Hoarding and Cognitive Behavioral Therapy
Jill Stoddard
By: Sarah Bond
Within the past couple years, the issue of hoarding has become polarized by the means of reality television shows and late night pundits. Although this media attention has contributed to an increased public awareness, interest, and concern, the long-term implications that hoarding can have are often overlooked. While hoarding has been associated with the diagnosis of obsessive-compulsive disorder (OCD) and obsessive compulsive personality disorder for many years, it was not until the recent publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that it became its own diagnosis.
Hoarding is characterized by collecting possessions that create clutter and serve minimal functional purpose (Tolin, Frost, & Steketee, 2007). Anything living or non-living can be hoarded. “Clothes, newspapers, and books” are reportedly the most common items hoarded (International OCD Foundation, 2010, p. 1). However, fifty-percent of hoarders choose to amass complimentary items, such as bubble wrap and fast food containers, and some even acquire large numbers of living animals.
Hoarding may result in the impairment of functioning and create significant distress. The disorder can pose additional health risks associated with sanitation and an increased risk of fire (Tolin et al., 2007). Aside from the physical hazards, it can also have immense social and psychological ramifications. For instance, hoarding will affect the lives of those who share living spaces and may adversely impact interpersonal relationships. Its clinical repercussions interfere with daily routines that many take for granted. Simple tasks, such as cooking and showering, may be hindered by the unnecessary accumulation of items hoarded. Thus, it is understandable as to why hoarders are commonly diagnosed with elevated rates of depression (Tolin et al., 2007, p. 1461).
Hoarders usually do not realize that they have a problem (International OCD Foundation, 2010). Many have trouble with organization and decision making. Thus, they find it difficult to arrange their possessions in a manner that makes efficient use of their living space. Additionally, hoarders often have an emotional attachment to their objects, which makes it challenging for them to discard or give away their possessions (International OCD Foundation, 2010). It may provoke a sense of fear in anticipation of losing the objects that are important to them. Thus, hoarders may arrange their items compulsively to help alleviate distress (International OCD Foundation, 2010). Hoarders do not typically exhibit ritualistic tendencies and the accumulation of items tends to be passive in nature. This differs from OCD, in which individuals deliberately seek to rid themselves of unwanted emotions by actively seeking out behaviors or rituals that provide comfort (International OCD Foundation, 2010).
If you or someone you know experience symptoms similar to the aforementioned, it is important to consult a professional. Although there is still a lot to be learned about the disorder, interventions such as cognitive behavioral therapy (CBT) can be effective.
Please contact CSAM if you are interested in speaking with a professional in the San Diego area who specializes in CBT.
References
International OCD Foundation. (2010). Hoarding. Retrieved from http://www.ocfoundation.org/hoarding/
Tolin, D.F., Frost, R.O., & Steketee, G. (2007). An open trial of cognitive behavioral therapy for compulsive hoarding. Behavior Research Therapy, 45(7), 1461.
Tags: CBT, Cognitive Behavioral Therapy, OCD, hoarding