, 2011). Since hoarders are less likely to be married, it is possible that help for a hoarder who has fallen or otherwise become injured may be severely delayed. Sometimes, it can be too late. Fire is another danger faced by a hoarder. Such a large number of items can make a house more flammable, and also make it highly difficult to escape if a fire does get started (Saxena, et al., 2011). That is something that should be taken into consideration.
Impairment and Insight
The levels of impairment and insight vary with hoarders. Some of them see that they have a serious problem for which they need to get help, and some of them do not see what is wrong with the way they are living (Steketee, et al., 2010). They are generally very reluctant to part with any of their things, and they can become resentful of family and friends who are only trying to help them free their lives from all of the clutter. Intelligence is not the issue. Many hoarders are of average or above average intelligence, so it is not the mentally deficient that usually hoard (Tolin, et al., 2011). Often, hoarders hold onto possessions because of emotional conflicts and problems (Steketee, et al., 2010). For example, a man who has lost his wife suddenly and unexpectedly may be reluctant to dispose of any of her things. He may also look for something to fill the void in his life, and may see things in stores and other places that his wife would have liked. Bringing those things home may make him feel closer to her, so he continues to do so.
There are, of course, other reasons why people hoard. Loss does not have to be part of the issue, and control may be more significant (Tolin, et al., 2011). Someone who was very sheltered and controlled as a child may hoard as an adult in order to feel as though he or she is in control of the future. Overall, the insight and impairment that hoarders have is not static and is not shared across all hoarders. Each one is different, and each one has his or her own ideas and beliefs about the hoarding and about why it is taking place. Some are defiant as to the hoarding, others are embarrassed, and still others seem to have very little emotion about it unless someone suggests getting rid of the clutter (Steketee, et al., 2010). Impairment from an intelligence sense is really not the issue, but insight into the problem is clearly important. Hoarders must come face-to-face with the reasons behind their hoarding behaviors (Tolin, et al., 2011).
Level of Clutter
The level of clutter that is seen in the home of a hoarder goes far beyond what someone would consider "a little cluttered," or "a messy house." Many people do not have time to keep their houses picked up well. Others are tired or not well, and they may let things pile up here and there. However, hoarding is so far beyond that as to be noticeable even for those who do not have experience with hoarders or with treating them for their problems. The level of clutter in a hoarder's home is often to the point that sometimes just getting in through the front door may be difficult. The hallways are full of boxes and stacks and piles of items, as are the rooms. There are generally narrow passageways that are used by the hoarder to get from one room to the next (Tolin, et al., 2011). Some of the rooms are completely full and are not used at all. Others may require the hoarder to climb over or walk on items in order to navigate through the house. Slowly, the items have taken over the home - and the hoarder's life. That did not happen overnight, and will not be fixed overnight (Steketee, et al., 2010).
Overall, a hoarder does not have rooms that are messy and rooms that are clean. The items have taken over the entire house, and have made it very difficult for the hoarder to have a life that can include other people. There may be shame over the level of clutter, or the hoarder may simply not want anyone else in the house for fear that person may take something, throw it away, or move it somewhere else. Because the majority of hoarders are single, they have no one to blame for the mess other than themselves. That can leave them feeling sad, conflicted, angry, and miserable, but yet they do not seem to know how they can solve their problems and get back to a life that they had before - or a life that they see other people living (Steketee, et al., 2010). Professional help is the best way for a hoarder to reclaim his or her house and life, so that healing and restoration can begin. Getting rid of the clutter in a healthy way can be the first step on the road to recovery for a hoarder (Tolin, et al., 2011).
As can be seen, there are many issues that are faced by those who are diagnosed (or should be diagnosed) as hoarders. There are some similarities when it comes to hoarders and those who have OCD, but there are also differences that have been discounted or ignored by the DSM in the past. Changing that can lead to better diagnoses and more appropriate criteria for those who hoard and for those who have OCD but who do not have hoarding as a component of it. The problem in the past was not with the issue of hoarding, but with the issue of it being a separate entity from OCD. Now that the differences have been established, more people will be helped in a way that is completely appropriate to their disorder, instead of fitting them into the category that is closest but yet is not quite accurate based on their actual problems.
Anderson, S.W. Domasio, H., & Domasio, A.R. (2005). A neural basis for collecting behaviour in humans. Brain, 128, 201-212
Frost, R. & Gross, R. (1993). The hoarding of possessions. Behaviour Research and Therapy, 31, 367-382
Saxena, S., Ayers, C.R., Maidment, K.M., Vapnik, T., Wetherell, J.:. Brstritsky, A. (2011). Quality of life and functional impairment in compulsive hoarding. Journal of Psychiatric Research, 45, 475-480
Steketee, G., Frost, R.O., Tolin, D.F., Rasmussen, J. & Brown, T.A. (2010). Waitlist-controoled trial of cognitive behavior therapy for hoarding disorder. Depression and Anxiety, 275, 476-484
Tolin, D.F., Frost. R.O., Steketee, G., Gray, K.D., & Fitch, K.E. (2008). The economic and social burden of compulsive hoarding. Psychiatry Research, 160, 200-221
Tolin, D.F. & Villavicencio, A. (2011). Inattention, but not OCD, predicts the core features of hoarding disorder. Behaviour Research and…