Compulsive Hoarding Research Paper

Hoarding: The Obsessive Compulsion to Collect Anything and Everything

Many people might claim that they know of someone who can be classified as a “pack-rat.” This type of individual usually has an accumulation of seemingly unnecessary items and refuses to discard them. These items may be a pile of clothes that have not been worn in years or a stack of books that are unlikely to be read. When confronted, this type of individual might claim that these items cannot be thrown away due to their “sentimental value” and/or “potential usefulness”. In many instances, the accumulation of superfluous items by this type of individual isn’t a serious problem that inhibits him or her from living a normal functional life. However, for some individuals that

are labeled as “pack-rats,” their situation is particularly distressing. It is not uncommon for every square inch of floor space in the homes of these individuals to be completely covered in a plethora of miscellaneous items. These individuals are classified as compulsive hoarders: their excessive acquiring impulses have become so uncontrollable that it is not only drawing the attention of others-- it is ruining their lives.

Many people that know compulsive hoarders lack understanding of the reasoning behind the hoarders’ rather perplexing behavior. There are many questions regarding the subject of compulsive hoarding: What is compulsive hoarding disorder? What causes compulsive hoarding? To what extent can compulsive hoarding disorder be treated? Compulsive hoarding is a type of behavior characterized by three main features: 1) the accumulation of and failure to discard a large number of seemingly useless objects, 2) extensive clutter in living spaces that prevents the initially intended use of the space, and 3) significant impairment caused by hoarding (Bratiotis et al. 4). There are a number of potential causes for hoarding; however, it appears to me that the primary cause for the disorder is traumatic events in an individual’s life, such as the sudden, unexpected death of a loved one, sexual and/or physical abuse, community violence, etc. These traumatizing life events can lead an individual to doubt their sense of security, thus causing him or her to resort to self-medication through excessive acquiring (Frost and Steketee

91). While compulsive hoarding disorder is incurable, it is manageable. There is a treatment offered to hoarding patients called cognitive behavioral therapy (CBT). This therapy can help a hoarding patient: 1) make more reasonable judgements when deciding if an object is valuable enough to be kept 2) learn how make quick decisions on whether to keep an object or discard it, and 3) practice discarding items regardless of the intense emotions they may trigger ( Metcalf 3).
For many years, compulsive hoarding disorder was believed to be a symptom of obsessive compulsive disorder (OCD). However, as more research has been done, experts have come to the conclusion that compulsive hoarding is not directly related to OCD (Metcalf 2). As a result, compulsive hoarding has recently been recognized as its own mental disorder in the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5.) According to the DSM-5, compulsive hoarding is characterized by the persistent difficulty of discarding possessions, regardless of their limited value, as a result of a strong perceived need to preserve the items. I admit, there does appear to be an element of compulsion in the accumulation of clutter and the inability to discard of it on one’s own volition; however, there other aspects of the hoarding disorder that makes it distinctive enough to be a mental disorder in its own right. For example, one distinguishing element of hoarding disorder is that the compulsive, excessive acquisition and accumulation of seemingly useless objects results in a pleasurable feeling; this is not the case for compulsions in OCD (“Similarities and Differences”).
Hoarders often times excessively acquire items that they consider to have sentimental value. These items are usually common possessions such as books, clothing, containers, etc. (“Hoarding Fact Sheet”) In the eyes of others, these items are considered “junk” because they hold no obvious value and/or serve no immediate use. Over time, severe clutter in a hoarder’s home causes functional consequences: “[c]lutter impairs basic activities, such as moving through the house, cooking, cleaning, personal hygiene, and even sleeping” (DSM-5). In extreme cases, severe clutter can put a hoarder at risk for major injury, poor sanitation, health issues and even death (DSM-5).
There are various theories as to what causes compulsive hoarding behavior.

Experts on the disorder suggest that causes for compulsive hoarding include, but are not limited to: 1) difficulty processing information, 2) strong beliefs about the value of possessions, and 3) the emotional distress associated with discarding the possessions, possibly due to a traumatic life event (“Hoarding: A Compulsive Mental Disorder”). I believe that traumatic life events are the greatest cause of compulsive hoarding behavior. In most cases, hoarders’ claim that there was some type of trauma that triggered their compulsive behavior. Such events can include the death of a friend or family member, domestic violence, physical and/or sexual abuse, etc. These events cause hoarders a great deal of pain, instills trust issues in the individual and makes them doubt their sense of security. As a result, hoarders turn to excessive acquiring as a way of coping with unbearable pain they feel. Many hoarders claim that they experience a “rush” or a “high” when they acquire new items--especially if the item is free or on sale (Slanzi). This pleasurable feeling serves as a distraction from the bad thoughts associated with previous traumatic events: “Accumulating “stuff” fills the emotional hole left by the trauma and allows individuals to avoid dealing with the pain” (Slanzi). However, this form of self-medication is only a temporary fix and hardly serves a truly beneficial purpose; eventually,

self-medication through excessive acquiring worsens the life of the hoarder. Compulsive hoarding behavior usually results in the inability to form and maintain functional relationship with other humans (Slanzi). Hoarders often times become so attached to their possessions that they view the items as more important than the relationships they have with people--even friends and family (Slanzi).
Many people assume that an individual’s compulsive hoarding behavior is merely a result of him or her being “lazy” or “messy.” These people make this assumption due to their ignorance of the severity of the trauma-related psychological pain the typical hoarder suffers from (Slanzi). I admit, however, that their lack of knowledge on effective treatments for the disorder is not entirely their fault. Many television shows and other popular media assert that compulsive hoarding can be solved by simply clearing out the home of the hoarder; I assure you that this is not the case. Massive clean-ups in hoarders’ homes fails to address and fix the underlying problem behind their compulsive behavior: “Families and community agencies may spend many hours and thousands of dollars clearing a home only to find that the problem recurs, often within just a few months. Hoarders whose homes are cleared without their consent often experience extreme distress and may become further attached to their possessions. This may lead to their refusal of future help” (“Hoarding Fact Sheet”).