates have put the number at less than 1% of the population. These people are often single, but among those who are married, divorces often occur when a spouse simply can't live in such chaos.

Is It OCD? Or ADD?

Many psychologists believe that hoarding is a subtype of obsessive-compulsive disorder (OCD), while others argue that it may be a variant of attention deficit disorder (ADD), which leaves people having difficulty with decision making, procrastination, and staying on task long enough to organize their surroundings. "Try to give hoarders an assignment to throw something out, and they won't do it," says Stephen C. Josephson, PhD, clinical psychologist in New York City, and clinical associate professor of psychology in psychiatry at Cornell Medical School. "I see the clutter more often in people with ADD than OCD."

In most cases, hoarders rarely look at the possessions they've saved, according to Fred Penzel, PhD, a Huntington, N.Y., psychologist and author of Obsessive-Compulsive Disorders. Nevertheless, they feel some sense of security knowing that these items are there "just in case."

Steketee has treated people who have refused to part with old sales slips "because they represent a day in their lives, even though they have no idea what they bought. Somehow, the fact that it has a date on it, and that it belonged to them, it becomes important."

Hoarding Animals

One of the oddest hoarding behaviors involves the accumulation of domestic animals. Individuals have been known to hoard dozens of dogs and cats in their houses. In Los Angeles, for example, a woman was recently arrested on suspicion of animal cruelty after 600 animals were found in her home, many of them dead or very sick.

Gary Patronek, PhD, director of the Tufts Center for Animals and Public Policy at Tufts University School of Veterinary Medicine in North Grafton, Mass., has studied animal hoarders and found that most of them are women, 46% are 60 years of age or older, and more than half live alone. In nearly 70% of the cases, animal urine and feces accumulate in living areas. About 700 to 2,000 cases of animal hoarding occur in the U.S. each year.

What About Treatment?

The treatment of hoarding can be challenging since it means changing behaviors that may almost be lifelong. Some hoarders are simply too embarrassed to seek help. Others panic when contemplating discarding their "treasures."

Medications that have been used to treat obsessive-compulsive disorder -- such as Paxil and Zoloft -- have had limited success for people who hoard. Stimulant drugs used in ADD (such as Ritalin) are often more successful, says Josephson, in combination with behavioral therapy.

The goal of therapy is to help people understand why they save items, teach them organizational and decision-making skills, and help them acquire the fortitude to drive past garage sales and thrift stores. Many hoarders explain that they're saving newspapers in order to read them someday. But a therapist may be able to help them gain insights into alternatives by having them answer pointed questions such as, "If you don't save these papers, what sources do you have to get the same information if you need it? Can you go online instead of saving these newspapers, and get more accurate and up-to-date information that's available on the web?"

"But hoarding is very difficult to treat," says Josephson. "I see it as a chronic condition that you can help people manage, but they may need ongoing help."

Published Feb. 24, 2003.

SOURCES: Stephen C. Josephson, PhD, clinical psychologist, Cornell Medical School, New York. Fred Penzel, PhD, psychologist, executive director, Western Suffolk Psychological Services, Huntington, N.Y. Gail Steketee, PhD, professor, School of Social Work, Boston University, Boston.

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