Hoarding can harm both the person with the condition and their loved ones. Despite the inconvenience of the mess, someone who hoards objects may feel unable to stop. The behavior tends to grow worse until the person gets treatment.
Getting rid of the items is rarely enough to solve the issue. Most people need to confront the emotions and beliefs causing the behavior. Otherwise, a person may replace the hoard with new objects.
A therapist can help an individual understand and change their behavior. A person may eventually learn to throw items away without fear.
Hoarding doesn’t only affect the individual. It can also impact anyone living with the person. Clutter can make a house hard to use. It can also pose a fire hazard or sanitation issue. Even if the person who hoards lives alone, friends and family may still feel anxiety and concern.
Talking to a loved one about their hoarding behavior can be hard. They may react with denial or defensiveness. Yet people who hoard often do not admit or even realize their hoarding is an issue. Many times, a person will not get treatment until they realize how their behavior affects others.
So how can a family or friend help? The most effective strategy is often an honest, respectful conversation. When discussing a person's hoarding, it may be best to:
- Avoid judging or criticizing the hoarding behavior.
- Emphasize concern for the person’s well-being.
- Discuss the effects that hoarding may have on others.
- Respect the person's right to collect things and keep possessions.
- Encourage steps that may make a living environment safer or more habitable.
- Help the person find a therapist for treatment.
Force rarely improves a hoarding situation. If family or friends throw away someone’s items without their consent, the person may grow angry. Once trust is broken, the individual may refuse further help.
Psychotherapy can treat compulsive hoarding…when someone is a willing participant. Cleaning by itself is rarely a permanent solution. If someone is unwilling to stop hoarding, they will likely get more items to replace the old hoard. The cycle of clutter and cleaning will likely persist until one addresses the underlying causes of hoarding.
Therapy often focuses on strategies to prevent further hoarding. A person in therapy may:
- Develop coping mechanisms for the distress they feel when throwing items away.
- Practice organization and decision-making skills.
- Learn to resist the urge to gather more items.
- Examine any delusions about an object’s sentience.
- Address the traumas and emotions which may compel them to hoard.
- Develop self-care habits to replace hoarding behaviors.
- Treat any co-occurring conditions.
Anxiety and depression often appear alongside compulsive hoarding. These conditions can make hoarding symptoms worse. Anxiety can hinder someone’s ability to decide which items to throw away. Depression can sap one’s motivation to change. A person may take an antianxiety medication or antidepressant to help treat those conditions.
Peer-organized support groups have also developed as a method of treatment for hoarding. Otherwise isolated individuals can benefit from social support. Seeing peers’ progress can also offer motivation.
Buried in Treasures workshops are free support groups that teach cognitive behavioral techniques. The programs are named after a book written by leading experts on hoarding. In research trials, these workshops were shown to reduce symptoms of hoarding by up to 27%.
When a person is ready to declutter, they may need help cleaning their living space. Friends or family may help lift heavy objects or sort through items. The cleaning process can involve several stages:
- Gather supplies: The cleaning team will need containers to carry the items, such as trash bags or shipping boxes. Plastic gloves, goggles, and paper masks can protect people from dust and bacteria.
- Empty out rooms: The team may want to set an empty staging area to place recovered items for later sorting. If all the rooms are full, a yard or driveway can suffice. The cleaning team may find it helpful to clean the bathroom or kitchen first. This way, they can access water faucets for later cleaning.
- Sort the items: The cleaning team can sort items into three categories: trash, donations, and keepers. If an item has gone unused for over a year, or if it is broken, it likely belongs in the trash category. The team may need extra caution when organizing papers, since some might have sensitive information.
- Dispose of items: Many city sanitation services rent out dumpsters and collect the trash for a fee. Charities will often pick up donations for free. Before putting back the “keeper” items, the cleaning team may wish to sanitize the house.
In some cases, a person may need professional help. Homes can require significant disinfection and repair. People who hoard animals might have to dispose of toxic waste. If a house has a mold or pest issue, experts recommend hiring a specialized cleaning service.
Specialized services may assign a case manager to walk a person through the cleaning process. Since hoarding is often stigmatized, many companies promise confidentiality. Specialized services may use unmarked vehicles and have policies against discussing a person’s situation with outsiders.
- Therapy after hoarding leads to injury: Sarah, 41, enters therapy somewhat reluctantly after falling down the stairs and breaking both legs. She admits to the therapist that the excessive clutter in her house caused her to trip and fall. Yet Sarah insists she cannot give away any of her belongings, because doing so would make the objects sad. The therapist asks Sarah about her family and friends. Sarah says she has not seen many people lately, as there is no room in her house to entertain others. She also admits she does not go out as often as she’d like, since she feels anxious when separated from her things. The therapist helps Sarah see how the people in her life have been pushed aside by her possessions. In therapy, Sarah learns how to cope with the guilt and anxiety she feels when discarding objects. After several therapy sessions, Sarah asks her sisters for help in sorting and disposing of her things. The therapist continues to work with Sarah, who reports distress each time she sees a box of her belongings leave the house. But as Sarah continues in treatment, she reports improvement in each session.
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