Help a Hoarder

Hoarding occurs when individuals compulsively keep items and constantly buy or acquire new objects; these behaviors can cause social, economic, and health-related issues. People who suffer from hoarding disorders are sometimes aware they have a problem, but need to reach a point of wanting help in order to reclaim control of their lives. With this in mind, it is not possible to force someone who hoards to seek help or let go of items in her collection. If you know someone who has hoarding anxiety and has now admitted there is a problem, then you can support and educate her, assist in her recovery, and help to clear out some of the clutter.

Steps

Providing Support

1. Provide a listening ear to your loved one. One of the most powerful means of supporting an individual who hoards is to simply listen without judgment. Listening can help her articulate and process difficult feelings and thoughts. Instead of attempting to offer a quick solution, ask clarifying questions that help the individual to organize thoughts in a manner that motivates the solicitation of help with the problem.
   • Inquire about the reason for saving items. Individuals who hoard often save items due to beliefs in sentimental value, instrumentality (they think they can use it somehow or someday), and intrinsic value (they think it’s pretty or interesting in some way). Ask questions about the reason why the individual obtains or holds on to certain items.
2. Exercise patience with your loved one. While it may be difficult at times to understand why your loved one cannot part with a particular object that may seem like junk to you, hold your tongue and realize that she may not be ready to part with that item just yet.
   • Be cognizant that if your loved one does have a Hoarding Disorder (HD), the process of recovery could take time.
3. Consider and encourage treatment. If your loved one mentions that she wants professional help, ask if she would like help in locating and selecting a therapist. If she is torn between the desire to seek help and the fear of talking to a stranger about such a personal matter, offer to go along for a session or two as moral support.
   • The best form of help for a Hoarding Disorder (HD) would be therapy with a Find a Good Psychologist, Marriage and Family Therapist (MFT), or a psychiatrist.
   • Remember that the person who hoards may not want to get treatment. Do not force this idea on her.
4. Determine treatment options. The most common form of therapy for hoarding is Cognitive Behavioral Therapy (CBT). CBT for hoarding is focused on changing the thinking that maintains the hoarding in order to reduce negative feelings and hoarding behaviors. Individuals who hoard tend to respond well to Cognitive Behavioral Therapy (CBT). There are also group therapy options that are beginning to emerge.
   • Online help and support groups have been suggested as helpful for recovery from hoarding.
   • Explore medication options. Several medications have been indicated in the treatment of hoarding including Paxil. Consult a psychiatrist for additional information or to discuss psychotropic options.

Assisting in Recovery

1. Educate the individual who hoards. Once you have provided adequate support, psychoeducation of the compulsion of hoarding may be the best first step in helping your loved one. Understand that hoarding is associated with excessive clutter, difficulty discarding items, and excessive acquisition of new items. Due to the emergence of hoarding behaviors, a new diagnosis of Hoarding Disorder (HD) was added to the most recent and updated version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the basis for diagnosing mental health concerns.
   • First and foremost, hoarding can cause health and safety risks. Explain to your loved one that hoarding is dangerous because: it may prevent you from being able to escape in an emergency, does not adhere to fire codes, and can lead to mold and other harmful buildup in the home. It can also cause complications in activities of daily living (ADLs) such as walking, moving around, finding objects, eating, sleeping, and using the sink or bathroom.
   • Hoarding can lead to social isolation, disruption of relationships, legal and financial issues, debt, and property damage.
   • Some issues that may coincide with hoarding behaviors include negative and unhelpful thoughts such as perfectionism and fear of regretting removal of information or objects, over-attachment to material items, reduced attention abilities, and lowered capacity to make decisions.
2. Use assertive communication. Being assertive means saying how you think and feel while being respectful and appropriate. Discuss how you feel about your loved one’s hoarding, and the specific concerns that you have about your loved one’s health and safety.
   • Explain your concerns and set boundaries. Explain that you will not continue to live or be in the house if it is unsafe or unsanitary (if this is feasible).
3. Offer your help. Tell your loved one that you are willing to help her if she is open to assistance. Be aware that people who hoard can have very strong emotional reactions when asked to give away their belongings.
   • Assess the level of openness to your assistance. You could say something like, "I know you've been concerned about your hoarding and I am also. I am here to help if you want it. What do you think?" If the individual responds negatively and says something like, "Absolutely not, I don't want you forcing me to throw away my prized possessions," you may want to back off for a while. If the individual says something like, "I might be open to that," give your loved one some space to decide if she is willing to let you help. You can revisit the conversation at a later time.
4. Help set goals. Individuals who hoard need specific goals to work toward in order to be successful in reducing hoarding behaviors. This helps them to organize their thinking and plans associated with reducing their hoarding. People who hoard may need help with motivation, organizing, avoiding acquiring items and removing clutter.
   • Write down the specific goals you have developed with your loved one. This list might look like: reduce clutter, be able to move through the living room with ease, stop buying new items, and organize the attic.

Clearing the Clutter

1. Develop an action plan. In order to reduce hoarding behaviors, you first need to help your loved one develop skills and a plan for organizing items. Discuss the specifics of this plan with your loved one, and offer suggestions if she is open to them.
   • Identify specific criteria for keeping and discarding items. Ask the person who hoards what criteria she would like to create for getting rid of items versus keeping them. You could say something like, "Let's see if we can make a plan that will help us organize our time. Would you be open to making a list of reasons to keep items? What are the types of items that you absolutely need to keep? What are the types of items that you can let go?" Make sure your loved one is still open to receiving help, and if she is receptive to this idea you can move forward with your plan together.
   • Make a list of the criteria to keep or discard items. This might look like - Keep if the item is needed for survival or daily life, or if it is a family heirloom. Toss/sell/donate if item is not currently being used or has not been used in the last 6 months. Categorize and organize wanted items, as well as unwanted ones.
   • Talk about storage locations and systems of discarding items. Select interim locations during sorting. Sort items into categories such as: trash, recycle, donate, or sell.
2. Encourage problem-solving skills. There are particular skills that are indicated in assisting the recovery of hoarding behaviors such as organization and decision making techniques. Help the individual who hoards decide on rules for acquiring, keeping and discarding items.
   • Do not simply choose which items to trash, have the person with the hoarding problem make her own decisions based on the criteria you developed together. If she is unsure, help her refer back to the list of reasons to keep or discard an item. You can ask questions like, "Is this item necessary to daily life, has it been used in the last 6 months, or is it a family heirloom?"
3. Practice getting rid of items. Focus on one step at a time. Instead of trying to clean out the whole house in one day, try starting with a room that seems to elicit the least amount of anxiety. Develop a plan that moves systematically by room or type of space or object.
   • Start with easy items first then move to harder ones. Ask the individual where will be the easiest place to start; the place that she feels will be easiest for her to deal with emotionally.
   • Always ask permission first before touching any item that the individual is hoarding.
4. Ask or hire someone to help. Sometimes getting rid of clutter can be a time-consuming and emotionally draining process. Fortunately, there are organizations that specialize in cleaning, hoarding coaching and removal of items. Check your local newspaper or do a quick internet search to find an organization in your area.
   • If you find that hiring help is out of your budget, you can attempt to get other friends or family members to assist you. Try asking by saying, "She needs our help with her hoarding, do you think you can spare a day or two to help clean the house and get rid of some of the items?"
5. Assist in avoiding acquiring new items. Help your loved one identify problems with obtaining new items.
   • Work with your loved one to develop a hierarchy from easier to harder situations to deal with such as: driving by a shopping center, standing at the entrance of a store, walking through a shopping center/thrift store/mall, browsing a store, seeing an item you desire, physical contact with said item, and leaving the store without the object.
   • Ask your loved one questions that may help her to develop alternative thoughts about the usefulness or necessity of the objects she may want to obtain. For example, you can inquire by asking, “Do you have a specific use for this item? Can you survive without it? What are the pros and cons of having this object?”
   • Assist your love one in making rules for obtaining new items such as having a direct use for the item, needing the financial means to purchase the item, and requiring enough space to house the item.
6. Help the person who hoards take small steps toward recovery. Once the therapy has begun, the individual may be assigned small tasks to perform in between sessions, such as cleaning out one corner of a room or clearing out a single closet. Offer to help with this process by holding the box or bag that will receive the discarded items, but do not take on the task of cleaning out the closet yourself. Part of the recovery is that the individual who hoards must be the one to make the decision of what stays and what goes.
7. Expect setbacks. A person with a hoarding issue who successfully cleans out a closet one day may be incapable of tossing anything out the next day. Depending on the severity of the condition, the recovery period may take anywhere from a few weeks to a year or more before significant and consistent progress is made.

Educating Yourself about Hoarding

1. Recognize the possible causes of hoarding. Hoarding affects 2-5% of people above the age of 18. Hoarding is associated with, “alcohol dependence; paranoid, schizotypal, avoidant, and obsessive-compulsive personality disorder traits; insecurity from home break-ins and excessive physical discipline before 16 years of age; and parental psychopathology.” Hoarding behaviors can also be a result of the individual wanting to hold onto items that remind her of individuals who have passed away, or to keep special memories from the past alive. Hoarding behaviors also tend to run in families, especially for women.
   • Individuals with Hoarding Disorder may have brain abnormalities that result in difficulty identifying the emotional worth of an object, having normal emotional reactions and regulating emotions while making a decision (whether to buy, save, or throw out an object).
2. Know the negative effects of hoarding. People who compulsively hoard may be more likely to: be evicted or threatened to be evicted, be overweight, miss work, and have medical and mental health concerns.
3. Remember that a hoarding disorder may not completely go away. Like many types of illnesses, the goal is to learn how to manage the disorder, not expect it to go away and never come back. Your loved one may always have the temptation to hoard. Your role as a friend or family member is to help the one who hoards balance that temptation with all the benefits that come from keeping the impulse in check.

Tips

• While documentaries about hoarding make the process of getting past this type of disorder seems like something that progresses rapidly once the home is cleared of non-essentials, this is not always the case. Therapy to address the underlying causes that triggered the hoarding in the first place may be essential to recovery and could take time. While clearing and cleaning the home are important, it should not be seen as the end of the journey.
• Individuals who hoard move forward at their own pace. It is important to support your loved one every time a step forward does occur and to withhold being too judgmental when setbacks occur. Like many mental disorders, a combination of time, therapy and sometimes medication may be needed along with a lot of support from loved ones before the behavior is overcome.

Related Articles

• Stop Hoarding
• Perform an Intervention
• Deal with a Hoarder
• Encourage Someone Else to Let Go of Clutter
• Deal With Parents Who Hoard
• Get Rid of Clutter

Sources and Citations

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