Lots of us know we probably have a bit too much stuff, and our homes would be calmer and easier to live in after a good sort-out. But for around 2–5 per cent of the population, hoarding can be a real problem.
Far more than just being untidy or collecting things, hoarding is a compulsive desire to hold on to things that may or may not have value – and the volume can get out of control, sometimes taking over people’s homes entirely.
“The worst cases are often people who are really old and losing their health and mobility, and their homes are so hoarded that they can’t sleep anywhere apart from sitting on a step in the hall. One lady’s whole house was so full, she was sleeping almost standing up – there was about a square foot left free in the hall,” says hoarding specialist Heather Matuozzo, who set up a social enterprise called Clouds End to help hoarders.
Lynn Howells, who runs a hoarding support group and describes herself as “a hoarder who’s continuously dealing with a work in progress”, adds: “Hoarding often creates such cramped living conditions that homes may be filled to capacity, with only narrow pathways winding through stacks of clutter. Virtually all surfaces are usually piled with all sorts of items. When there’s no more room inside, the clutter may spread to the garage, vehicles, outside spaces and other storage facilities.”
Here, Ms Howells and Ms Matuozzo tackle some common questions about hoarding.
What exactly is hoarding?
“It’s the excessive accumulation of items and an inability to let those items go, even the ones that have no or low value, and the accumulation is so great that you can’t use your rooms for their purpose – so you can’t sleep in your bedroom, for example,” says Ms Matuozzo. “The symptoms also significantly impair other areas of your life, including health, work and relationships.
“Those with a hoarding disorder are typically stereotyped as unclean and lazy, but it’s more than that, possessions remind them of the past and foreshadow a potential future. They are extremely attached to the things they own, sometimes they don’t know why, but they do know they will feel great loss if those things are removed. This is why a hoarding disorder needs to be tackled slowly and with great empathy, evictions or forced clearances can be traumatising for the person.”
What ‘types’ of hoarding are there?
As well as hoarding disorder, there’s also chronic disorganisation, which Ms Matuozzo says is when people don’t know how to make homes for things.
“Often people have a certain level of hoarding, and if they can maintain that level and their house isn’t a fire hazard, the only people who’ll be annoyed with it are their relatives, who are going to have to clear the house when they die,” she says. “If it’s not affecting their lifestyle and they can still get around their house and access windows and doors; as long as there are no piles of newspapers that are fire hazards, and if they still invite people in and are happy about their house, then that’s fine. But it’s when those things start to slip away that it becomes an issue.”
The criteria for a hoarding disorder diagnosis include:
- difficulty discarding items regardless of their actual value
- a perceived need to save the items and associated distress at the idea of losing them
- clutter that prevents the home being used for its intended purpose.
What causes hoarding?
Ms Matuozzo says there can be a genetic propensity to hoarding, but the most common cause is trauma. “It’s a coping mechanism to deal with traumatic life events, usually involving loss. Bereavement is the most common one, but it can also be triggered by losing your job or a relationship, or even by empty nest syndrome. Sometimes it’s a combination of many things, (sometimes seemingly small) but if these things become overwhelming, subconscious coping strategies can kick in.
“You’re not aware you’re doing it, and that’s why hoarding is so difficult – it’s hidden to the person it’s happening to. Distraction is a technique often used as a way to stop painful thoughts from happening, and it comes in many forms. Some people drink, others overeat, and for some people acquiring things is the form of distraction that helps them get through the day.
“But we all acquire, we all buy stuff, and we’ve all got really special things we want to hold on to. That’s what makes it difficult – you don’t know at what point you’re actually hoarding.”
Are hoarders aware they’re hoarding?
“There’s very often an underlying acknowledgement. They can be very obtuse and say, ‘I’ve chosen to live like this, mind your own business’, and act like they are not bothered about the situation. But sometimes the person can’t see the problem hoarding is becoming.
If hoarders refuse to let people come into the home, it can show that they know there is a problem, but they don’t want it to be seen.”
How can you tackle hoarding?
Ms Howells says: “Hoarding should be tackled sensitively and individually. Have a support network, work with people you trust, make sure the hoarding person is at the centre and nothing is done without their permission. Getting them to make the decisions ultimately helps them cope in the long-term. Clearing everything out and making things ‘better’ often results in the person either digging their heels in and refusing help, or them acquiring more possessions very quickly after the clear out.”
Ms Matuozzo adds: “It’s difficult to force someone to tackle it – the person has to want to be helped. If they’re aware of the problem, you can work on it. But if someone’s saying, ‘This is my stuff, leave me alone’, that’s when it’s difficult because you’re going against their will.
“I try to lead with examples of how people have turned their lives around. But if you tell people they’ve got to get help, they may just clam up and refuse.”
Just thinking about disposing of their items makes people with hoarding disorder feel highly anxious. Their anxiety is similar to what others may feel about giving a speech or finding a spider in their shoe. Believing they can’t cope with the distress of losing their possessions, they hang on tightly. Doing so, unfortunately, strengthens their beliefs that their possessions are needed.
The current treatment approach teaches individuals how to challenge their beliefs about possessions. It also teaches them how to resist acquiring urges and how to sort, organise, and discard possessions. Unfortunately, this approach helps only a fraction who receive it and there are many more people out there without access to this help.
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