From Clutter to Calamity

At what point does hobby item collecting become unsafe, imbalanced or unhealthy hoarding?


A missing person's case in Las Vegas came to a ghastly end in August 2010 after a four month search. Billie Jean James had vanished from her home in April and had taken no belongings. There was no evidence of foul play. Metro police took the report and searched the home, a difficult task because the victim was a compulsive hoarder. Search dogs were brought to her home to no avail. The desert around Billie Jean's home was scoured extensively by Metro, community members, family, and friends for months. Then Bill James, her husband, made a shocking discovery in a back room of the house. He saw his wife's feet sticking out from under a ceiling-high pile of trash and clutter. The Clark County's coroner reported that the body's condition had deteriorated to the point that determining how she had died was impossible. Her death was deemed accidental.

You have probably seen one of several television shows about hoarders. You may know a compulsive hoarder. You may have even gone to a call related to checking the welfare of a hoarder, or complaints of offensive smells by neighbors. As you enter the home or yard, you notice an inordinate amount of clutter and the stench makes you sick. You have to ask yourself, How does anyone live this way?

Compulsive Hoarding Syndrome

Hoarders keep their possessions for the same reason others do: for sentimental value (to remember an important emotional attachment or event); for utility value (the object is or could be useful); or for aesthetic value (the object is considered to be attractive or beautiful).

People elevate the pros and cons of discarding objects:

  • This is too good to throw away;
  • This is important information;
  • I may need this later on;
  • This should not be wasted.
  • and more...

Obsessive hoarding involves amassing objects that have little if any value. Commonly hoarded items include: newspapers, old mail circulars, clothing, boxes, bags, decorations, and discarded food packaging. Hoarders can fixate on almost anything. Sometimes the items may be valuable but are in far excess of what can reasonably be used. Some people hoard garbage or rotten food. In extreme cases, items like hair, fingernail clippings and even feces are hoarded.

Professionals look for these three things when evaluating for compulsive hoarding:

  1. An inability to discard objects which appear useless that is coupled with discard anxiety
  2. Significant life distress or impairment in functioning due to hoarding
  3. A cluttered living space that has become so filled with objects that its functionality has become useless

Hoarders also display marked indecisiveness, disorganization, and procrastination. They are frequently perfectionists who postpone doing anything. They may appear lazy to others. Fundamentally they are terrified of making mistakes, including discarding items. In order to prevent making a mistake, they will avoid making decisions. Even the smallest task, such as washing the dishes, may take all day because it has to be done just right.

Epidemiology

Compulsive hoarding is a mental health condition that currently falls into a sub-category of obsessive compulsive disorder (OCD). It is also seen in individuals who have other disorders including anorexia, schizophrenia, and dementia. Because compulsive hoarding sufferers are often isolated and embarrassed by the secretive nature of their lifestyle it is difficult to determine how many individuals have the disorder. It seems likely that serious hoarding problems are present in between 2-5% of the population. Compulsive hoarding is estimated to affect up to 2 million people in the United States. It is an equal opportunity disorder affecting all age groups and both sexes. The initial onset for compulsive hoarding is believed to occur in childhood or adolescence, more specifically between the ages of ten and twelve. However, hoarding is a chronic and progressive process. The average age of a person seeking treatment for the disorder is fifty. Dementia and hoarding may be the only psychiatric disorders that actually increase in severity and prevalence throughout the life course.

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