Today I am going to write about a very different type of psychological problem, called compulsive hoarding. The Boston Globe had a very interesting article about hoarding. Researchers Gail Steketee and Randy Carlson have a new book, called “Buried in Treasures,” which documents their new approach to treating this disorder.
First of all, what is compulsive hoarding? It’s when you can’t get rid of anything, and can’t put in order what you have, so much so that you end up having difficulties using the spaces you live or work in.
Are you a hoarder? Of course not! But Steketee and her colleagues developed a simple photo test for hoarding . Take a look at these photos, and pick out the one that looks the most like your bedroom. If it is number 4 or higher, then you probably have a problem with hoarding. (Hoarders, it turns out, are very accurate at identifying the level of chaos in their spaces.)
Your official Lounge Wizard, Dr. Psychology took the test, and scored a 2 or 3, which puts him in the normal range, but right on the borderline of hoarding. So this article is close to his heart.
What causes hoarding? It’s not what most non-hoarders think; laziness, messiness, or even depression. Although many hoarders have some elements of depression or anxiety, the core of hoarding is that they have strong attachments to things. They are sentimental about possessions, and often have very intense feelings about them. They tend to be creative, and can think of many uses for objects.
Most hoarders function fairly well outside their homes. They have jobs, friends, and active involvements. Where hoarding seems to impact them is in romantic relationships. The hoarders I know tend to not have long term romantic relationships, which isn’t surprising, as girlfriends and boyfriends tend to want to come over to your house, and for a hoarder than is a painful experience. “Why do you have all of this stuff? Why don’t you get rid of all this junk? I can’t believe you live this way!” are all typical comments they may hear. Needless to say, there are no more invitations after that. Steketee finds that at least 50% of hoarders are single.
So is there any hope for hoarding? One thing that doesn’t seem to work very well is traditional medicines for depression like antidepressants. Although these medicines work well for regular obsessive compulsive disorder (OCD) they don’t appear to do much for hoarding. Traditional psychotherapy doesn’t work either.
Steketee and colleagues have developed a very nice cognitive behavioral model for treating hoarding. They find that hoarders have similar cognitive models. For instance, hoarders have four common fears: 1) missing important information or opportunities, 2) forgetting something important, 3) experiencing loss, and 4) being wasteful. They tend to focus on lost opportunity, so getting rid of a newspaper entails a possibility of losing some opportunity that was in the newspaper. In general, all of their possessions get elevated in value.
Another common issue is needing to keep things in sight. This is tied into the need to not forget anything. “Out of sight, out of mind,” is the hoarder’s mantra. This causes the visual chaos that creates many of the problems of hoarding, since if one just had many possessions, but they were well organized and stored, hoarding would not be a big problem.
So it is not surprising that Steketee’s treatment plan focuses on helping hoarders learn to organize their space, rather than focusing on getting rid of stuff. This is more palatable goal for most hoarders, who know that their space is poorly organized.
The treatment also focuses on helping hoarders overcome the need to acquire things. The rules for acquisition are: 1) immediate need for the object (this week), 2) time enough to acquire and use the object, 3) money to buy it, and 4) an appropriate space for the object. This nips the problem in the bud.
The treatment works, but it’s not a miracle. According to Steketee, it’s not unusual for someone to move from 7 to 3 on a 9 point scale where 1 is neat and organized, and 9 is total mess. But relapse is always a danger, as there is something very compelling about hoarding.
So what is the core of hoarding? Even Steketee and her colleagues are a little baffled about this. As a borderline hoarder who closest friends include some hoarders, I can give some intriguing answers.
Hoarding is about possibility. The thought “I could use this item someday,” is central to the decision to hold onto something. For instance, I have a box of scrap pieces of wood and plastic, which I keep because I might have a use someday. Every once in a while, I use a piece from my scrap box. And that reinforces keeping it.
Or papers. I used to clip articles from papers, thinking I would write about the topic someday. I had many files of articles on travel, psychology, and technology. The technology innovation that has changed that is computers, and more specifically, the email program Gmail. Instead of printing out articles, now I email them to myself. Since Gmail can hold thousands of articles, and with a simple search I can find any of them, I’ve tossed out my article files.
One of the beauties of computers is that even massive hoarding of articles or writing takes very little space on a hard drive. I can hold every email I’ve ever written in my life on a single USB memory stick. So if you are a hoarder of articles, or papers, consider buying a scanner, and using computer technology to hoard more effectively.
Another aspect of hoarding is sentiment. I hate throwing out something that reminds me of a good time in my life, or almost anything that has significant meaning. So I’d never throw away a photograph or a letter from someone I care about. I will throw out cards, though, unless they have a significant written message inside.
And some of hoarding is simply about difficulty in making decisions. For instance, I have too many books. But it is hard to figure out which books to toss. Some rules are easy. A bad paperback novel is easy to toss. But a good novel is tougher; maybe I will want to reread it sometime.
And reference books are still arder. Will I need the information in this book sometime? I try to ask myself realistically if the info is something I’ll need in the foreseeable future, and especially if the information is still even relevant. Thus old computer books are easy to toss, since in the computer world things date quickly.
One trick I’ve used successfully in de-hoarding is to remind myself that one of the advantages of getting rid of things is that you can get new things! For instance, if you go through one’s clothes closet and toss all the clothing that doesn’t fit and doesn’t look good, then you get to buy some cool new threads! The same is true with books. The key is to replace less than you toss.
Conquering hoarding is about psychological growth. Central to the process of growth is letting go of the old in order to make room for the new. New things, new people, and new experiences. Another aspect of de-hoarding is traveling through life less encumbered. That gives you more flexibility to move, and change. The irony of hoarding is that the biggest hoarders I know love to travel. And when they travel, they leave almost all of their stuff behind. And they are perfectly happy living out of a suitcase or backpack, and don’t miss their stuff at all.
Maybe this is really a metaphor for our psychological baggage. Travel light, and leave the junk behind. Throw out old stuff, and organize what you keep. Let go of things, and make room for new things.
Copyright 2007 The Psychology Lounge/TPL Productions
Dr. Andrew Gottlieb is a clinical psychologist in Palo Alto, California. His practice serves the greater Silicon Valley area, including the towns of San Jose, Cupertino, Santa Clara, Sunnyvale, Mountain View, Los Altos, Menlo Park, San Carlos, Redwood City, Belmont, and San Mateo. Dr. Gottlieb specializes in treating anxiety, depression, relationship problems, OCD, and other difficulties using evidence-based Cognitive Behavioral Therapy (CBT). CBT is a modern no-drug therapy approach that is targeted, skill-based, and proven effective by many research studies. Visit his website at CambridgeTherapy.com or watch Dr. Gottlieb on YouTube. He can be reached by phone at (650) 324-2666 and email at: Dr. Gottlieb Email.