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The Neglected Side of Hoarding

Compulsive hoarding has attracted a great deal of media attention. These media portrayals, whether they are television, newspaper, or other illustrations of the problem, tend to be somewhat unidimensional.  Yes, these individuals’ homes are frequently difficult to navigate, and, yes, these individuals appear to be excessively attached to items that many of us view as of very little or no value. However, these snapshots into the lives of these individuals sometimes lack the depth of difficulty these individuals have in their lives.

Let’s look at a few of the challenges that are often under-conveyed, but that are very real, very significant challenges to individuals, their family members, and to us, as psychologists who treat them.

  • Interpersonal Difficulties. Hoarding behavior frequently leads to social isolation in individuals who reside alone. They tend to keep to themselves and do not have guests in their homes. This can lead to problems with depression, loneliness, and further difficulties. Adult children often have strained relationships with a parent who hoards, as the stress of the situation causes significant conflicts.
For those who do not live alone, this behavior is frequently a significant strain on a marriage and on relationships between the individual and his/her children. Feelings of anger, resentment, sadness, embarrassment, and frustration are commonly reported by such family members.

  • Co-Occurring Psychopathology. These individuals frequently have co-occurring psychopathology which poses an added challenge to their treatment and to improving their living conditions. For example, 60% of these individuals meet criteria for major depressive disorder.  Other conditions that commonly co-occur include social phobia (30%), generalized anxiety disorder (25%), and obsessive compulsive disorder (15%-17%). These problems also need to be identified and treated.
  • Perfectionism and other Erroneous Beliefs. Compulsive hoarders frequently have thoughts, beliefs, and values that are maladaptive and contribute to the maintenance of the problem. For example, an individual may believe that they must clean and organize their kitchen perfectly. They then get overwhelmed by this expectation and do not approach the task at all because they believe they will not do it perfectly.
By avoiding the task, they avoid experiencing those unpleasant, anxious, overwhelmed feelings, but the clutter continues (negative reinforcement). These engrained patterns of thinking need to be identified, challenged, and replaced with more adaptive thoughts, a major goal in therapy.
  • Insight and Desire to Change. Many individuals are considered to have poor insight and are resistant to change; however, this is often misunderstood. These individuals typically know there is a problem and they experience a great deal of anxiety about failed efforts or desires to change, but their anxiety can be so significant that it is paralyzing.

Many of these individuals have made efforts to change their environment. They do not have guests in their come, as they know that their home would not be met with approval, yet their tendency toward over-valuing of their belongings, fear of losing their belongings, as well as many other associated worries leads them to emotionally shut down and reject assistance, leaving them prisoners in their own homes.

Contrary to some beliefs, individuals who hoard are not simply “lazy.” Their difficulties are complex. It is only with compassion, understanding, and dedication that we may help these individuals improve their homes and their lives.

 

Dr Deibler

This entry was originally written by Dr. Deibler as a guest entry for the blog of professional organizer and talented “tech-ee,” Deb Lee, MA:
www.dallisonlee.com & www.organizetorevitalize.com

Lead photo available at 123RF

The Neglected Side of Hoarding

Marla W. Deibler, PsyD

Marla W. Deibler, Psy.D., is a clinical psychologist and nationally-recognized expert in anxiety disorders and the obsessive-compulsive spectrum, including trichotillomania and other body-focused repetitive behaviors, obsessive-compulsive disorder, hoarding, and tic disorders. She is the Founder and Executive Director of The Center for Emotional Health of Greater Philadelphia in New Jersey, an outpatient facility specialized in providing evaluation and evidence-based, cognitive-behavioral therapies for these and other difficulties. She currently serves on the Board of Directors of OCD-NJ, the New Jersey affiliate of the International OCD Foundation (IOCDF). Dr. Deibler gained her formative clinical experiences at the National Institute of Mental Health (NIMH) at the National Institutes of Health (NIH), Children’s National Medical Center, and the Kennedy Krieger Institute at Johns Hopkins University Medical Center. She gained specialized behavior therapy experience in the treatment of obsessive-compulsive spectrum disorders at the nationally-recognized Behavior Therapy Center of Greater Washington. Dr. Deibler served as a clinician at the National Center for Phobias, Anxiety, and Depression. She also served as Director of Behavioral Sciences at the Temple University School of Dentistry and served on the clinical faculty at Temple University Schools of Medicine and Allied Health as well as Temple University Children’s Medical Center. Dr. Deibler has published scientific research in peer-reviewed journals and has presented clinical training seminars and research findings at national and international meetings. She has appeared on the Dr. Oz Show, A&E’s “Hoarders”, TLC’s “Hoarding: Buried Alive”, CBS News, ABC News, FOX News, It’s Your Call with Lynn Doyle (CN8, Retirement TV), and CBS’s “Swift Justice with Nancy Grace”. She has been quoted by media outlets, including the Wall Street Journal, CNN, Philadelphia Inquirer, Philadelphia Daily News, and the Connecticut Post, among others. Dr. Deibler holds licenses to practice psychology in New Jersey (Lic. No. 35S100438000) and Pennsylvania (Lic. No. PS0157790). She is an active member of the American Psychological Association, Trichotillomania Learning Center, International OCD Foundation, OCD-New Jersey, Association for Behavioral and Cognitive Therapies, and Anxiety Disorders Association of America. Dr. Deibler resides in suburban Philadelphia with her husband (who is also a psychologist) and three children.


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APA Reference
Deibler, M. (2013). The Neglected Side of Hoarding. Psych Central. Retrieved on October 24, 2018, from https://blogs.psychcentral.com/therapy-that-works/2013/02/the-neglected-side-of-hoarding/

 

Last updated: 3 Feb 2013
Last reviewed: By John M. Grohol, Psy.D. on 3 Feb 2013
Published on PsychCentral.com. All rights reserved.