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Understanding Hoarding: Therapy, Dangers, and Strategies to Help



Hoarding is a complex mental health disorder that often goes unnoticed until it reaches severe stages. This is mainly because hoarding behaviors can be easily mistaken for harmless, even endearing tendencies, such as saving or collecting. Let's take a closer look at what hoarding is, how it differs from saving and collecting, the signs, risks, and potential therapeutic interventions.


What is Hoarding?

Hoarding is a recognized mental health condition characterized by an extreme difficulty parting with possessions, regardless of their actual value. Individuals with hoarding disorder excessively save items they perceive to be necessary or valuable, creating clutter that disrupts their ability to use their living or work spaces. Hoarding is not a choice, but a disorder often associated with other mental health conditions like depression, anxiety, and obsessive-compulsive disorder (OCD).


Saving, Collecting, and Hoarding: What's the Difference?

Understanding the difference between saving, collecting, and hoarding is key to identifying if there's an issue.


Saving is a typical behavior involving keeping things that might be useful in the future or have sentimental value. Savers usually keep their possessions organized and their living spaces functional.


Collecting is a hobby or a passion. Collectors gather items of a particular type that interest them, like stamps, coins, or art. These collections are often well-organized and bring joy to the collector.


On the other hand, hoarding involves amassing items indiscriminately, often without any clear utility or value, there is an immense urge to “hold on” to items. The volume of possessions can overwhelm living spaces, making them unusable and potentially dangerous. The person hoarding often experiences distress at the thought of getting rid of items.


Signs of Hoarding

Identifying hoarding early can be key in providing timely help. Here are some signs to look out for:


  • Inability to throw away possessions

  • Severe anxiety when attempting to discard any items

  • Difficulty organizing possessions

  • Indecision about what to keep or where to put things

  • Distress, such as feeling overwhelmed or embarrassed by possessions

  • Suspicion of other people touching items

  • Obsessive thoughts and actions: fear of running out of an item or of needing it in the future

  • Functional impairments, including loss of living space, social isolation, family or marital discord, financial difficulties, health hazards


The Dangers of Hoarding

Hoarding poses several risks, not just to the individuals themselves but also to those around them:

  • Physical health hazards: Excessive clutter can lead to unsanitary conditions that breed pests or mold, causing health issues. This can intensify if there are pets also in the living environment. The clutter can also increase the risk of falls or injuries and can hinder emergency response efforts.

  • Mental health risks: Hoarding is often linked with increased stress, anxiety, and depression. The social isolation that often accompanies hoarding can exacerbate these conditions.

  • Social and family issues: Hoarding can cause significant family and social conflicts. It may also lead to financial hardships and even eviction or child custody issues in severe cases.


Self-Help Strategies for Hoarding

While professional help is often needed, individuals struggling with hoarding can also undertake self-help measures:

  • Self-awareness: Recognize and acknowledge the problem. Understanding that your saving habits may be harmful is the first step towards recovery and reclaiming your power back.

  • Organization: Attempt to categorize items and designate specific places for different types of items. This process should be gradual to avoid overwhelming anxiety, focus on one category at a time. For instance, plates, one kitchen cabinet, one bin in the bathroom, the nightstand drawer.

  • Decluttering: Start small by discarding or donating items you feel less attached to. Gradually move on to items that cause more anxiety.

  • Seek support: Connect with supportive friends, family, or a support group who understand your struggle and can provide encouragement.


How Can Therapy Help With Hoarding?

There are several types of therapy that can be effective in treating hoarding disorder. The choice of therapy often depends on the individual's specific circumstances and the therapist involved, the severity of the condition, and the presence of any co-occurring mental health issues. Below are the most commonly used therapeutic approaches for hoarding:


  • Cognitive-Behavioral Therapy (CBT): This is the most widely used and researched therapy for hoarding. CBT helps individuals understand the thoughts and feelings that lead to their hoarding behaviors. Strategies often include:

    • Skills training: Enhancing decision-making and organizational skills, and learning to categorize and sort possessions.

    • Exposure therapy: Gradual exposure to the anxiety of discarding items can help individuals tolerate the distress and anxiety associated with getting rid of possessions.

    • Cognitive restructuring: This helps to challenge and change unhelpful beliefs related to hoarding, such as fears about needing possessions in the future.

  • Acceptance and Commitment Therapy (ACT): ACT is a type of mindfulness-based therapy that helps people accept their feelings and thoughts rather than trying to change them. It encourages commitment to personal values as a guide for behavior. In the context of hoarding:

    • ACT might involve recognizing the distress caused by discarding items, but accepting it and choosing to discard items nonetheless because it aligns with broader life values, such as maintaining a safe and clean home.

  • Family Therapy: Since hoarding often affects the whole family, family therapy can be beneficial. This approach:

    • Helps families understand the nature of hoarding and develop supportive strategies.

    • Aims to reduce family conflict and enhance motivation for change.

  • Group Therapy: Sometimes, people with hoarding disorder can benefit from group therapy. This setting allows individuals to:

    • Learn from others who are dealing with the same issues.

    • Share experiences and coping strategies.

  • Motivational Interviewing: This is a counseling approach designed to enhance readiness for change. It can be particularly useful for individuals who are reluctant to acknowledge the impact of hoarding on their lives.

  • Home-based Therapy: In some cases, therapists may make home visits to help individuals sort and discard items and to provide direct advice about organizing and decluttering.


In some cases, medication, usually selective serotonin reuptake inhibitors (SSRIs), may be used as part of the treatment plan. But it's important to note that medication alone is rarely sufficient.


If you or someone you know is struggling with hoarding, it's important to seek professional help. Remember, it's never too late to reach out and start making changes for a better, healthier life. Hoarding is a complex disorder, but with understanding, patience, and the right treatment, it can be overcome.


How can Better Minds Counseling & Services help with hoarding?

Better Minds Counseling & Services has Brittany Webb who works with anxiety disorders, including hoarding disorder. She is a Licensed Professional Counselor and a Certified Clinical Anxiety Treatment Professional. Brittany will work with you as the client to establish a cadence of appointments from in-home services to virtual appointments. Brittany provides in-home services up to 50 miles from Philadelphia, Pennsylvania. She will bring her training and experience into working with you so you can live a less stressful life and a safer one. You deserve to enjoy the home you live in.

Contact Better Minds Counseling & Services to find out more about the hoarding services provided.




Blog Disclaimer - These posts are not meant to treat, diagnose, or serve as a replacement for therapy. If you or someone you know is experiencing a mental health emergency, please contact your local crisis center or dial 911. Here are more immediate resources as well.


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