Dr Eddie Murphy Coping with hoarding

A reader who compulsively fills her house with detritus seeks Dr Eddie’s advice

People with hoarding may not see it as a problem, making treatment challenging. But intensive treatment can help people with hoarding understand how their beliefs and behaviors can be changed so that they can live safer, more enjoyable lives.

Symptoms

Getting and saving an excessive number of items, gradual build-up of clutter in living spaces and difficulty discarding things are usually the first signs of hoarding, which often surfaces during the teenage to early adult years. Problems with hoarding gradually develop over time and tend to be a private behavior. Often, significant clutter has developed by the time it reaches the attention of others.

Signs may include:

* Excessively acquiring items that are not needed or for which there’s no space. * Persistent difficulty throwing out or parting

with your things, regardless of actual value. * Feeling a need to save these items, and being upset by the thought of discarding them. * Building up of clutter to the point where rooms become unusable.

* Having a tendency toward indecisiveness, perfectionism, avoidance, procrastination, and problems with planning and organisation.

Excessive acquiring and refusing to discard items results in:

* Disorganised piles or stacks of items, such as newspapers, clothes, paperwork, books or sentimental items.

* Possessions that crowd and clutter your walking spaces and living areas and make the space unusable for the intended purpose, such as not being able to cook in the kitchen or use the bathroom to bathe.

* Build-up of food or trash to unusually

excessive, unsanitary levels.

* Significant distress or problems functioning or keeping yourself and others safe in your home.

* Conflict with others who try to reduce or remove clutter from your home. * Difficulty organising items, sometimes losing important things in the clutter.

People with hoarding disorder typically save items because:

* They believe these items are unique or will be needed at some point in the future.

* The items have important emotional significance — serving as a reminder of happier times or representing beloved people or pets.

* They feel safer when surrounded by the things

they save.

* They don’t want to waste anything.

Hoarding disorder is different from collecting. People who have collections, such as stamps or model cars, deliberately search out specific items, categorise them and carefully display their collections. Although collections can be large, they aren’t usually cluttered and they don’t cause the distress and impairments that are part of hoarding disorder.

Treatment

At present, the treatment pathway is going to your GP and referral to community mental health services. Previously hoarding was seen a subtype of Obsessive Compulsive Disorder (OCD) but now is seen as a discrete problem. What we are also looking at is that for some individuals with hoarding, there may have been significant trauma in their lives, such that the “creation” of hoarding as a problem is to avoid the hurt of the original trauma.

Myth

Big clean-outs are often seen as the cure for hoarding, but in fact they can lead to further distress as the root cause and trauma and loss is not addressed.

What we need when it comes to hoarding are regional teams that encompass health professionals, housing and compassionate declutterers working as a team. Unfortunately, at present they don’t exist but I believe that they would both make economic sense and more significantly, help individuals with hoarding issues to improve their quality of life.