Aging in Place with Grace

Someone’s Trash – The Problem of Hoarding Part 2

English: Living room from a person with compul...

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In our last article, we defined what hoarding behavior is and why it causes so much havoc in not only the life of the hoarder, but on friends and family as well.  It becomes an issue that needs to be dealt with when it creates an unhealthy or unsafe living environment, disrupts family and friend relationships, serves to compound a mental health issue or isolates someone so much that it threatens their very existence.  Now let’s look deeper into how best to help someone with this behavior.

If you search on the term “hoard” you will inevitably see that it is said to be connected to obsessive-compulsive (OCD) behavior.  I believe, however, that while it may have an OCD component, it more frequently follows the path of an addiction.

Recently Lance M. Dodes, M.D., a professor at the Harvard School of Medicine and author of The Heart of Addiction (HarperCollins, 2002) and Breaking Addiction: A 7-Step Handbook for Ending Any Addiction (HarperCollins, 2011) became a consultant and advisor for us.  Dr. Dodes’ opinion on addiction is that, “Virtually every addictive act is preceded by a feeling of helplessness or powerlessness.  Addictive behavior functions to repair this underlying feeling of helplessness.  It is able to do this because taking the addictive action (or even deciding to take this action) creates a sense of being empowered, of regaining control – over one’s emotional experience and one’s life.”  Dr. Dodes labels this feeling a “trigger.”

Over the years of working with people affected by hoarding behavior, invariably at some point they reveal certain details about a past event that has caused them to feel hopeless and helpless and often will say that they never hoarded things until that event happened, hence my tendency to relate hoarding behavior to an addiction.  When a client says they never hoarded things until their son died or they became divorced, they are experiencing this “trigger.” Similarly, an upsetting memory of never having a new dress in childhood is another example of how past events are played out through hoarding.  This is evidence of a spark that causes this person to react in a way that, to them, restores their control. The person experiencing this feeling of helplessness is now coping by deciding when, how much and what they will save or collect, as this visually surrounds them with things that comfort them and give them false security of a restoration of power, even if it is saving every newspaper or plastic bag or continually purchasing unnecessary items.

In order to create or return a living or working space to a healthy and safe one, it is obvious that the choices of what to keep and what to get rid of are going to have to be made, but not by us.  The overall goal is to guide the person into recognizing what has triggered the feeling of not being able to let go or discard something and to redirect it to a healthier choice. The core concept is that the person is not tied to the object or item itself, but to the memory of what that item represents.

Arguably, this is a difficult and exhausting process and is fraught with unfaced feelings, anger and the old helpless/hopeless cycle.  And unless there is support from family members and friends, the road becomes all the more difficult.  Many have given up on this person, thinking that they will never change.  The families and friends often experience a feeling of hopelessness over this person’s behavior and have either accepted it or ignore it. They become enablers for this addiction.  But for the hoarders and their families who are willing to face their fears, it is possible for them to carve out a new way of thinking and behaving. It takes time and patience to tackle cleaning up spaces that have become overwhelmingly chaotic.

Does this work every time?  Definitely not.  Hoarding is one of the most difficult behaviors to change, if it can be changed at all.  But that does not mean that someone with this problem should give up – quite the opposite.

These feelings are nothing to be ashamed of.  If a person can admit they are a hoarder, they have taken the biggest step there is to finding a way to solve the problem.  If you or someone you love has experienced hoarding and would like to find ways to cope with this disorder, it is wise to seek treatment from a mental health professional first, however a word of caution.  If the person who is hoarding does not feel that there is a problem with this behavior, there is little anyone can do to help; for it is very true that “you can’t change what you don’t acknowledge.” When a therapist asks us to become part of a treatment plan (as the majority of therapists will not carry out therapy in a patient’s home), we work at the direction of the therapist.  But whether in treatment or not, the goal remains the same: creating clean and simple spaces.

 

© Dr. Jill M. Bjerke 2012. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to [Your Name] and [Your Blog Name] with appropriate and specific direction to the original content.

 

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