In a recent blog, we wrote about a specific subtype of Obsessive Compulsive Disorder known as Hoarding OCD. In that blog, we noted that Hoarding OCD seriously disrupts the lives of its sufferers.

Often, a massive accumulation of useless junk causes major portions of household living space to overflow and become unusable.

We also discussed the fact that those with Hoarding OCD have problems with their thinking, decision making, and organizing whereas those with other types of OCD typically do not experience such difficulties. Perhaps it should come as no surprise that the treatment for Hoarding OCD differs from other types of Obsessive Compulsive Disorder. We review in depth the treatment of all types of OCD in our book Obsessive Compulsive Disorder For Dummies.

For everything but Hoarding OCD, the absolute best and most researched treatment is what’s known as Exposure and Response Prevention (ERP). The core feature of ERP consists of gradually exposing the person with OCD to the client’s primary worries and fears (i.e., the triggers for the compulsions) and preventing the enactment of compulsive behavior designed to lessen the worry. For example, someone with Contamination OCD would be asked to touch doorknobs, dirt, motor oil, floors, and so on, while refraining from washing his or her hands until the distress comes down on its own.

ERP for Hoarding OCD doesn’t work so well. Sure, you can remove all of the people’s useless junk and ask them not to acquire more, but most of them will revert to their old habits rather quickly. Effective treatment of Hoarding OCD takes longer than other types of OCD and must tackle more issues. Among other things, the treatment must address:

• Teaching the person to see the costs and the benefits of the problem in detail

• Challenging dysfunctional beliefs about hoarding

• Training in how to make decisions

• Helping sufferers realize what’s truly essential and what isn’t; in other words, how to prioritize

• Teaching strategies for preventing themselves from accumulating “stuff”

• Working on tossing out the junk

If you, or someone you care about, suffer from Hoarding OCD, please seek out a professional with experience in this specific problem; it could take a little persistence because not all mental health professionals have this experience. We also highly recommend any of the books written by Randy Frost and Gail Steketee, renowned experts on this topic. They have workbooks, self-help books, and treatment manuals. One of their most fascinating books presents a series of case studies and is called Stuff: Compulsive Hoarding and the Meaning of Things. Highly recommended!

Photo by watchsmart, available under a Creative Commons attribution license.

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    Last reviewed: 9 Jun 2011