Hoarding behavior is obsession and compulsion

By Janice Gaston
Media General News Service
Published: May 6, 2008

If clutter imprisons you, if you feel too embarrassed to let anyone visit your home, if the mess in your house is becoming a health hazard, you probably have a problem.
You are most likely a hoarder.
Experts consider hoarding to be a form of obsessive-compulsive disorder, or OCD, an anxiety disorder, said Tommie Jackson, a pastoral psychotherapist in private practice in Winston-Salem. Obsessions are thoughts that people have that bother them, sometimes to an extreme, and compulsions are behaviors that people perform to deal with the anxiety caused by their obsessions. The obsessions are usually random and not related to such real-life issues as work or money stresses, Jackson said. They are inappropriate thoughts that they can’t block.
In typical cases of OCD, said Gretchen Brenes, people might be obsessed with whether they turned off their stoves. Brenes is a professor in the department of psychiatry and behavioral medicine at Wake Forest University Baptist Medical Center and a psychologist with a special interest in OCD.
“The compulsion is that they repeatedly go to the stove and check it. It’s not a problem with their memory. They know good and well that they have turned off the stove.” But they feel so much anxiety that perhaps they didn’t turn it off properly that they can’t handle it and must continue to check.
Hoarders calm themselves by saving things.
“That 20-year-old piece of foam probably will not come in handy,” Jackson said, “But you never know. It’s an important thing to emphasize that these people do focus on that extremely, extremely small chance that something may happen or that they may need that item or that something bad would happen if they didn’t have it.”
People might hang on to old newspapers, thinking that they could need the information they contain some day.
“You never know when you might want to check what the score was for the Appalachian football game in 2007 for homecoming,” Brenes said. Knowing that the information is at hand soothes anxiety. “Most don’t go back and check that information, but the knowledge that it’s there is calming.”
Hoarders may save anything from rubber bands to plastic containers, but the most-commonly hoarded items include newspapers, magazines, mail, clothes, books and lists.
Experts with the Obsessive-Compulsive Foundation estimate that 700,000 to 1.4 million hoarders live in the United States.
Recently, actress Delta Burke went public about her problems with depression, OCD and hoarding. In one report, she mentioned that hoarding had run in her family. According to several Web sites devoted to hoarding, researchers have found chromosome anomalies that are linked with hoarding in families with OCD.
Many of us laugh about our tendency to collect clutter and call ourselves pack rats. But pack rats don’t let their clutter interfere with their lives. They don’t feel secretive or ashamed about the stuff they save. It makes sense to many of us to save napkins with our names printed on them from our weddings. It does not make sense, unless you are a hoarder, to save a napkin from Burger King because you think you might need it some day.
Hoarding, like other disorders, comes in degrees.
“If your house is extremely cluttered and there’s stuff coming out of all your closets, then you might be a little bit more than a pack rat,” Brenes said. “If you are saving items you haven’t seen or used in years and have difficulty parting with them, then you’re a little bit more than a pack rat.” You are most likely on the mild edge of hoarding.
Collectors might save specific items, such as old issues of Sports Illustrated. They are proud of their collections and will show them off.
Hoarders might collect every single magazine, catalog and other piece of mail that has ever come into their houses, but they don’t talk to others about their piles of paper.
In some instances, according to the Obsessive Compulsive Foundation, hoarders may have severe problems with making decisions and avoiding tasks. The thought of cleaning up and organizing their stuff overwhelms them. They may be perfectionists who are so afraid of washing dishes the “wrong” way that they simply avoid doing it.
Some people may think of hoarders as simply eccentric. But hoarding can become such a serious problem, Brenes said, that hoarders can face physical danger.
In a famous hoarding case in New York in 1947, two reclusive brothers died in a boarded-up dwelling filled with tons of debris, including tin cans, cardboard boxes and telephone directories. One died of malnutrition. The other smothered when a pile of debris fell on him.
The risk of fire becomes a bigger danger for those who block exits with their junk and fill their homes with flammable items, such as newspapers stacked to the ceilings. One study of elderly hoarders showed that 81 percent of them faced such physical risks as falling, being injured by falling debris, an inability to cook and unsanitary conditions.
Some older people who grew up during the Depression may show a tendency toward hoarding but may not be true hoarders, Brenes said. To go through such deprivation at a young and impressionable age “is certainly something that stays with you through a lifetime,” she said.
True hoarders rarely seek treatment because they are too embarrassed, according to the OC Foundation. Therapists often hear about hoarding issues from concerned family members.
Hoarding is often treated with a type of psychotherapy called cognitive-behavioral therapy, Brenes said. Therapists work to change faulty patterns of thinking into accurate ones.
“In layman’s terms, if you ask someone how to overcome a fear of water, they will tell you have to face that fear and eventually get in the water,” she said.
With hoarding, a therapist might ask patients to do something they fear, such as reading that day’s newspaper, then throwing it away.
Some doctors will prescribe antidepressants that are also used to treat anxiety disorders, such as Zoloft, Prozac or Paxil. Such drugs can help decrease the obsessive thoughts that lead people to hoard so that therapy can be more effective, Brenes said.