What is Hoarding Disorder?

Every now and again we might notice that our clothes aren’t quite fitting into our wardrobe anymore, or perhaps that pile of junk mail on the bench is getting just a little too high … and so we decide to get rid of a few things. You might find yourself wanting to hold onto a pair of jeans you haven’t worn in years, or an old assignment you’d written years ago that might come in handy one day. We are all guilty of this from time to time however for people with Hoarding Disorder (HD) these difficulties are excessive and may cause safety concerns, significant distress and have an impact on all other aspects of life too.

HD is a disorder primarily characterised by a persistent difficulty discarding or parting with unnecessary possessions such as old newspapers, junk mail or objects that most others would consider to be rubbish. The reasons people engage in hoarding behaviours may vary however people with HD may believe that they will need these possessions at a later date or that they hold some sentimental value that others are simply not aware of. Some even report feeling safer having these items around.

Hoarding in many cases will often lead to an extremely cluttered living space, which may result in a lack of hygiene, safety hazards and an inability to engage in social, recreational, educational or work related activities. This preoccupation and excessive attachment to ones possessions may often leave one feeling overwhelmed and so consumed with their excessive hoarding that they are unable to focus their attention onto other aspects of life.

What are the causes of Hoarding Disorder? 

While the causes for HD are not very well known, research suggests that there may be a number of triggers for the onset of HD:Personality: Research has found that hoarding may be linked to certain personality traits, the most prevalent being that of indecisiveness. In one study, those who exhibited significant hoarding behaviours reported more decision-making problems when compared to those who did not. These decision-making difficulties are associated with all three core features of hoarding including excessive acquisition, difficulty discarding items and clutter/disorganisation.

Genetics:

Hoarding does appear to have a genetic basis, with many individuals experiencing HD reporting at least one relative with hoarding problems. A recent twin study suggested that genetics factors account for approximately 50% of the variance in compulsive hoarding while non-shared environmental factors accounted for the other 50%.

Trauma:

Studies have suggested that individuals exhibiting significant hoarding behaviours were more likely to have experienced at least one traumatic life event when compared to those who did not exhibit such behaviours. It has been suggested that the accumulation of items is a coping mechanism used to fill the ‘emotional hole’ left by the trauma.

What are the treatment options?

Trauma therapy: The first and perhaps most obvious treatment option is trauma therapy. If trauma appears to be the trigger to ones hoarding behaviours it may be useful to engage in this style of therapy in which the trauma may be talked through until it is no longer distressing and processed in a comprehensive and healthy manner.

Attachment based therapy: Attachment based therapy may assist the individual experiencing HD to understand his or her own ‘unhealthy’ attachment and assist in creating a healthier attachment style instead.

Cognitive Behavioural Therapy (CBT): While evidence for the effectiveness of CBT in treating HD has been inconclusive it may be a useful therapeutic option to explore. By challenging ones falsely held beliefs and replacing them with healthier ones people with HD might be better equipped to reason with and deal with their beliefs around the significance of particular items.

HD is a highly misunderstood mental illness with a number of misconceptions, however over time we are slowly becoming more aware of its characteristics, causes and treatment options. HD can be a distressing and debilitating mental illness that can quickly take over a number of aspects of ones everyday life. Treatment, however is out there and with the assistance of both formal and informal supports, recovery becomes a realistic outcome.