Hoarders: You Feel Superior to Them, Right? Wrong.

 

I have watched the TV show Hoarders once, but in visiting the homes of patients as an LCSW have seen the effects of real-life hoarding played all too often. It’s difficult not to stare at what is typically-though not always a mess. (Some who hoard are in fact anal about it.). Not to ask “why?” and “how?” In other words, not to judge.

There have been recent reports and books written about this hoarding phenomenon, a disorder which, by the way, is not listed in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), a manual that lists criteria for clinicians to use for diagnosing and identifying all types of mental disorders. Yet. That may change with the new edition, set to be published by the American Psychiatric Association (APA) in 2013.

In the current issue, the DSM-IV, hoarding is listed under Obsessive-Compulsive Personality Disorder, as one of 8 criteria for diagnosis. It’s described as:  “The inability to discard worn-out or worthless objects even when they have no sentimental value.”

It seems as though it deserves its own category.

National Public Radio recently aired a story about how researchers are realizing that hoarding behaviors begin in the mind. At the University of California, San Diego Department of Psychiatry, psychologist Catherine Ayers, a specialist in anxiety disorders and late-life hoarding, is researching treatment for older adults who hoard. Currently, she’s using a form of behavior therapy and cognitive remediation that focuses on building concrete skills.

That’s a good thing.

Hoarding resembles an addiction, progressing in severity over time. Which means it affects the family members, too. For some people the worsening of symptoms is slow and steady, for others it’s rapid and frantic.  If a big clean-up is imposed to rid the house of clutter but no follow-up treatment is offered to treat the underlying disease process, the person will typically replenish the clutter and then some, much to the dismay of the interveners. That’s the pathological part. Remember that if you care about someone who hoards, so you don’t find yourself too angry that your efforts to clean up once and for all failed, over and over again. Be gentle with them—and yourself.

Which brings me back to the TV show, or rather,  viewers and their comments. I’ve heard people  say they feel “superior” when they watch the drama unfold on screen. They say it with a touch of arrogance, impatience, disdain, directed at the people, rather than the disease. The first time I heard it I thought it was odd, a fluke. Then I heard it again. And again.

I reminded myself, humbled, not to judge that either.

To find a therapist who specializes in the treatment of hoarding, contact the American Psychological Association.

Photo credit: Hoarders

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