OCD and
Hoarding
Understanding Hoarding in relation to OCD
Although it was once thought that hoarding was less treatable than other types of obsessive disorders, amongst many professionals, hoarding is often recognized as a very treatable condition. Using many of the techniques that can help with OCD, hoarding is manageable and can have little to no impact on the sufferer’s life with the right skills and treatment.
Below are some of the common problems concerning hoarding:
Forming emotional bonds with items, which can make it very difficult to throw them away
The amount of space that they have left in the house can be irrelevant. Even if there is minimal room left, a hoarder will always find somewhere to put their collected items.
A struggle in organizing items
Often the organization of objects can help to make sense of the world around them
The person will find any excuse to keep an item, even if they are not sure when they will be able to make use of it
A niggling feeling that if they throw something away, then something is not complete, or ‘just not right.’
The exact causes of hoarding are unknown. However, as with many psychological disorders, it is believed to be a combination of biological and environmental factors. Possible suggested causes put forward by professionals include:
The experience and sudden onset of unwanted and painful emotions
Perfectionist traits
The experience of trauma and loss Family history or habits
Other associated mental health problems
Hoarding Disorder:
Recognising the Symptoms
Prevention of harm: Common to OCD, a feeling that
if they throw something away, something terrible might happen
Deprivation hoarding: An intense feeling that they
may need the item later, so they have to keep on to it. This type of hoarding can often be caused by a loss earlier in life that they are now trying to fill.
Emotional hoarding: For some, hoarding can have
an emotional element to it. Commonly explained by past trauma or stress, emotional hoarding fills some emotional need that the person may have been deprived of in their past.
More specifically, there are three recognized forms of hoarding, these are:
The very nature of hoarding is exceptionally obsessive, and that is an apparent similarity between OCD and hoarding. Whether trying to work out where to put everything in the house, reorganizing objects within a room, or desperately trying to get everything organized, compulsive behaviour related to hoarding can be tiresome and very time-consuming. Often people that fall into hoarding obsessions find it very difficult to make progress and find it difficult to ‘get anywhere.’ Finding the right treatment for hoarding is crucial. Hoarding itself also poses significant practical health and safety risks, such as cooking near piles of paper, or clutter blocking emergency and fire escapes within a household.
In trying to grasp an understanding of hoarding, it is essential to understand what happens when a person decides to save something, and resist
throwing it away. Often the thought of keeping an object can provide a high, or at the very least, a feeling of safety. These pleasant thoughts often dominate thinking, cloud the ability to have clarity around other ideas and make any urges to resist the hoarding challenging to accept. The benefits of throwing something away are often ignored or overshadowed by the downsides, such as a loss of identity or a missed opportunity. Feelings also play a pivotal role, with feelings like regret and guilt surfacing when either throwing objects out or often just thinking about it. Therefore in keeping the item, they can avoid these negative thoughts and feelings for a short amount of time.
Many hoarders are living in unsafe, and perhaps even dangerous surroundings. More commonly relating to extreme cases of hoarding, a person’s environment can become chaotic and disorganized. However, for the person themselves, this may be how they function and make sense of the world. Unlike other people who may prefer a clean, tidy, organized, safe house, a hoarder is likely to live in an environment without any of those things. For example, when something breaks in the house and needs to be fixed by a professional, such as a boiler, most people would allow the qualified person into their home to fix the issue.
However, the idea of letting someone else into their home can be a distressing one for many hoarders, and so go on living with a broken boiler, rather than take steps to fix it. Hoarding can also have an enormous impact on friends and family. Often bringing about negative feelings in those closest to the person, hoarding can take priority over anything else, creating feelings of anger, resentment, and depression for all partied involved, sometimes even leading to broken down friendships, romantic relationships, and isolation.
Those who collect are often proud of their achievements around possessions. Whether it be a classic car
collection or a stamp collection, someone accumulates as a hobby is provided with enjoyment by their group, and will often talk fondly of it. On the other hand, for a hoarder, the experience is something entirely different. Many hoarders feel embarrassed about what they have collected, realize that what they are obtaining may not be necessary, and begin to feel ashamed. Supporting isolation, often those who hoard avoid showing their collections to anyone else, and may refrain from coming into contact with people or letting them inside their own house. Hoarding can lead to depression, low self-esteem, and significant disruptions in the life that they once knew.
Hoarding and the effects on the person quality of life
What is the difference
between hoarding and
collecting?
Hoarding in relation to OCD
What are some the key similarities?
Can feel a sudden urge to hold onto something and therefore not throw certain objects away (often present when concerned with preventing harm to another person)
A general concern of feeling out of control when trying to throw things away
The urge to check the bottom of bags, as well as other items and objects in case there is something important or valuable at the bottom that may go unseen
A general feeling of anxiety and a heightened state of awareness when attempting to throw things away
The urge to perform safety seeking behaviours that can include ruminating, checking and seeking reassurance
What are some of the key differences?
For those with OCD around hoarding, emotions are likely to revolve around heightened states of acute anxiety and fear only, whereas someone who is a hoarder is likely to feel deep sadness, loss and grief when attempting to throw objects away
Whereas for some with OCD, worries are often related to fears relating to fraud or harm, someone with hoarding is often more concerned with either the sentiment of an object, or a more general feeling that they may ‘need it’ one day
For individuals with OCD, compulsions are performed to simply reduce distress, whereas a person with hoarding has a desire to hold on to objects
It is unlikely for the home of someone with OCD to end up with a home that is packed from floor to ceiling, as their fears usually relate to certain objects. On the other hand, as hoarders can find it more challenging to throw anything away, their home can become increasingly full often making it difficult to move around the home freely.
Although now recognized as a stand-alone condition, hoarding and OCD have many similarities. Namely, the emotions that drive both conditions stem from anxiety and our unhealthy
relationship with wanting control. Someone experiencing hoarding struggles to live with the uncertainty that throwing an object away may be very similar to the effects that refraining from doing compulsions may initiate for someone with OCD. A common misconception is that someone with OCD is tidy and organized, and although this may be the case for some, this is not true for all OCD sufferers. Many people that experience obsessive-compulsive disorder are messy and chaotic as only a small percentage of OCD cases revolve around organization. The hoarding cycle is similar to OCD in that some intrusive thoughts and feelings drive the urge to hoard the objects.
If you feel that yourself, or a loved one may be experiencing hoarding visit your GP and ask for a referral to the appropriate medical professional. Such assessments can also be conducted privately.
Obtaining a diagnosis
What do Doctors look for when diagnosing hoarding?
When diagnosing hoarding, doctors often refer to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) to reach a diagnosis. Please see below for the criteria that is assessed during this process.
Persistent difficulty discarding or parting with possessions, regardless of their actual value. This difficulty is due to a perceived need to save the
items and to distress associated with discarding them. The difficulty discarding possessions results in the
accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of third parties (e.g., family members, cleaners, authorities).
The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others).
The hoarding is not attributable to another medical condition (e.g., brain injury, cerebrovascular disease, Prader-Willi syndrome).
The hoarding is not better explained by the symptoms of another mental disorder (e.g., obsessions in
obsessive-compulsive disorder, decreased energy in major depressive disorder, delusions in schizophrenia or another psychotic disorder, cognitive deficits in major neurocognitive disorder, restricted interests in autism spectrum disorder)
How common is
hoarding?
Hoarding disorder occurs in an estimated 2-6% percent of the population and often leads to distress and prob-lems in daily functioning. Some research show hoarding disorder is more common in males than females.
How can our
treatment help?
As already stated, many of the underlying processes are the same behind both OCD and hoarding. While it can be essential to look at how the tendency to hoard may have come about, understanding one’s self and our relationship with intrusive thoughts and anxiety can play a vital role in the ongoing suffering of someone that hoards. Through carefully looking at every individual’s experience, we can help the person to shift those unhelpful coping strategies and look at more positive ways to respond to such anxious feelings and intrusive thoughts. Although it can be useful to be able to identify the origins of OCD and hoarding, this is not a necessity for a successful recovery.
The key aspects of our program that help to treat both OCD and hoarding alike are made up of Psychoeducation, Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), Mindfulness Based Stress Reduction (MBSR), Compassion Focussed Therapy (CFT) and talking therapy, which together prove to be very effective in treating both OCD and hoarding.
More specifically, helping clients challenge their beliefs around what it means to hoard, or throw things away, as well as learning how to sit with unwanted and painful emotions are particularly prudent for clients that successfully recover from both hoarding and Obsessive Compulsive Disorder.
Thank you for reading our guide
If you would like to find out more about treatment options for Obsessive-Compulsive Disorder (OCD) and hoarding please contact us today on:
Alternatively give us a call to speak to one of our friendly and professional team on: 01823 619 374
Recommended Reading and Resources
Buried in Treasures: Help For Compulsive Acquiring, Saving and Hoarding by David Tolin and Randy O. Frost Hoarding Disorder help: 15 Minimalist Steps to Help You Declutter by Milton Harrison
Overcoming Hoarding: A Self-Help Guide Using Cognitive Behavioural Techniques by Satwant Singh and Margaret Hooper
Understanding Hoarding by Jo Cooke
References
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA., American Psychiatric Association, 2013 Mataix-Cols D, Wooderson S, Lawrence N, Brammer MJ, Speckens A, Phillips ML. Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive-compulsive disorder. Archives of General Psychiatry. 2004;61:564–576.
Muroff J, Steketee G, Bratiotis C, Ross A. Group cognitive and behavioral therapy and bibliotherapy for hoarding: a pilot trial. Depress Anxiety. 2012 Jul;29(7):597–604.
Steketee G, Frost RO, Tolin DF, Rasmussen J, Brown TA. Waitlist-controlled trial of cognitive behavior therapy for hoarding disorder. Depress Anxiety. 2010 May;27(5):476–84.
Wu KD, Watson D. Hoarding and its relation to obsessive-compulsive disorder. Behaviour Research and Therapy. 2005;43:897–921.
