Compulsive hoarding (or pathological hoarding or disposophobia) is the excessive acquisition of possessions (and failure to use or discard them), even if the items are worthless, hazardous, or unsanitary. Compulsive hoarding impairs mobility and interferes with basic activities, including cooking, cleaning, showering, and sleeping. A person who engages in compulsive hoarding is commonly said to be a "pack rat," in reference to that animal's characteristic hoarding. It’s not clear whether compulsive hoarding is an isolated disorder or a symptom of another condition such as obsessive-compulsive disorder
There is no clear definition of compulsive hoarding in accepted diagnostic criteria (such as the current DSM), Yet, Frost and Hartl (1996) provide the following defining features:
In its worst forms, compulsive hoarding can cause fires, unclean conditions (e.g. rat and roach infestations) injuries from tripping on clutter and other health and safety hazards, according to Sanjaya Saxena, MD, director of the Obsessive-Compulsive Disorders Program at the University of California, San Diego.
The hoarder may mistakenly believe that the hoarded items are very valuable, or the hoarder may know that the accumulated items are useless, or may attach a strong personal value to items which they recognize would have little or no value to others. A hoarder of the first kind may show off a cutlery set claiming it to be made of silver and mother-of-pearl, disregarding the fact that the packaging clearly states the cutlery is made of steel and plastic. A hoarder of the second type may have a refrigerator filled with uneaten food items months past their expiration dates, but in some cases would vehemently resist any attempts from relatives to dispose of the unusable food. In other cases the hoarder will recognize the need to clean the refrigerator, but due (in part) to feelings that doing so would be an exercise in futility, and overwhelmed by the similar condition of the rest of their living space, fails to do so.
Although not commonly used by clinical psychologists, criteria for five levels of hoarding have been set forth by theNational Study Group on Chronic Disorganization (NSGCD) entitled the NGSCD Clutter Hoarding Scale. Using the perspective of a professional organizer, this scale distinguishes five levels of hoarding with Level I (Roman numeral one) being the least severe and Level V (Roman numeral 5) being the worst. Within each level there are four specific categories which define the severity of clutter and hoarding potential:
Level I Hoarder
Household is considered standard. No special knowledge in working with the Chronically Disorganized is necessary.
Level II Hoarder
Household requires professional organizers or related professionals to have additional knowledge and understanding of Chronic Disorganization.
Level III Hoarder
Household may require services in addition to those a professional organizer and related professional can provide. Professional organizers and related professionals working with Level III households should have significant training in Chronic Disorganization and have developed a helpful community network of resources, especially mental health providers.
Level IV Hoarder
Household needs the help of a professional organizer and a coordinated team of service providers. Psychological, medical issues or financial hardships are generally involved. Resources will be necessary to bring a household to a functional level. These services may include pest control services, "crime scene cleaners," financial counseling and licensed contractors and handy persons.
Level V Hoarder
Household will require intervention from a wide range of agencies. Professional organizers should not venture directly into working solo with this type of household. The Level V household may be under the care of a conservator or be an inherited estate of a mentally ill individual. Assistance is needed from many sources. A team needs to be assembled. Members of the team should be identified before beginning additional work. These members may include social services and psychological/mental health representative (not applicable if inherited estate), conservator/trustee, building and zoning, fire and safety, landlord, legal aid and/or legal representatives. A written strategy needs to be outlined and contractual agreements made before proceeding.
|Cluttered Lives, Empty Souls
Spending, and Hoarding
By Terrence D. Shulman
JD, LMSW, ACSW, CAADC, CPC
The Shulman Center