Hoarding

Q:We recently moved close to my husband’s elderly aunt, whom he hadn’t seen since he was a teenager. Her house was filled with moldy newspapers and just “stuff.” There was literally no place to sit. This couldn’t be healthy, could it?

A: You describe a well-developed case of hoarding—and, no, it’s not healthy, on several levels.

Hoarding is a subtype of obsessive-compulsive disorder, in which affected individuals stockpile and have emotional attachments to items—regardless of the objects’ real value—that others view as worthless. Hoarders have a compulsive need to constantly acquire “stuff” and have difficulty in getting rid of possessions. The thought and process of discarding brings significant stress and distress, often because of fear of losing something valuable, important, or useful. This appears to be the driving force of the disorder. Hoarding is estimated to affect between 2 and 5 percent of the U.S. population, is more common in Western countries, and, unfortunately, is a growing problem.

Health Risks of Hoarding

• Sanitation

• Mold

• Indoor air quality

• Pest infestations

• Increased falls

• Fire hazard

• Collapsing clutter

• Structural damage to house

• Cleaning-related injuries

• Psychosocial problems

• Financial problems

• Legal problems

• Social “shunning”

• Social isolation

• Depression

As in the case you described, accumulated possessions grow to the point of blocking off living spaces (bathroom, kitchen, utility and clothes closets) and appliances (stove, refrigerator), thus affecting the ease of doing everyday household tasks, such as cleaning and cooking. As a result, sanitation and hygiene become challenging, and personal safety becomes compromised.

Interestingly, the situation is often not perceived by the affected individual as a “problem.” Clutter inhibits free passage, thereby increasing falls and injuries. It poses a fire hazard and impedes access by emergency personnel. Clutter invites and shelters pests, mold, and structural damage, increasing the risk of respiratory, allergic, and infectious conditions.

Genetics, brain functioning, and stressful life events are all being scientifically evaluated as contributors to this derangement. Although elderly people exhibit more extreme examples, most can trace telltale behaviors as far back as childhood or adolescence. Despite being more prevalent than anxiety, hoarding hasn’t received much attention. The main treatment, cognitive behavioral therapy, is highly successful but requires time, often six to 12 months. The goal is to help hoarders think through and “see” the situation; stop the acquisition; acquire new, effective, organizational skills; and begin the act of discarding the accumulated items. Hoarders often know that they can’t find things and realize they prize things that are of dubious potential usefulness, are spending unnecessarily, and are placing themselves at risk; but they have an inner script that overrides corrective action.

In a way, many of us have some tendency toward accumulating “stuff,” even knowing that our value isn’t based on our possessions and that discarding what isn’t useful may not necessarily be wasteful. But even our spiritual understanding may not fix this psychological problem, which is best attended to professionally and with Christlike compassion.

Peter N. Landless, a board-certified nuclear cardiologist, is director of the General Conference Health Ministries Department. Zeno L. Charles-Marcel, a board-certified internist, is an associate director of Adventist Health Ministries at the General Conference.