Hoarding – Could the brains of hoarders really be different?


By David Joel Miller.

Hoarding is about to become a recognized mental illness.

Hoarders just can’t make decisions when it comes to their own stuff. They don’t have trouble evaluating other people’s things, just their own, according to a study funded by the National Institute of Health.

There has been a lot more publicity about this than in times past but I have to believe that there have always been hoarders. People who lived through the “Great Depression” (1929 not 2008) tended to keep lots of stuff because if you ran out of wire or nails there might not be money to buy more. That is not the sort of saving that gets diagnosed as hoarding.

There seems to be something uniquely different about the way the mind of a hoarder works. Even when outsiders come in and reorganize the place, dispose of the garbage, the problem is not solved. The hoarder faced with new stuff, today’s mail or a left over napkins and condiment packets from fast food, can’t make a decision about what to keep and what to save. The result is they keep everything.

Proposed for inclusion in the new DSM-5 the new “Hoarding Disorder” is a fairly straightforward diagnose with only a few characteristics needed to make the diagnosis.

The characteristics needed, in my over simplified explanation of this one are:

1. Can’t bear to throw things away whether they are worth saving or not.

2. They feel like they must keep it and get upset if forced to part with the item.

3. As a result of the hoarding they run out of room and can’t use parts of their home for what it should be used for.

4. Hoarding is causing them problems with job, friends, making them unhappy or creating an unsafe situation.

5. No other reason, medical etc., for this behavior is found

6. This is not caused by another mental illness like depression or anxiety etc.

Points one to three are what makes this disorder different and points four to six are standard conditions for almost all diagnosis to look for other possibilities and make sure this really is a problem before making the diagnosis.

There appear to be two types of hoarders.

Those who are indiscriminate collectors and go out of their way to get new stuff, buying, stealing and scavenging things even when they have no use for the item.

Those hoarders who do not go out of their way to get things but can’t figure out what to keep and what to toss after they get things.

Whichever type of hoarder you or a person close to you are, the hoarder needs help. Cleaning out a hoarder’s collection is a short-term temporary fix. Hoarders need help from a profession to change their thinking or the whole process of accumulating just keeps repeating its self.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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2 thoughts on “Hoarding – Could the brains of hoarders really be different?

  1. I’m pleased that Hoarding Disorder is likely to be a stand-alone mental health diagnosis from next year. That it’s distinct from OCD is in line with my experience. I’ve worked with many hoarders who show neither the compulsions nor the obsessions of OCD.

    I help people all over the world declutter and create homes they love (I provide a free masterclass at http://www.mygreenandtidylife.co.uk) and I hope that this change will encourage more, and more appropriate/targeted, research into this much misunderstood condition, and treatments/interventions for it.

    I have encountered hoarders who fit neither your first nor your second criteria though. It’s not that they can’t bear to part with things, it’s more that it never seems like a priority to them. So they end up in squalor, with absolute rubbish (supermarket receipts, carrier bags, empty pill packets etc) all over the floor and surfaces, mixed up with items they want and need. When the situtation reaches crisis point (e.g. their home becomes a hazard to children living with them or neighbours and Social Services get involved), they are willing to address the problem and can quite quickly work through sections of their home making rational decisions. The challenge is to work with them long-term so they build up habits and attitudes that enable them to stay clutter-free for good.

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    • Thanks for adding that information. My guess is that once Hoarding Disorder becomes official we will see others who don’t fit the “types” and our understanding of the disorder will change. Please consider telling us more about your experiences working with people who hoard.

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