What is it?
Hoarding is the unnecessary and excessive collection of items, object, keepsakes, supplies, without being able to discard them.
Even a person hoards small, little items rarely, over time the collections grow until there is little room left for other aspects of the hoarding person’s life. As such they tend to live in significant discomfort in tiny fractions of their homes which may be filled to capacity. Often they have only tiny passageways through their collection.
Nor are collections limited to non-living items. People frequently collect and hoard animals – keeping dozens, and hundreds of pets and being unable to care for them descending into unsanitary and unsafe conditions.
Hoarding, also known as compulsive hoarding and compulsive hoarding syndrome, may be a symptom of obsessive-compulsive disorder (OCD). But many people who hoard don’t have other OCD-related symptoms.
How can CBT Help?
There are CBT protocols designed specifically for hoarding; they address:
- Information processing: People who hoard have trouble making decisions regarding whether to keep possessions or not, and with organization and categorization. As such, treatment focuses on skills in sorting, organizing and decision making.
- Emotional Attachment to Possessions: It is not uncommon for people who hoard to report an intense sentimental attachment to objects. This attachment, of course, can make it difficult to discard objects that otherwise have little to no value. Therapy using techniques such as cognitive restructuring and exposure are used to challenge beliefs around these objects and explores the true consequences of discarding such objects.
- Beliefs About Possessions: Hoarding often involves an intense belief that control must be maintained over possession and that there is a responsibility to ensure that possessions do not go to waste. Again, treatment focuses on cognitive restructuring and exposure to critically examine beliefs around possessions.
- Behavioural Avoidance: Although hoarding can destroy a person’s home and relationships, this behaviour does have the advantage of allowing the person to avoid making decisions, making mistakes, interacting with others, and facing the unpleasant task of organizing one’s possessions. The CBT protocol focuses on creating behavioural experiments that allow the person to face situations that generate anxiety, while at the same time replacing avoidance with more adaptive coping strategies.
Research into combining new protocols of treatment with different combinations of medication is ongoing.