Understanding Hoarding
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Overcoming Common Problems
Understanding Hoarding
JO COOKE
First published in Great Britain in 2017 by Sheldon Press
An Hachette UK Company
Sheldon Press
Carmelite House
50 Victoria Embankment
London EC4Y 0DZ
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Copyright © Jo Cooke 2017
All rights reserved. No part of this book may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopying, recording, or by any information
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British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
ISBN 978–1–84709–453–7
eBook ISBN 978–1–84709–454–4
For people who hoard
Contents
Acknowledgements
Note: for people who hoard, their families and friends
Introduction
1 What is hoarding disorder?
2 Why do people hoard?
3 Seeing the problem: learning to visualize clutter
4 Decluttering techniques and tips
5 How to help someone who hoards
6 Sustainability – keeping it clear
7 Where does my stuff go?
8 Helpful therapies
9 The professionals’ perspective
10 The voice of the hoarder
Useful addresses
Further reading
Search terms
Acknowledgements
I would like to acknowledge my true appreciation of all those who have
contributed to this book. In no particular order, thanks are due to Amanda Peet
for her role as former Director of Hoarding Disorders UK, for her passion and
also for her contribution to the section relating to Emotional Freedom Technique
in Chapter 8.
Thanks to Cherry Rudge for her wonderful contributions on ADHD and
perfectionism, for the diagram on ADHD and for sharing the story of her client,
Peter.
Thanks to Heather Matuozzo for K’s story and for her sound advice when I
have needed guidance, and to Lynn Howells for her openness, honesty and
support, not only with her contribution to the book but also her commitment to
our support group in Bracknell.
I would also like to thank all the people I have spoken with and met who have
been impacted by ‘stuff’ for their stories and contributions. Their input has been
invaluable in writing this book.
Note: for people who hoard, their families and
friends
It’s important to be sensitive in our use of language when talking about hoarding,
and we need to use terminology that respects individuals’ dignity and avoids
labelling them. ‘A Psychological Perspective on Hoarding’, a division of the
Clinical Psychology Good Practice Guidelines published by the British
Psychological Society, uses the term ‘people with hoarding difficulties’. One of
the people we work with prefers the term ‘clutteree’! However, when referring to
someone who hoards, for the sake of brevity and clarity I have also respectfully
used ‘hoarder’, a term which is in common usage and person-centred.
Certain names have been changed to protect the identity of the individuals
whose stories and contributions have been included in this book.
Introduction
For centuries, as a result of deprivation and scarcity, both humans and animals
have hoarded and accumulated not only foodstuffs but also objects. Just as
squirrels hoard nuts to feed themselves through the winter months, and magpies
collect objects for their nests, so do humans preserve and stockpile foods, water
and other essentials to see them through periods of shortage, recessions, war or
natural disaster. Many of us, too, were brought up by parents and grandparents
who were wartime babies, and who consequently hoarded to see them through
periods of rationing and austerity. Historically we have hoarded as a natural
response to being unable to gain easy access to certain foods and essentials, or to
being ‘stuck inside’ during bad weather. We stack and stock logs, tins of food,
coffee, nappies, toiletries and medicines. There are generations of ‘just in case’
hoarders, hateful of waste and fearful of running out. Observe food shoppers
panic buying just before bank holidays, at Easter and Christmas – loaves of
bread and bags of potatoes fly off the shelves.
Nowadays we so easily and readily dispose of many items, abandoning
clothes that are no longer in fashion, books we have read, household and
technological items that are no longer cutting-edge, toys that our children have
outgrown. With the ever-increasing urge to purge, and a growing culture of
decluttering, there is a new throwaway generation. Items can be so easily bought
and accessed: shops are open on Sundays, while buying online is easy and
readily accessible. If we need a new winter coat, we don’t wait until Christmas,
we can buy it here and now, at midnight, on our phone or our computer, and
receive it in three or four days, or even pay extra for next-day delivery. We have
throwaway plates, disposable napkins, pre-chopped garlic, pre-peeled oranges,
prefab houses, and electrical items that are not designed to be fixed or repaired.
Invariably, as our washing machine, TV or dishwasher becomes faulty, we tend
to replace it, not repair it.
Buy one, get one free – who can resist such a bargain offer? Shops in every
high street sell products for a pound, charity shops are popping up everywhere –
50p an item. There are car boot and jumble sales every weekend. Stuff is readily
accessible everywhere, and shopping and buying is steadily becoming a
recreation, a social event. No wonder our homes, garages and sheds are
crammed full.
In more recent times, it has been recognized that the reasons for hoarding are
not just deprivation and the need to survive disaster, but are far broader, more
complex. It is now widely acknowledged that hoarding can be linked to deep-
seated psychological and emotional issues. We hoard as a way of seeking
comfort and distraction from trauma and difficult life events, and hoarding is
often connected with other mental health issues. Hoarding is a solution to a
problem and can act as a comfort blanket, just as people may drink, gamble,
exercise excessively or over-eat as a coping mechanism.
Possessions play an important part in people’s lives. They can define who we
are as individuals, and provide us with pleasure, comfort, joy, convenience and
opportunity. But accumulating possessions that impact adversely on our living
spaces, put a strain on our finances, affect our physical and mental health, and
challenge our relationships and our homes can cause significant distress.
Hoarding can greatly affect a person’s ability to function and carries a high level
of risk to those who hoard, the people they are living with and others. Excessive
acquiring and saving, collecting items others have thrown away, and not
throwing anything away ourselves, can all qualify as characteristics of hoarding.
Hoarding is being increasingly recognized as a mental health disorder. The
media has done much to bring hoarding into the limelight, but the subject is
frequently portrayed in sensational terms. When the British Psychological
Society (BPS) issued a perspective on hoarding, one of its recommendations was
that ‘The national media should seek advice from experts including clinical
psychologists about the portrayal of people with hoarding problems and desist
from using mental health problems to entertain and shock the public.’
This book is designed to help those who are affected by hoarding difficulties,
including friends and family members. I hope it will raise awareness and provide
not only a better understanding of and insight into hoarding, but also tools and
techniques for those wanting to help. I hope too to help reduce the stigma
surrounding hoarding. Language used by the media, the portrayal of hoarders’
homes, and drastic means of ‘helping’, such as insisting on a dramatic clearout,
have all been damaging. It is not always possible, for example, for hoarded
homes to be cleared out within weeks, as is often portrayed on television. While
I find it enjoyable and satisfying to work with people who hoard, I want to be
able to help them to come forward without feeling that they will be judged and
subjected to a forced clearout without their consent. It’s important that, if they
want help, they should feel free to ask for it – not have it forced upon them.
Research in the USA over several years, and increasingly in the UK, is adding
to our understanding of why we hoard, and significantly contributes to how we
can help those affected by clutter. I would like to share with you some of these
insights into hoarding, some real stories, some ‘how tos’ and some ‘what to dos’,
so that hopefully you will feel better equipped to help someone you know who
may be affected by hoarding.
Did you know . . .
• hoarding disorder is now recognized as a mental health disorder?
• 1 in 4 people are affected by a mental illness?
• hoarding is not a lifestyle choice?
• 2–5 per cent of the population in the UK hoard?
• around 1.2 million people in the UK have hoarding disorder?
• according to a 1981 study, approximately 70 per cent of those who hoard
animals are single women?
• hoarding is also associated with other mental health issues – 57 per cent of
hoarders in a 2006 study were found to have a major depressive disorder?
1
What is hoarding disorder?
In this chapter, I shall present definitions of hoarding disorder (HD), describe the
condition and how it manifests itself, and look at the behaviours and thought
processes of someone who hoards.
Hoarding
Hoarding disorder was recognized as a mental health disorder within the
Diagnostic and Statistical Manual of Mental Disorders V (DSM-V) in May
2013. The five diagnostic criteria it uses to identify a case of hoarding disorder
are:
• Persistent difficulty discarding or parting with possessions, regardless of their
monetary value.
• This difficulty is due to a perceived need to save the items and distress
associated with discarding them.
• The difficulty discarding possessions results in the accumulation of
possessions that congest and clutter active living areas.
• The hoarding causes clinically significant distress or impairment in social,
occupational, or to other important areas of functioning.
• The hoarding symptoms are not restricted to the symptoms of another
disorder (e.g. hoarding due to obsessions in obsessive–compulsive disorder or
delusions in schizophrenia).
The DSM is an American publication and it may be useful to know that hoarding
is not yet entered in the World Health Organization’s International Classification
of Diseases (ICD), but it is anticipated that it will be in the next version, which is
to be published in 2018. Until May 2013, hoarding was only recognized as a
symptom of obsessive–compulsive disorder (OCD). Many hoarders exhibit the
same level of anxiety, compulsions and anxiety issues as those affected by OCD.
The conditions of hoarders’ homes are quite often challenging. Not all are
squalid and dirty but many are, with very little access to hot water and heating,
to a sink to wash up at or the use of a shower, let alone a bed to sleep in or the
use of a cooker. Toilets are often blocked, with damp and mould prevalent. Some
homes trap bad smells; others are deep in dust through the sheer volume of
paperwork and books, while the smell of rotting food, urine and cat faeces can
be overwhelming. With limited access to open windows, air within a hoarded
home is often stagnant and polluted.
Hoarding manifests itself in multiple forms, from the hoarding of yoghurt
pots or unusual-sized cereal boxes, to books and newspapers, animals, electrical
items, food, and more recently digital items.
At the extreme is the hoarding of substances produced by bodily functions, a
phenomenon referred to by environmental health personnel as ‘wet hoarding’. I
have occasionally seen houses where jars of urine were stored away in milk
bottles used so the person did not have to get up and go to the toilet in the middle
of the night. This is an example of when we should avoid presuming the case is
not one of hoarding but of laziness. But how do we treat wet hoarding? Just as
we would any other type of hoarding, but obviously with even more diligence
and care.
The implications and impact of hoarding are vast and present a range of
health, safety and fire problems. Research suggests that 30 per cent of accidental
deaths in domestic fires involve hoarding. The challenges presented by hoarded
homes can include difficulties in gaining access to gas and electricity, restricted
entry and exit access, water leaks, mould, and pest, flea and rat infestations.
Additionally, there are financial implications for those with hoarding
tendencies. They may not have access to their paperwork or know where it is.
Money is spent on replacing duplicates not only of important documents, but of
unpaid bills, lost keys and mobile phones. If environmental health officers are
involved in clearing a house, the costs relating to a forced clearout are charged to
the homeowner and a further charge made on the house. Financial pressures are
also presented by hoarders who have a compulsive need to shop.
Hoarders’ reasons for not discarding items are varied, and include:
• it would be wasteful;
• it cost money;
• it was a gift;
• I will miss it;
• I will forget;
• it is part of my history, or my present, or it represents possible missed
opportunities for the future.
Hoarding can be triggered by a severe trauma, bereavement, a sense of loss, grief
or poverty. Additionally, redundancy, low self-esteem and a lack of nurturing
and/or love felt as a child can trigger hoarding behaviours. Sometimes hoarding
behaviour can develop through the influence of parents, or be learnt. Some
people with hoarding difficulties may suppress their psychological pain by
hoarding. Confronting, recognizing and reconciling with traumas and other
emotional issues is often difficult. Hoarding can be seen as a solution to the
problem.
Adults who exhibit hoarding behaviours often have powerful reasons for
holding on to their acquisitions, whether for sentimental reasons, for their beauty
and/or aesthetic value, their usefulness (‘it might come in handy one day’), their
emotional connection to an event or person, their monetary value or for the
associated memories.
Hoarding is not just a private concern. Hoarding affects the whole family:
children, wives, husbands, parents, as well as best friends, pets, neighbours and
the wider community. Family members may experience embarrassment, shame
and guilt relating to the person with hoarding issues. Hoarding can have a
significant impact on family life; there may be increased tension and resentment
towards the hoarder. Hoarding can mean children are unable to have friends
around to visit or stay over. Family traditions and rituals can be compromised: it
may not be possible to eat at the table together, or to invite extended family over
at Christmas. In severe cases resulting in the loss of living space, homework
cannot be done, and sleep can be disturbed as children have to share beds.
Relations with spouses and other family can be strained.
The man with a thousand fishing rods
The most common form of hoarding is the hoarding of inanimate objects,
which can be quite unusual – porcelain pigs, egg cups, milk containers,
shoe polish or dental floss sticks, to name but a few.
We met one man who had a vast collection of fishing rods – for the sake
of round numbers, he called it a thousand, and certainly there were enough
to fill his bedroom. He had asked his local council to collect his bed, as his
fishing rods were kept in his bedroom and like many of those with hoarding
difficulties, he slept in a chair. Ironically, he rarely fished. He is now in the
process of downsizing to a smaller flat and has been motivated to sell his
fishing rods in order to raise funds for a new carpet and bed for his new
flat.
Hoarders quite often view their possessions with a sense of hope and
opportunity. They may value items that capture history, or they may collect
objects for their unique shape, their lovely colour or their usefulness. People who
hoard often describe such objects in intricate detail, enthuse at the unearthing of
a lost item, and perceive each object as a treasure.
They feel an attraction to their things, not only to obviously beautiful ones
such as the shiny silky texture of a fabric, but also to items with less obvious
qualities such as the coarseness of a Brillo pad, the texture of a ball of wool, or
the wealth of words in a local newsletter. A ball of string presents an array of
opportunities, usefulness, purpose and potential. Crafters can see the use in most
items – the lid of a milk bottle can also act as a chess piece or a serving plate
within a doll’s house kitchen, or may even be repurposed to act as a wedge to
prop up a door.
The ‘hoarder profile’
I am quite often asked if I can ‘spot a hoarder’. My immediate response is to say
no – there is no stereotypical hoarder. Many people with hoarded homes are
clean and functioning, and go to extreme lengths to present themselves as well,
hygienic, ‘in control’. However, it’s true that I can quite often spot a hoarder
while out shopping – just by the number of bags and shopping trolleys that such
people trail around with. Likewise, compulsive shoppers are easily spotted at car
boot sales and in charity shops, and demonstrate a sense of urgency and thirst in
purchasing their goods.
Physical implications
