Explanation of Hoarding

We live in a time when owning something is important. From early childhood on, we become aware of the fact that possessions often separate us from others. It may be more toys than our friends. It may be our family lives in a bigger or better house, or has more cars, or we have more clothes. However, as these articles point out, there is a vast difference between possessing something for which we worked or which was given to us, and possessiveness, which is identified as on obsessive compulsive disorder. Even the ordinary "normal" human being cannot escape reading or hearing about someone's possessions, whether it is Fortune's survey of the world's richest men, or Architectural Forum showing off the mansions and homes of "important" people. However, "(T)he meaning of possessions and the role they play in our lives has received very little attention in the psychological literature in recent years (Frost & Gross 1992 367). What we need to investigate, therefore, is the fine line between wanting and having possessions and a somewhat unnatural desire to hoard- that is, to have possessions we may not actually want or need merely to have them. This is possessiveness at its most extreme, referred to as "hoarding".

"Compulsive hoarding or collecting of possessions is an uncommonly described variant of OCD" (Fitzgerald 599). It is more than "eccentricity". The fact, as some of these articles point out, is that the compulsion to hoard may be the result of some other underlying psychological problems. Greenberg et al (1990) actually consider hoarding a "pathological behavior". So they reason that "many neurotic patients are unable to part with a variety of useless and valueless objects..." (Greenberg, Witztum & Levy 1990 417). What is important to consider here is that hoarding is far different from amassing possessions. We are not talking about a shop-a-holic here who buys shoes and clothes, or new rugs or even more cars. That is ostentation, from my point of view, but not unnatural compulsive behavior. While the world may have laughed at Imelda Marcos' enormous shoe collection, she was not a compulsive hoarder. She was merely showing off that she had the money to buy more than she really needed. Hoarding is more than just "possessiveness", it is considered part of a psychological disorder.

While it is persuasively argued that hoarding may be the tip of a psychological or obsessive compulsive disorder, we need to assess whether one person's "pack rat" instincts are potentially dangerous to others. This is made abundantly clear in "Hoarding: A community health problem" (Frost, Steketee & Williams 2000). The authors argue that the "accumulation of possessions can pose a fire hazard if means of egress are blocked, if flammable materials...are piled near stoves...or of the volume of possessions would make a fire harder to control" (Frost et al 2000 229). In other words, neighbors and the community at large are concerned about the private compulsive behavior of one person. Not only are what we may consider useless items or trash be involved, but the authors also claim that nearly a third of the reported cases involved the hoarding of animals.

It seems valid here to ask oneself whether neighbors or the community at large has a legal right to consider one person's hoarding behavior as dangerous, or whether reporting such hoarding is an invasion of that person's privacy. When it comes to accumulation of animals, for example, one has to wonder whether that person is being benevolent and rescuing stray dogs and cats, or whether this animal hoarding is the result of some psychological disorder. Yes, fouling a home or its environs and the unwillingness or inability of the person to clean up does represent a health hazard. But, this again brings out a question: Could neighbors help that person control her animals better, and lend her a hand? (I use the female gender here because the authors point out that most "animal hoarders" are women). Should this woman be considered a "kook" and a health or mental danger to the neighborhood? Or is she merely trying to be a sort of modern-day Francis of Assisi?

There seems to be more "proof" that some forms of hoarding have serious implications for psychiatrists: "....hoarding was associated with higher levels of general psychopathology" (Damecour and Charron 1998 267). While this may be true (I use the words "may be" because, as my introduction indicated, not enough study has been done on possessiveness and hoarding for a definitive foundation) another question needs some answers: Is hoarding, per se, dangerous? Is it just that tip of the iceberg of a far more serious psychological disorder? Furthermore, is it treatable, and if so, how?

We often hear or read about psychologically disturbed people who are considered "walking time bombs". These are people who may be dangerous to themselves as well as to the community if not treated, and on occasion, hospitalized. Do hoarders fall into this category? Are they truly dangerous? Or, is the psychiatric community merely opening a new door for some novel and innovative experimentation, something that surely the pharmaceutical industry will find some new drug to alleviate?

A partial answer to my questions arise in Norma Thomas' article, which poses the question whether hoarding is part of a serious psychiatric disorder or only eccentricity. At the beginning of her article, she focuses on the hoarding activities of the elderly. Most of the examples of compulsive, obsessive hoarders we hear or read about these days, seem to be senior citizens. Ms. Thomas covers my point about invasion of privacy when she wonders if involuntary intervention is justified "because the choice they make are thought to be causing harm to themselves or others" (Thomas 1997 45). The word "choices" stands out here. Is the hoarder (elderly or not) making a rational choice to accumulate unneeded items? Or is he or she doing so irrationally. Her article seems to point to hoarding by the elderly as a sign of ageism, maybe even Alzheimer's disease.

There is another aspect of the compulsive desire to hoard. Many people seem to satisfy their owning needs on television. Programming such as the Home Shopping Network is literally a 24-houor a day enticement to buy merchandise that is really not necessary. But, persuasive hosts and come-on pricing lure many people into buying unneeded, and often eventually discarded goods. Christenson et al claim that "(T)he psychiatric literature has been almost silent on compulsive buying" (Christenon et al 1992 5). They cite sources which call compulsive buying "'oniomania'....'reactive impulses'....'impulsive insanities' (Christenson et al 1992 5). As is obvious from this article, psychiatrists are struggling with finding both a name, an all-pervasive symptom. In a sense, they seem to be floundering because there is no single symptom, no one recognizable and distinctive means of identifying hoarding as an obsessive compulsive disorder. Greenberg (1987) at least gives us a reasonable definition for hoarding as part of a underlying illness when he states that it becomes a personality disorder when hoarding interferes with normal daily functioning.

From reading the various articles, one can assume that hoarding becomes a problem, and perhaps merely one instance of a deeper personality or compulsive problem, when it interferes with normal daily life, and when it takes over a person's reasonable functions. In other words, until and unless hoarding becomes something both obsessive and excessive it may be merely a desire to "have" things and keep them, even if those things seem irrelevant to almost anyone else. Hoarding also may become a psychiatric problem when the hoarder is unable (or maybe unwilling or both) to stop his activities.

It seems fairly normal even for young children to be possessive. Unlike obsessive hoarders, however, Greenberg et al (1990) see children's possessiveness as being transitory, moving from, say, a teddy bear to a GI Joe or Barbie Doll as they grow. They are not reluctant to leave their "older" toys behind. This, of course, distinguishes what seems to be called "transitory" hoarding or possessiveness with the more serious pathological types as described in these articles.

Nevertheless, what is missing in today's "hoarding" or OCD literature is at what point intervention is called for, either by friends, neighbors, family, or health providers. We continue to tread a fine line of division between helping solve a psychiatric problem and invading someone's privacy.

References:

Christenson, G.A., Faber, R.J./, deZwaan, M, Raymond, N.C., Specker, C.M., Ekern,. M.D, et al: "Compulsive Buying: Descriptive characteristics and psychiatric comorbidity" Journal of Clinical Psychiatry, 55 3-11 (1994)

Damecour, C.L. & Charron, M.: "Hoarding: a symptom not a syndrome: Journal of Clinical Psychiatry, 59, 267-272 (1998)

Fitzgerald, P. B. "The bowerbird symptom: a case of severe hoarding of possessions", Australian and New Zealand Journal of Psychiatry 31, 597-600 (1997)

Frost, R. & Gross, R.: The hoarding of possessions": Behaviour Research and Therapy, 31, 367-382 (1993)

Frost, R.O., Steketee, G., and Williams, L "Hoarding: A community health problem" Health and Social Care in theCommunity, 8, 229-234 (2000)

Greenberg, D. "Compulsive hoarding" American Journal of Psychotherapy, 41, 409-416 (1987)

Greenberg, D., Witztum, E. & Levy, A.: "Hoarding as a psychiatric symptom" Journal of Clinical Psychiatry 51, 417-421 (1990)

Thomas, N.D. "Hoarding: Eccentricity of Pathology: When to Intervene?" Journal of Gerontological Social Work, 29, 45-55 (1997)