Compulsive hoarding 

Introduction 

Animal hoarding

Animal hoarding is more uncommon. It is considered a problem if the owner:

  • is not able to provide basic needs for the animals, such as food, shelter and veterinary care
  • is allowing their animals to live in poor conditions – for example, overcrowding or severe lack of hygiene
  • is not aware that the animals are having a negative effect on their personal health or the health of family members

The person hoarding will often not understand they are neglecting the animals and putting their own health at risk. They often have an emotional attachment to their pets, making it extremely difficult to give up any animals during treatment.

Read more: 

Video: obsessive compulsive disorder

Diana Wilson talks about how she dealt with her obsessive compulsive disorder (OCD) and the support available.

Compulsive hoarding means excessively acquiring items that appear of little or no value and not being able to throw them away, resulting in unmanageable amounts of clutter.

It is considered to be a significant problem when:

  • the amount of clutter interferes with everyday living – for example, someone is unable to use the kitchen or bathroom and cannot access rooms
  • the clutter is causing significant distress or negatively affecting a person's ability to function – for example, their social life, employment and maintaining a safe environment

People with hoarding difficulties may suffer from obsessive compulsive disorder (OCD), which may or may not be directly connected to their clutter problem. Hoarding is also often associated with other forms of anxiety and depression.

Compulsive hoarding is challenging to treat because many people who hoard don't see it as a problem, or have little awareness of their disorder and how it's impacting their life or the lives of others.

However, it's really important to encourage a person who is hoarding to seek help, as their difficulties with discarding not only cause loneliness and mental health problems, but pose a health and safety risk too. If not tackled, it is a problem that will most likely never go away.

This page explains:

Why someone may begin hoarding

The reasons why someone begins hoarding are still not fully understood. However, the problem tends to persist because:

  • the person finds it difficult to discard things
  • they may have problems with order, organisation and decision-making
  • they acquire more things than they throw away

The person will also have strongly held beliefs related to acquiring and discarding, such as:

  • "I may need this some day", which can be applied to a very wide range of items
  • "If I throw this away, I won't be able to cope with the feelings of loss"
  • "If I buy this, it will make me happy"

Attempts to discard things often bring up very strong emotions that can feel overwhelming, so the person hoarding often tends to put off or avoid making decisions about what can be thrown out.

Often, many of the things kept are of little or no monetary value and may be what most people would consider rubbish. 

However, there is always a reason behind keeping these items. For example:

  • sentimental reasons
  • because the objects appear beautiful or useful
  • the items "may come in handy someday"
  • they may have stockpiled food or clothes "just in case"

Compulsive hoarding is associated with:

  • a family history of hoarding
  • the experience of deprivation
  • growing up in a cluttered home
  • another mental health condition, such as anxietydepression or social phobia (a fear of social occasions)
  • struggling to cope with a stressful life event, such as the death of a loved one (bereavement)
  • lack of relationships with family or friends

Typical profile of someone who hoards

Someone who hoards may typically:

  • keep or collect items that are of no monetary value, such as junk mail and carrier bags, or items they intend to reuse or repair
  • find it hard to throw anything away and just move items from one pile to another
  • find it hard to categorise or organise items
  • have difficulties making decisions
  • struggle to manage everyday tasks such as cooking, cleaning and paying bills
  • become extremely attached to items, refusing to let anyone touch or borrow them
  • do not socialise with other people

Some studies suggest that hoarding often starts in the teenage years (as early as 13 or 14), where broken toys or school papers may be collected. The hoarding then becomes worse with age.

It is estimated that around 2-5% of the UK adult population experiences symptoms of compulsive hoarding.

Why compulsive hoarding is a problem

Compulsive hoarding is a problem for several reasons. Because of the amount of clutter, the person may not be able to use the rooms in their house for their intended purpose, or even be able to sit in a chair without having to move things.

In extreme cases, the piles of clutter can become a fire risk and can result in tripping and falling. Because the home is virtually impossible to clean, living conditions tend to be very unhygienic and can lead to rodent or insect infestations, blocked drains and other problems that may also affect neighbouring properties. 

The person hoarding is usually reluctant or unable to have visitors, or even allow tradesmen in to carry out essential repairs. People who hoard can be isolated and lonely and often experience anxiety and depression.

They may ignore the pleas of family and friends to get help, as they do not see it as a problem or cannot bring themselves to tackle it.

The hoarding literally takes over the person's life, causing their work performance, personal hygiene and social life to suffer.

What you can do if you suspect someone is hoarding

If a member of your family or someone you know is a compulsive hoarder, try to persuade them to come with you to see a GP. This will not be easy, as someone who compulsively hoards may not think they need help and may not want to seek treatment.

Ask your GP to refer you to your local community mental health team, which may have a health professional who specialises in OCD and is familiar with hoarding.

If you have difficulties accessing therapy, the charity OCD-UK may be able to help.

Reassure your loved one or friend that nobody is going to go into their home and throw everything out. You're just going to have a chat with the doctor about their hoarding to see what can be done and what support is available to empower them to begin the process of decluttering.

It's generally not a good idea to call in the council or environmental health to clear the rubbish away, as it won't solve the problem and the clutter often quickly builds up again. However, local authorities may take legal action to ensure that the property is cleared if the problem is not addressed.

Do not be tempted to get extra storage – this is only a quick fix, is costly, and does not address the problem. The problem is too much stuff, not too little space to keep it in.

How compulsive hoarding is treated

It's not easy to treat compulsive hoarding, even when the person is prepared to seek help, but it can be overcome.

The main treatment is cognitive behavioural therapy (CBT). The therapist will help the person understand what makes it difficult to throw things away and the reasons why the clutter has built up.

This will be combined with practical tasks and a plan to work on. It is important that the person takes responsibility for clearing the clutter from their home. The therapist will support and encourage this.

A type of antidepressant – selective serotonin reuptake inhibitors (SSRIs) – has also been shown to help some, but not all, compulsive hoarders.

Cognitive behavioural therapy (CBT)

CBT is a type of therapy that aims to help you manage your problems by changing how you think and act. It encourages you to talk about how you think about yourself, the world and other people, and how what you do affects your thoughts and feelings.

By talking about these things, CBT can help you to change how you think (cognitive) and what you do (behaviour), which can help you feel better about life.

The National Institute for Health and Care Excellence (NICE) recommends that a period of cognitive behavioural therapy is considered for adults who have significant problems with hoarding.

Regular sessions of CBT over a long period of time are usually necessary and should include some home-based sessions, working directly on the clutter. This requires motivation, commitment and patience, as it can take many months to achieve the treatment goal.

The goal is to improve the person's decision-making and organisational skills, help them overcome urges to save, and ultimately clear the clutter, room by room. 

The therapist won't throw anything away, but will help guide and encourage the person to do so. The therapist can also help the person develop decision-making strategies, while identifying and challenging underlying beliefs that contribute to the hoarding problem.

The person gradually becomes better at throwing things away, learning that nothing terrible happens when they do so, and becomes better at organising items they insist on keeping.

They may also be encouraged to keep a daily log of what they have purchased to monitor incoming clutter.

At the end of treatment, the person may not have cleared all their clutter, but they will have gained a better understanding of the problem. They will have a plan to help them continue to build on their successes and avoid slipping back into their old ways.

Page last reviewed: 05/09/2013

Next review due: 05/09/2015

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Comments

The 11 comments posted are personal views. Any information they give has not been checked and may not be accurate.

ALYSELINA70 said on 14 March 2014

My Hoarding and compulsive eating are causing me too much stress, I do not like any one to visit me as I feel ashamed.

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GreenAndTidy said on 05 December 2013

It's great that hoarding disorder is beginning to be better understood and supported.

From my experience supporting people (including hoarders) to declutter, I say to all those commenting here - there is hope. With a combination of psychotherapeutic and practical support, it's possible to manage the condition and create a home that works.

The person who suffers from hoarding disorder has to be willing/ready to address the condition though - forced clearances, while they may temporarily improve health and safety, are not a long-term solution.

That's why the "get a skip" comment is so unhelpful. It's not just about clearing out the unnecessary stuff - it's about developing new attitudes, habits and understanding that enable you to manage your stuff in the future.

If you're concerned about someone else's hoarding, keep gently exploring with them how they feel about their situation. Chances are, on some level, they know it doesn't really work.

If you are concerned about your own hoarding tendencies, your GP is your first port of call.

To add to Linjoghet's helpful method: include a "don't know" receptacle so that, if you can't decide, you don't get stuck. Just put the item you're not sure about in the "don't know" receptacle and move on. At the end of your session, go through the "don't know" stuff. If you're still not sure, keep it, but you might find that you are now able to decide because having refamiliarised yourself with items you may not have looked at in some time, your brain has had time to process the thoughts and emotions associated with them.

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Delphinia said on 10 September 2013

Can any one advice me how to get help for a relations friend,who I know is a hoarder, maybe not as bad as some but there are probably degrees of it. He had 2 failed marriage's not through this complaint though, but has now no contact with his adult children& has been on his own for over 20 odd years, he worked abroad a lot so we think he used his house just as a base as lots of men are not as fastidious as women. he has found love with my cousin& realises that he has some problem & needs to sort his life out should he wish the relationship to continue. Any advice to help would be appreciated

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dawniepops said on 19 May 2013

Can anyone help or advise me please. My brother is in his 70's an just been taken to hospital, his health is in a poor state due to his living conditions I have at last been into his house an could not believe what I found, it is uninhabitable and because there is mice or something in the house I have thrown all the food out as it was stacked high some of it green. I have not touched anything else in any other rooms. But I am worried that when an if he comes home he will go into a panick because of what I have done. I know it is his his decision if he wants help or not an he has every right to go home. He does not see there is a problem or that he needs care at home. Any advice greatly appreciated.

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kathybramley said on 16 May 2013

But we still need to ask, if the Smaugs of this world can sit on their gold, why can't the little people sit on theirs? Oh yes, it's a fire hazard, and it could make us stumble. How terribly ironic.

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susan1961 said on 14 May 2013

I have suffered this illness ever since I can remember, I'm so relieved that it is a recognised illness although treatment isn't always successful. I have tried CBT with little progress but sessions were limited to 8 which was never enough. I do want to be relieved of this awful illness and will see if I can have the drugs mentioned on this page, I have nothing to lose. The programs are nit understood by people, my friends just think I should get a skip, if only things were that simple. If anyone had helpful tips I am all ears.x

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tamale said on 23 April 2013

I have a friend with this problem, each time i help her get the clutter out it goes back with clutter worst, she has 3 kids and they dont understand their mom has a problem and do not help her at home at all, infact the house is currently not safe to live in, social seervice know but nothing is been done, is there any charities who can help her with therapy to enable her get rid of this clutter. Any suggestions will be appreciated.

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chopssmith said on 27 February 2013

Opaline, have you managed to find some help yet? The effectiveness of CBT seems to vary (the report I read at http://www.hoardinguk.org/3.html said that it helped in c. 45% of cases, but roughly the same number left the programme before completion), so I would suggest not getting too hung up on that particular issue. I believe that GPs should be more aware of the issue, and that the approach should be consistent across the country, as you seem to suggest.

I know some people for whom NLP has helped considerably, but is not currently funded by the NHS, and can therefore be very expensive. Personally, I have a strong interest in hoarding, and how to support people with this difficulty. I have recently qualified at a very low level in NLP, and would be happy to make suggestions to help, if I can.

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Opaline said on 27 December 2012

My GP has never heard of hoarding and wasn't interested enough to even look at photos I had taken of my home for him to see how serious it is. I was referred to local mental health team who told me that I don't need CBT and offered tips for tidying my house! I am SO angry and frustrated, and having depression, this only makes things so much worse for me. What's even more annoying, if I lived in the village 3 mile away, I would be with a different council and could get CBT straight away. I am at my wits end and feel so alone with this. Any ideas anyone? Please.

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Linjoghet said on 13 November 2012


At last ! I am delighted to learn that that the problems are being recognised.
The problem of hoarding and the problem of discovering how to help hoarders.
In my own case, I don't do any more acquiring than average but find difficulty in disposing of anything.
There has been a series of mental health professionals supposedly helping me. None have had very much effect. Each has either looked at me only or they have looked at the clutter only. Some were very nice caring people but didn't have much of a clue how to proceed.
However, I have made some progress in decluttering and my home now only contains 400 Boxfulls* of clutter. It was 500 a few months ago. Even this much has been well worthwhile. There is more space to enjoy living in. As I sort through the old stuff, most of it gets disposed of . But now and then I come across something I am really glad to find.
The method:-
# Clear the top of a table ( may well be difficult in itself )
# Arrange three receptacles. Recyclables, landfill, good stuff .
# Tell yourself " I am going to work "
# Carry one Boxfull to the table.
# Sit down in your "office".
# Pick out one item, decide and place appropriately. Immediately pick out next item, etc
# When you reckon that your shift is over, clear it all, and empty all receptacles.
# Have a cup of tea and enjoy the space that you have created.
( * The unit of Boxfull is defined as an actual full box or the equivalent amount of clutter. )
You are not doing any “throwing away”: That’s a negative action. Think positive. You are putting this item where it should be - the recycling bin or the landfill bin, or if you really to keep it, then on the right shelf. We are creating space by doing so.

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cluttergo said on 24 April 2012

I am so glad this is recognised by NHS, but GP's need to have more awareness and access to strategies to help "hoarders". I have just discovered my father has this illness, he has kept it a secret for 20 years, this has damaged his relationship with his children and denied him the involvement in his grandchildrens lives. He never let us into his house, we thought he didnt want us, but recently because he is ill, i forced him to let me in and discovered his hoard, narrow passage ways weave through junk joining the rooms together. This has also affected his treatment for his cancer, not opening the door to the pharmacists delivering his much needed medication etc. No one would have ever guessed he had it, because he is an intelligent man to talk to, this is all such a shame.

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