Hoarding disorder

Hey everybody! Today we're going to talk about Hoarding.

What is it? Why do people do it and what are the treatment skills to stop? Hoarding is complicated. It's not just an individual who decided to hold on to many items for the fun of it.

A person collects and keeps many items. Even things that appear useless or have little value to most people. These items clutter living spaces and keep the person from using areas of their home as intended. Meaning, they may have not used their kitchen table in months or even years. Maybe, haven't sat on their couch in a long while. Their world continues to shrink until there are only a few places in their home to actually reside. It's important to know that these items cause distress or problems in their day-to-day life. If an item is thrown away, it can cause an immense amount of anxiety. Many I've worked with explain to me that throwing away an item almost feels like they are throwing away a memory or part of themselves. It's the grocery bag they got when they went shopping with their mom 10 years ago. It's the decoration they got for their future grandchild. The jewelry making kit they got so they could learn a new skill. Those 10 blankets they got on sale, with intentions to give them away, but they never did.

Why do people hoard?

Every item has meaning. Even if they forgot they had it. It could be a traumatic moment that happened in someone's life that started their hoarding. Abuse, loss of a spouse, lack of money growing up and so forth. BUT, individuals can hoard and not have any trauma in their life. There can be a genetic component as well. It doesn't have to be a history of hoarding. It could be OCD, anxiety, hair pulling, skin picking. Hoarding behaviors can begin early in life,
Yet individuals seek treatment at around 50 years old.

So why can't they just throw things away? Wouldn't their life be so much better if the home were clean? Well, yes...and....no.... Yes, because they can use their furniture again. Have guests over. Cook in the kitchen....and NO because it means they would likely feel guilt, fear, and anger by getting rid of items. They feel these items have value or could be used someday. They feel responsible for the objects and I've heard some even say it feels like they are having a funeral for the item if we throw it away. It causes that much distress in their life. Even if it's a napkin. Something you wouldn't think would matter.

Cycle of hoarding disorder

Here is a cycle I see. The joy or delight when getting a new item. It's now in their life, in their area, in their home. It's comfort. Then it's the anxiety or thought that comes of, I could get rid of this, but then I'd feel super anxious. I'll just leave it.

Good feeling bringing items in.
Bad feeling taking items out.

You can see why overtime, this causes an excess of items in the home. Denial of a problem overtakes and starts interfering in their life. They come up with excuses why the item is more important than using their kitchen table again, sitting on the couch, or moving around their home.

I also want to say, I in no way want to make it sound like I am shaming these individuals. I feel so bad for those in this cycle and do all I can to help, which is why I'm going to teach what we actually do about hoarding.

Hoarders TV show

You've probably seen the show hoarders right? Often, by the end of the episode, they had a cleaning crew come in and take away truck loads of stuff. It looks all fine and dandy on the show, but what you don't see is the weeks, months, years of recovering from such event. In other words, don't go into someone's house and throw all their things away.

It's a very methodical process. We've got to switch our brain from thinking the stuff is the problem to, the individual's brain is throwing off some signals that are getting in the way of life. If we only focus on the stuff, the individual never heals. I've seen it first hand working in various homes. We would clean and clean and clean for hours. Vacuum, it looked hopefull! You can use the couch again. One week later....more stuff.

How to do treatment for hoarding

Here is how treatment actually works and I find it ONLY works if the individual wants it. More times than not, it's a family member calling asking help for their loved one. It can cause extreme strain on a family who wants so badly for their loved one to stop, yet often they don't want help. Even with risk of health and safety. Even a fire.

So this is how we treat it. Challenge thoughts and beliefs about the need to keep various items. Here is what it may look like. We write down all the areas in their home that they want to start using again. We rank them from most to least important. Maybe it's their bedroom is the most important. They want to be able to sleep in their bed again. We go in and latterly pick up one item. It can be anything and ask the following questions.

Do I use it?
Have I used it in the past month?
Do I need it? Meaning, while something bad happen if I don't have it. (Need it also can't mean, I could need it someday.) It has to be right now.
Do I really really love it?
Does it have home? A dedicated space that it I can live. Do I love it enough to fit it into my home?

When we work through these questions, more times than not, we find the item isn't needed, isn't loved enough, but the drive to keep it is still strong. So we work with that. Use cognitive behavioral therapy to think through these moments. Process emotions, what it means to them, and eventually throw the item away.

I don't throw the item away. They do. They need that distress and process through it to realize they are going to be okay without it. It's interesting that in my experience, it seems like every item we pick up has a story or meaning. "I got that napkin when I went to the fair with my grandkids 5 years ago"

We repeat this process over and over again until the room is clean. Sometimes it takes hours to throw away one item, but what I find is that it's not forced, they learn, and the process gets quicker.

What not to do with Hoarding Disorder

Here are some traps we avoid and already tell us, the item needs to go:
“I could use this someday.”
“What if I need it later?”
“What if I made the wrong choice throwing something away?”

If the item is something we are going to hold on to, we take the time to put it in its place. It has a home, we don't create new piles to sort through later. That necklace goes in the jewelry box. That jacket goes in the closet. Here is a problem we often run into though. The jacket goes in the closet, but there isn't room in the closet....so what do we do? Work on making a home.

Sometimes we create various rules. I can have up to 5 items in a box that I'm not sure of right now, but once we hit that 5, we have to make a decision.

It has to be natural. Nothing pushed or forced.

Now, I'm not bashing these hoarding shows and I do feel like many feel the best way is to have someone else remove it all, but in my experience, it just leaves more space for things to be collected in the future. Without the proper care and therapy to work through the pain, the cycle continues.

Sometimes we practice going to various places and being there without buying anything. Allowing the brain to tolerate discomfort. When someone is serious about treatment, they want a better lifestyle, they are willing to work through some pain and discomfort, they can get better. But it has to be them and there is hope.

Have you or something you care about struggled with hoarding disorder? Hoarding is often related to OCD and can be treated as well. Go watch this video on what OCD actually looks like to see if you can make a connection.

Thanks so much for watching, and I'll see you next time.