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Hoarding: More Than Just a Mess

Hoarding is a common problem that is difficult to treat.

Sifting Through a Hoarding Problem

Most people who hoard don’t seek help on their own, Tompkins says. Sometimes they come in under pressure from their family, but in most cases it’s the family members themselves who seek help in bringing the home under control. Sometimes people must take action because a landlord, a condominium association, or the city has put pressure on them to clean up the mess.

TV viewers may breathe a sigh of relief when they see a tidy, spacious home -- or room of a home -- at the end of a hoarding program. But solutions aren’t often simple, quick, or lasting. “It’s a very difficult syndrome to break,” says Kolberg, who offers training for other organizers to help them deal with clients who hoard.

“I think you want to keep in mind that no amount of shaming them or yelling at them or having temper tantrums about it is really going to change the issue. It’s important for hoarders to realize they’re causing other people harm and stress. I get that. But hammering away at them for behaving this way is just not helpful,” she says.

Expecting to see a substantial portion of the floors and tabletops in the near future may not be realistic, either. 

“Obviously there are success stories, but it’s important to recognize that this is a chronic and severe problem. When it comes to chronic and severe problems -- like drug use, bipolar disorder, severe depression, or hoarding -- even with best of treatment, a lot of people will still be struggling,” Tolin says.

Therapy for Hoarding

Tolin and Tompkins suggest an approach called cognitive behavioral therapy (CBT). This treatment teaches people to see the objects around them in a new light and to change their hoarding behaviors. Tompkins says that CBT sessions can help a hoarding client:

  • Make more reasonable judgments when deciding if an object is worthy of keeping or not
  • Learn how to make quick decisions on whether to keep an object or toss it
  • Practice discarding items while sorting through the intense emotions they trigger

Since most hoarders don’t seek help -- and those who do tend to have trouble changing -- experts often also focus on an approach called harm reduction, Tompkins says. This can help cut down on vermin, fire hazards, and other threats to the hoarder and the community. 

“Harm reduction, as applied to hoarding, assumes that the behavior will continue, and so long as the behavior continues, what we try to design is a plan that reduces the risk that the person and the community face from the behavior," Tompkins says.

Pairing a mental health professional with an organizer can be helpful, Kolberg says. An organizer can guide people toward understanding the benefits of changing their habits, then setting goals to help them tame the mess.

“When you put people in touch with their goals, then you have something to work with,” she says. “Then you can say [to the hoarder], ‘I thought we were working toward this goal,' when [the hoarder] objected to my saying, 'Are you sure you need to hang onto that? It’s a comb without teeth.' Does keeping it help you toward your goal?’"

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Reviewed on April 19, 2011

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