What is Hoarding Disorder?
Hoarding Disorder was recognized for the first time as a distinct disorder in May 2013 with the publication of the new DSM-5 (APA,2013). Hoarding disorder is diagnosed when an individual has trouble discarding or parting with their personal possessions, and their saving behavior causes significant clutter of their living spaces. The clutter may also be exacerbated by the person's acquisition of objects either by excessive shopping, taking discarded items from others, or other means of acquiring . Individuals who hoard experience functional impairment and/or subjective distress either directly or indirectly because of their hoarding. This might include limited functional space at home, becoming isolated due to feelings of shame about others seeing the disorganization and clutter in their home, family and marital discord, and physical, health, or safety concerns due to the clutter. Many individuals who hoard also demonstrate marked impairment in organizational skills such as difficulty categorizing and organizing objects in a meaningful fashion, poor decision making skills, and extreme anxiety at attempts to clean the clutter. While hoarding behavior can occur on its own, individuals who hoard may also experience other mental health problems such as depression or OCD.
How is hoarding treated?
There is a cognitive behavioral treatment specifically designed to treat hoarding (Steketee & Frost, 2007). The goal of treatment is to help individuals who hoard reclaim their homes and use their space in a functional way. In order to achieve this, the patient is taught how to sort their belongings, decrease clutter, and improve decision making and organizational skills, thereby allowing patients to once again use their homes and improve their quality of life.
Treatment sessions for hoarding begin with education about the problem and the treatment. Then the patient and the therapist establish goals together and the patient is taught basic organizational and decluttering rules. Cognitive therapy is used to challenge those beliefs that support the hoarding and help the patient prepare themselves for the decluttering phase of treatment. With the therapist's support, and at a pace that is comfortable for the patient, the patient begins to sort through their possessions and organize their home. Only a small area is worked on at a time and the patient makes all decisions (with the therapist's assistance) about what to keep, throw out or donate. As the organizing progresses, before and after pictures are taken as positive reinforcement, so that the patient can see their accomplishments as they are made. Once an area is cleared, treatment will focus on maintenance and relapse prevention so that the patient can maintain their treatment gains.
To purchase a video tape of a lecture given by Dr. Rabinowitz about Hoarding, visit www.njocf.org/VideoTapes.htm (all proceeds go to the NJ Obsessive-Compulsive Foundation chapter). To read a review of the talk, visit www.njocf.org/Documents/june04.pdf
Understanding Obsessive Compulsive Hoarding Site
Obsessive Compulsion Foundation Hoarding Site
"Overcoming Compulsive Hoarding: Why You Save & How You Can Stop" by: Fugen Neziroglu, Ph.D., Jerome Bubrick, Ph.D.& Jose Yaryura-Tobias, M.D. - Hoarding Self Help Book
Dena Rabinowitz, Ph.D. has been featured on TLC's Hoarding: Buried Alive program.