Hoarding is a phenomenon that has affected people for centuries. It’s not a matter of laziness, a lack of self-control or even a bad habit that causes people to hold on to rooms full of belongings that aren’t particularly valuable. Hoarding disorder is a distinct clinical diagnosis that’s related to obsessive-compulsive disorder (OCD), but researchers have only recently started studying it as such. 

In this blog post, we’ll discuss the psychology of hoarding and its widespread effects on individuals and families.

What’s the psychology behind hoarding disorder?

Most people with hoarding disorder inherit genes that make them more likely to develop it. When they see a close relative struggling with the condition, especially a parent, they may learn these behaviors by example. It can also be related to traumatic experiences that cause pain or create a sense of scarcity. Many people with this condition also have attention-deficit/hyperactivity disorder (ADHD), depression, OCD, or other mood and anxiety disorders. Thorough assessments and accurate diagnosis are critical steps that help ensure people with these conditions get proper treatment.

For people with hoarding disorder, keeping things isn’t a matter of choice. They may feel a sentimental attachment to certain things that remind them of fond memories or people they love. Or they may want to hold on to things because they’re unique or because they may need them later. However, the sense of security they may get out of saving things is matched with a fear of getting rid of the wrong things or letting them go to waste. Hoarding things is often a form of perfectionism or a compulsion. It can be painful for these people to have empty spaces in their homes. 

What’s the difference between collecting and hoarding?

Collectors typically accumulate things with a very specific theme. They may display them prominently and enjoy showing them off to other people. Those with hoarding disorder are more likely to keep anything and everything, especially things that don’t have much value to others. They may not see their behavior as problematic, but they often know that others do, so they often try to hide their things out of shame. This doesn’t mean they’re stingy or unfriendly. Many people with hoarding disorder are very generous and caring.

What are the signs and symptoms of hoarding disorder?

When someone has hoarding disorder, their accumulation of things causes problems in their life or their relationships. They may not be able to get around their home, or it may become unsafe. Severe hoarding can lead to unsanitary conditions, increased risk of falls, fire hazards, and health risks due to mold or pest infestations, posing serious safety concerns for individuals and their families. People with hoarding disorder have a lot of difficulty organizing or getting rid of things, regardless of their value. Hoarding disorder can affect a person’s ability to make decisions, and it can cause them to procrastinate. 

The following are some of the most common signs and symptoms of hoarding disorder:

• Feeling a need to acquire things regardless of whether they’re needed or whether the person has space for them
• Difficulty getting rid of things, regardless of their value
• Being upset by the thought of getting rid of things
• Building up clutter in the home that blocks walkways and fills rooms to the point that they can’t be used
• Perfectionism and procrastination
• Problems with planning, organizing or decision-making

What are the long-term effects of hoarding on individuals and families? 

Individuals with hoarding disorder eventually accumulate so much stuff that they can’t get around their house or use certain rooms for their intended purpose. This puts a strain on them, and at the same time, they’re distressed at the thought of getting rid of their things. They may feel ashamed of their home, and they may withdraw from their relationships. In the worst cases, people may lose their homes or their children.

Family members are usually concerned for their loved ones with hoarding disorder. However, they may have a hard time understanding the condition or supporting them effectively. They may show impatience or anger toward them, or they may threaten to cut off contact with them until they’ve recovered. Throwing out a person’s things without their knowledge or consent when they have hoarding disorder is very harmful. 

What treatments are helpful for people with hoarding disorder?

People with hoarding disorder may need psychotherapy, medication or a combination of both. With effective treatment, they can hope to change their habits and reduce the amount of clutter in their home. Learning strategies to manage their emotions and relationships is also an important part of their treatment. Family therapy sessions can help their loved ones understand what they’re going through and learn helpful ways to support them in their recovery.

The following are some treatment approaches that may be helpful for those with hoarding disorder:

• Cognitive behavioral therapy (CBT) — Typical CBT helps people learn to reflect on their own thoughts and feelings so they can choose responses that are more aligned with the life they want to live. Exposure and response prevention (ERP) is a form of CBT that helps people build up distress tolerance. Acceptance and commitment therapy (ACT) is another variation that helps people change their relationship to stressors and unpleasant thoughts.
• Motivational interviewing — This technique helps people find practical solutions for problems that they’ll feel good about. It focuses on helping them connect with their motivation and commit to improving their situation.
• Family therapy — Family therapy for hoarding disorder usually involves psychoeducation and creating empathy. Family members will learn about their loved one’s treatment and their roles in supporting them.
• Group therapy — Talking with others who have hoarding disorder can help people gain valuable perspective and hope for their future.
• Medications — While no medications are specifically approved for hoarding disorder, selective serotonin reuptake inhibitors (SSRIs) have been used with some success, particularly when co-occurring with anxiety or depression.

More than anything, people with hoarding disorder need care providers who understand their condition and treat them as a whole person. Feeling seen and understood helps them feel less ashamed and believe in their ability to change. The healing journey starts with baby steps. Over time, with the support of licensed clinicians and their friends and family, people with hoarding disorder can develop a sense of safety and security that isn’t tied to physical things.

At Lightfully, we provide comprehensive treatments that we personalize for each client’s unique lifestyle and mental health goals. We help people build up core processes that support long-term mental well-being.

Are you seeking mental health treatment for yourself or a loved one who has hoarding disorder? Reach out to our Admissions Concierge Team. Let’s talk about your next stage in life after hoarding and how we can help you get there.