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25 January 2012

Extreme hoarding

Some people have so much stuff in their homes they can hardly move around. And they keep on bringing in more and more junk. Why do people do this?

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Some people have so much stuff in their homes they can hardly move around. And they keep on bringing in more and more junk. Why do people do this?

What sort of disorder is this?
"Hoarding of both animals and things was long thought to be a form of obsessive-compulsive disorder," says Roné Gerber, Cape Town psychologist. "And while this is quite possible in certain cases, hoarders are often depressed, and sometimes respond better to medication for depression than to treatment for OCD. It must be remembered that hoarding can also be a symptom of quite a few other mental disorders, such as anorexia nervosa and dementia. All hoarders do not necessarily have OCD."

Many hoarders don't hoard animals - they hoard things such as newspapers, old tin cans, old containers, boxes, magazines, broken tools, and in some cases, rubbish collected out of neighbours' bins.

Many hoarders can hardly move around in their homes, and as these houses are crammed so full of things, little pathways often have to be made to get from the front door, to the bed, or to the toilet. This also leads to social isolation, as one cannot invite visitors to a home where such conditions exist.

Some people hoard animals of all kinds. Animal hoarders are not deliberately cruel to animals. They love their animals, but are unable to see that they are harming them by not providing adequate care, according to Wikipedia. They cannot provide them with adequate food, water, sanitation facilities and healthcare. The accumulation of urine and faeces in the home obviously poses a health threat not only to the inhabitants, but also to the animals themselves, and ultimately to the neighbours.

So what is hoarding and who does it?
So, if your neighbour isn't too tidy and you hardly ever see her throwing anything out, does that make her a hoarder? Not necessarily, so take care before you start throwing around accusations. The definition given of hoarding by Professor Randy Frost, professor of psychology at Smith College, is the following:

  • The acquisition of, and failure to discard, a large number of possessions that appear to be useless or of limited value;
  • Living spaces sufficiently cluttered so as to preclude activities for which those spaces were designed;
  • Significant distress or impairment in functioning caused by the hoarding.

Hoarders make up less than one percent of the population, according to Professor Frost. These people are often living on their own, are single, separated or divorced. Both men and women can become hoarders. Hoarding often involves elderly people, who lead lives of reasonable social isolation.

And many studies point to the fact that hoarders do not seem to be bothered by the conditions in which they live. On the contrary, the thought of someone else cleaning it all up, terrifies them. Many hoarders feel that discarding things such as old birthday cards would be like discarding the people who sent them. Some people hoard mounds of things such as old clothes for sentimental reasons.

An astonishing example of hoarding is mentioned by Dr. Fred Penzel in his book, Obsessive-Compulsive Disorders: A complete Guide to Getting Well and Staying Well. He tells of Langley Collyer, who, between 1933 and 1948, filled a mansion on Fifth Avenue in Manhattan with 120 tons of refuse, junk, and human waste. He would prowl the streets of Manhattan at night looking for items to rescue from the trash. Both he and his invalid brother, Homer, were found dead among possessions that included 11 pianos and all the components of a Model T Ford. Langley was actually crushed by a falling heap of heavy items he had rigged as a booby trap for burglars.

The objects that are hoarded by others may not always include pianos, but fall into four main groups: some are bought (such as groceries), or collected from other peoples' refuse (old newspapers or containers or broken implements), or received through the mail (pamphlets), or things just kept from years and years ago (clothes and birthday cards).

So why is hoarding a problem?
Often the extent of the hoarding is such that people are unable to use things such as the stove or the bath, as the clutter has made this impossible. And it is causing a health or fire hazard. Relatives also become loathe to visit, as they are upset by the disorder. Once a person has died, sorting out a house that is filled to the ceilings with mostly junk, can take weeks.

The keeping of many pets in a confined space obviously brings about problems of its own. Some people hoard dogs, others cats, or even birds. The authorities are usually alerted by complaints from neighbours to health departments or animal societies. This is what happened now in the Caledon case.

Why do people do this?
There seems to be an overriding fear amongst hoarders that they will discard something which they then need the next day, according to Dr. Penzel. Undoubtedly, being surrounded by these things provides a certain measure of security in an uncertain world. This goes for the keeping of excessive numbers of pets too.

"People who hoard are often highly perfectionist and have a fear of making mistakes and this stops them from making decisions to discard things," said Dr Frost in an interview on ABC news. "When people are depressed, they also are less motivated to organise things. Things such as newspapers are often kept for later perusal, but this never happens – it all becomes too overwhelming. And so does the thought of cleaning up."

What treatment is available?
For many years it was thought that hoarders suffered from a form of Obsessive-Compulsive Disorder (OCD). But treatment for OCD was found not to be very successful.

Not surprising, as researchers from the University College of Los Angeles, recently reported in the American Journal of Psychiatry that hoarding may actually spring from a unique, previously unrecognised neurobiological malfunction, which may lead to a rethink on the classification of psychiatric disorders. Many hoarders appear to be depressed, and a combination of therapy and anti-depressants is recommended by the experts.

Expert tips for families of hoarders

  • Simply cleaning up someone's house without their permission can cause an extreme reaction and is not recommended.
  • Stress the importance of reorganising things rather than discarding things. Throwing things away can be very threatening for the hoarder. Stress the importance of greater comfort that a clean-up can achieve.
  • For many the job of organising and cleaning out seems too overwhelming – it may be an idea to start with one spot in a room per day.
  • Use the fact that the hoarder's home can no longer be used for things like cooking, sleeping comfortably and getting clean to convince the hoarder that it is time to clean up, at least partially.
  • Remember that the hoarder keeps many thing out of fear of needing them later, but will probably be unable to find them among the huge mounds of stuff. There are other psychological reasons why these things are kept. Logical arguments will get you nowhere.
  • Get professional help for the hoarder.

(Susan Erasmus, Health24, updated January 2012)

 
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