Hoarding is Complex and Challenging to Treat

As a concerned relative of someone who is unable to detach from his belongings or change his immediate environment, I would not advise you to do anything underhanded like taking his belongings out of his home without his consent, permission, or stated desire. To execute this type of plan would require that you placed your will over his will. Will this weaken or strengthen an already strained relationship? Do you think your relative would consider this a violation in trust? I think your relative’s problems are deeper than can be solved by a trip to U-Haul and cleaning out his home.

Compulsive hoarding has often been linked to Obsessive Compulsive Disorder (OCD) but recent research as shown it to be an independent condition which has often been linked to other psychological disorders; such as major depression, generalized anxiety, social phobia, post-trauma stress disorder (PTSD), attention deficit disorder (ADD), dementia, and grooming disorders (skin-picking, hair plucking, nail biting). Standard and traditional treatment has seen hoarding as a component of OCD and treating it as such. However, there is a difference between compulsive hoarding and OCD. Results from treating hoarding as a component of OCD has produced mixed results. Treatment is complicated and made complex as hoarders are often disorganized, in denial, and forgetful when taking scheduled medications.

The problem with getting hoarders to treatment is that they do not see anything wrong with holding on to their possessions and do not consider it a psychiatric disorder. The argument could be made that they overly attached to material objects which may be seen as more reliable objects than the people in their lives. Something to consider when considering any type of intervention…

Standard interventions for hoarding include, but are not limited to, Cognitive Behavioral Therapy (CBT), medication (Seroxat or Paxil, Prozac, and Effexor), intervention, and self help groups. A combination of CBT and medication appears to be the most effective treatment for compulsive hoarding. Some sources for more information about hoarding can be found at these websites:

• http://www.compulsive-hoarding.org/OCD.html
• http://www.compulsive-hoarding.org/Diagnosis.html
• http://www.compulsive-hoarding.org/Treatment-options.html
• http://psychiatry.ucsd.edu/OCD_hoarding.html
• http://www.ocfoundation.org/hoarding/types.aspx

A friend recommended a book which offers a greaat resource and recovery program for compulsive hoarders. Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding by David F. Tolin, Randy O. Frost, and Gail Steketee. I would encourage you to investigate this resource as it has been highly recommended and can be found on Amazon.com.

From a careful review of professional literature, most people are shown to not fully understand the phenomenon of hoarding as laymen or professionals. I would highly recommend that you support your relative by supporting him in seeking a professional assessment for hoarding or any other associated psychological concerns by a qualified mental health professional. As importantly, I would attempt to identify and utilize professionals or programs which can give evidence to their success in treating hoarders.

My sincere wish is that your relative obtains the help needed to overcome the hoarding and stop the suffering or distress for all involved. If I can be of further service to you, please do not hesitate to contact me.

Respectfully,

John W. O’Neal, Ed.S, MSW, MA, LPC, NCC