What is compulsive hoarding syndrome, the mental disorder that leads you to live in the midst of garbage

Laura Plitt
BBC News World

4 hours

Caption,

Edward Brown is aware of his problem and is trying to overcome it and help other people in the same situation.

Teacups, empty jars, cans, stuffed animals, plastic containers, CDs… In Edward Brown’s house one can get almost anything.

Stacked one on top of the other without any apparent logic, the objects that Edward Brown has accumulated throughout his life have made his home a difficult place to inhabit.

“There is no room for people to move if they come here,” the 60-year-old from Blackburn, an industrial city in northern England, tells the BBC.

You recognize that you have a problem, but you have a hard time dealing with it.

“(The tendency) to collect stuff sometimes gets out of hand,” she says, “but the stress of living with that mess puts me in ‘leave me alone mode.'”

Brown suffers from what is known as compulsive hoarding syndromea mental disorder that generates in those who suffer from it a great difficulty getting rid of objects that for other people have no value or are of little importance.

“This difficulty disposing often leads to considerable clutter, making living space unnavigable” and where “rooms can’t be used for what they were designed for: you can’t use the kitchen for cooking or the room to sleep,” Gregory Chasson, a clinical psychologist and associate professor in the department of psychology at the Illinois Institute of Technology, in the USA, explains to BBC Mundo.

From newspapers, magazines, food containers, shoes and cables, to umbrellas or bottle caps. Things in good condition or destroyed by use and time, they become prized items for the hoarder.

It is a condition that does not distinguish between men and women, culture or socio-economic situation.

Affects at least one 2.6% of the world populationwith higher percentages in people over 60 years of age and in those with other psychiatric diagnoses such as anxiety or depression, according to the American Psychiatric Association.

And, the severity of your symptoms, according to a study published in the Journal of Psychiatric Research, “has gotten noticeably worse” during the covid-19 pandemic.

“As if she were my sister”

Another important characteristic is the strong impulse that people with this disorder have to acquire and save objects.

“It is not only the chaos that we can see but also that urge to buy things or pick up free stuffor to save objects that came passively into your life,” Christiana Bratiotis, associate professor at the School of Social Work at the University of British Columbia, in Canada, tells BBC Mundo.

“They want to preserve them because of the beliefs they have regarding these objects and because of the strong emotional connection What do you have with these?

Bratiotis says that some of his patients may say things to him such as, “This collection of objects means as much to me as it does to my sister. And to part with it would be like cutting all ties with it.”

“It represents part of their identity,” he explains.

Added to this is the belief that, one day, they can come to need these objects, either for their intended use, for an alternative use, or as part of a creative project.

The dangers of hoarding

The health dangers of not addressing this problem are multiple and more serious than they seem, starting with the physical ones.

“Compulsive hoarding can give rise to all kinds of dangerous environmentss: fire hazards, fall hazards, injury hazards, and a tremendous risk of infestation that increases the chance of developing diseases like asthma,” notes Chasson.

In terms of mental health, it leaves those who suffer socially isolated: they keep the secret of a condition “stigmatized by society, which interprets it as a problem of laziness, immorality or lack of personal standards and does not understand it as one of mental health”, argues Bratiotis.

Continuum

Although many of us can identify with the tendency to keep objects either because they are beautiful, just in case, because they bring us nice memories or because we think that we can find some kind of use for them – from the evolutionary point of view we are essentially hunter-gatherers and we tend to to bring and keep objects in our life – that does not necessarily make us compulsive hoarders.

It is important to understand that it is a behavior and, as such, “occurs on a continuum, ranging from mild to severeexplain Bratiotis.

When are we facing a case of compulsive accumulation or simply facing a person with a “collector’s soul”?

“Sometimes it’s a hard line to draw,” says Chasson, “but it becomes a problem and diagnosable when it causes impairment or distress for the individual or those around them.”

Also when the daily activity within the home is impossible by clutter and accumulation.

You probably have in your head the image of a house full to the ceiling of useless things, where a pin does not fit, with a mountain of accumulated objects that barely leaves room for its owner -a person of middle age or older- to pass through the gate.

It’s not ill-advised, but these are the most extreme casess, and those that arrive -for obvious reasons- in the news and television programs.

To get a more accurate picture you can refer to the photo below, which is one of the resources used to assess when hoarding has become a mental health issue.

It is part of a series of images showing 9 photos of a living room, 9 of a kitchen and 9 of a bedroom, ordered from 1 to 9 according to the number of objects accumulated (1 is without clutter, 9 is the most severe).

They come from a study published in the Journal of Psychopathology and Behavioral Assessment in 2008, and indicate that, above 3, we are in the presence of a compulsive hoarder.

Causes

The accumulation of objects, however, is only the manifestation of the problem, the obvious face.

“Underneath the clutter, both metaphorically and literally, are parts of this problem that are less visible, but are nonetheless very important drivers for the development of this behavior,” explains Bratiotis.

There are certain personality traits -difficulty making decisions, perfectionism and procrastination– which, when combined, can predispose an individual to developing compulsive hoarding syndrome.

Father and son with a collection of cars — Caption,

Unlike a collector who keeps and organizes a very specific type of object, a compulsive hoarder keeps all kinds of things that he stores in a chaotic way.

“We know that these people make decisions more slowly and question their decision almost immediately after making it,” he says.

There is no single cause for this disorder. “It’s not just the evolutionary biology, it’s not just genetics, or neurobiologybut all those things play a role,” says the researcher.

“We know that the brain of a compulsive hoarder works differently,” explains Bratiotis, noting that these differences were observed in CT scans of people who were asked to perform tasks that involved putting away and discarding possessions.

“We understand that the combination of these causes with some life experiences and in particular experiences around loss is what drives this problem,” he adds, which despite becoming obvious in middle age, begins to develop in childhood or adolescence.

“Research suggests that in more than 50% of cases the problem arises between 11 and 20 years old,” says Bratiotis.

“It can manifest itself with things like putting away objects that others consider garbage, but above all the thought process and beliefs around them“, tells BBC Mundo Chasson.

What happens is that it becomes obvious later, adds the psychologist, because children have people who order for them and one does not really have the possibility of collecting and storing things until later in life.

Treatment

To date, there is no cure. But the most promising treatment is specialized cognitive behavioral therapy in compulsive hoarding disorder.

The goal of CBT in the broad sense is to change the way people think in order to modify their behavior and improve how they feel.

“The results have been moderate. They are not irrelevant, but not completely successful,” says Bratiotis.

Woman with shopping bags. — Caption,

Some hoarders feel the urge to buy things.

It also seeks to make “interventions to reduce the severity and impact of its consequences, and improve the quality of life (of the person suffering from the disorder) and maintain achievements,” explains Chasson.

“And there are other modalities such as self-help groups with facilitators or different group approaches,” he adds.

Likewise, there is much that family or loved ones can do to help.

First, you need to approach the problem “with empathy and warmth, instead of taking an accusatory position, saying Me instead of You,” says Bratiotiss, giving the following example:

“You can say ‘I’m worried about you living in this house, because I know you’re going through something difficult and you can’t use this hallway because it’s blocked and I don’t want you to fall.’ It’s very different from saying ‘You need to clear this hallway. because you’re going to fall'”.

It’s also important to recognize that no matter how well-meaning they may be, friends and family aren’t always the best people to help, she adds.

Still, they can offer the accumulator support to seek and secure outside intervention.

Meanwhile Edward Brown, the Blackburn hoarder, is struggling to improve his situation and has helped set up a support group in his town to help others in similar conditions.

He says he’s “excited to support compulsive hoarders and see how they improve their lives.”