Hoarding Compulsion: Symptoms, Underlying Causes, and Treatment

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According to experts, hoarding is a psychological condition whose sufferers excessively acquire and form unhealthy attachment to objects - so much so that they find it nearly impossible to part with anything, even items that may seem to have little or no value.

And even though hoarding has garnered a lot of attention in the recent past due to television shows and widespread magazine, newspaper, and online articles, many people still view hoarding as a life choice instead of the serious psychological condition that it is. The good news, however, is that this attention has also meant that more and more people are wisely seeking help for themselves or someone they love.

Indicators

hoarding affects people in varying degrees, but always includes unhealthy attachments to objects, an inability to differentiate between important and useless items, and fear of letting go or losing things.

Hoarders may also:

• Live in massive amounts of clutter that pose risks to their health and safety
• Rationalize that they collect things because they may need them in the future
• Excessively rescue animals such as dogs, cats, and birds
• Describe themselves as “pack rats” or “collectors”

Root Causes for hoarding Compulsion

Research into the precise root causes for hoarding (which affects people with varying degrees of severity) continues, and to date there is no definitive data on the topic.

It is clear, however, that hoarders experience distorted and obsessive thought patterns which are triggered by a variety of psychological and emotional factors. This ultimately evolves into unhealthy attachments to objects. Additionally, they are unable to distinguish which of their possessions are functional, important, and/or meaningful and which ones are not.

For example, one of my clients believed that her hoarding behaviors began because she feared letting go of objects (no matter how insignificant or useless) that were attached to happy memories. In her mind, these items represented those memories and if discarded, would lessen the significance of those events and/or cause her to forget them.

On the surface, these feelings may seem perfectly understandable and not unusual; in fact, many people without hoarding compulsions save objects that remind them of happy occasions. However, as this client progressed through therapy, I learned that she grew up in a home where important mementos such as Mother’s Day cards, her childhood drawings, and vacation souvenirs were viewed as insignificant – something she vowed to correct in her own life. However, she never learned to differentiate between those objects that were truly meaningful and those that were not... so she held onto everything.

Why It’s Important to Seek Help for hoarding Compulsion

Even though experts continue to search for the root causes of hoarding compulsions, it’s clear that a hoarder’s living conditions take a severe toll on every aspect of their lives.

If left untreated, the compulsion progresses and worsens. Understandably, they are increasingly embarrassed and reluctant to invite people into their homes. As a result, they become more and more socially isolated and find it more and more difficult to nurture intimate relationships.

At its most extreme stage, hoarders’ living conditions may be so out of control that they pose serious health and safety risks to themselves, family members, and even neighbors.

Given this, the solution may seem quite simple: clean up and clear out the mess. In truth, however, the resolution is more complex, because if the emotional aspect of the condition is not treated, most hoarders will continue their behaviors.

Although hoarding behaviors are not always curable, people who seek help from a competent, experienced, and qualified psychologist or psychotherapist are far more likely to learn the strategies they need to improve their living conditions for the short and long term.

In order for counseling to be effective, therapists must first accurately assess the severity of the hoarding. Then, they can work with their clients through the stages of recovery from hoarding compulsion, which are very similar to the stages of grieving.

They must also understand that these stages are not linear (i.e. clients may move in and out of these in no particular order,) except the process almost always begins with denial.
Very briefly, the five stages are:

   1. Denial: Hoarders rejects the idea that they have a problem and may describe themselves as “collectors,” “savers,” or “pack rats.”

   2. anger: Resentment and irritation is directed at themselves or others – especially to those who confront them about their living conditions. 

   3. Bargaining: In an attempt to delay taking steps to improve their situation, hoarders bargain (i.e. “I’ll throw this out, if I can keep this.”) with themselves, family members, authorities, or even God.

   4. depression: This occurs when hoarders acknowledge that they have a problem, and begin to feel hopeless and overwhelmed.

   5. Acceptance: Hoarders finally accept their condition; recognize that they must seek help in order to identify the root causes and learn how to retrain their obsessive thoughts and compulsive behaviors; and understand that sustainable gains are achievable if they’re willing to commit their time and energy to the process.

Qualified therapists help their clients manage through these stages and continue to work with them even after they have reached the acceptance level. After progress is made, it’s often a good idea to enlist the help of friends, family members, and/or cleaning professionals to begin clearing out their living spaces.

Ideally, this should occur after all involved – including those with the condition - have agreed to specific and comfortable boundaries. By understanding the dynamics of hoarding behaviors, offering an emotionally safe environment, and working together, a therapist, hoarder, and their loved ones can emerge through this process with more freedom from their attachment to objects. 

by Kathleen Dwyer Blair, LCSW, BCD

Director

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