Scientific American recently published an article about compulsive hoarding, which is defined as the excessive accumulation of stuff and the refusal to discard it, resulting in problematic clutter. This May, the new edition of psychiatry's standard guidebook (the DSM-5) will recognize compulsive hoarding as an official disorder, separate from obsessive-compulsive disorder. Research in the last 10 years has shown that hoarding and OCD are distinct, changed the way psychologists think about hoarding, refuted popular assumptions about people with excessive clutter and informed new, promising treatments. Today at 4 P.M. EST, Randy Frost of Smith College—a leading expert on hoarding—and Lee Shuer, who is currently decluttering his home in Massachusetts, join us for a live Web chat.
CHAT TRANSCRIPT
ferrisjabr
Welcome to everyone who has joined so far. I'm Ferris, one of the associate editors
ferrisjabr
We'll be starting the chat in 15 mins at 4pm EST
ferrisjabr
Welcome to Randy Frost of Smith College, a leading expert on hoarding
ferrisjabr
And Lee Shuer who leads Buried in Treasures workshops. They are both in the story I wrote
ferrisjabr
To kick things off, I'll ask Randy and Lee some specific questions and then we'll open it up to more questions
ferrisjabr
Randy, can you tell us a little about how researchers currently define compulsive hoarding and how thinking has changed in recent years
Randy Frost
Hoarding is defined by difficulty getting rid of a large quantity of possessions that clutter living areas of the home
Randy Frost
Many of us have many more possessions than we need, but they don't prevent us from using our living spaces
Randy Frost
It used to be the case that people thought hoarding was a form of obsessive compulsive disorder, but we now know it is something separate.
Randy Frost
That's why it is being included in the new edition of the diagnostic code for mental disorders.
standupcomedyfa
Hi, I have a ? for Lee. How do you feel about the Hoarders TV show?
Lee
The Hoarders show depicts some people's experience with clutter, but not all of us. When someone is in crisis, it is hard to watch them be pushed to change. We strive to support people in understanding their challenges, finding motivation for change, and sharing tools and support. There's no quick fix.
ferrisjabr
Lee & Randy, what do you think about family, friends or cleaning services that clear out all clutter at once?
Randy Frost
Cleanouts without the persons permission probably do more harm than good.
Lee
The clutter tends to pile back up. I understand why others would want to 'make it better,' but it doesn't make the person better. Just the space, and probably not for long.
Randy Frost
If someone's home is cleared out, the condition of the home changes, but the behavior does not.
standupcomedyfa
True, it must be a difficult condition to have. Have you gone to therapy?
Lee
I find the support of my peers, family, friends and colleagues to be therapeutic. The Buried in Treasures Workshop has been my biggest means of understanding my challenge.
Lee
As I've come to understand my attachments to possessions, I've been able to let things go. I'm not responsible for the cause of my problem but I am responsible for making things better.
Susan Kim
If hoarding is not considered a form of OCD what is the current thinking on it's biological basis?
Randy Frost
We don't yet know the basis for hoarding, but we do know it is partly genetic.
Randy Frost
Several studies have found family linkages. We also know that there are differences in the brains of people with this problem.
Randy Frost
Behaviorally, we see problems with the way information is processed in addition to extremely strong attachments to possessions
standupcomedyfa
Lee, do you know any other former hoarders?
Susan Kim
Lee, do you undergo a specific process for each item that you let go of?
Lee
I think that we are never really 'former' hoarders. We just change our responses to the impulses to collect and save.
Lee
Many of us do get better at it. :-)
Lee
Susan, I ask myself why I have that object, and if it's a good reason, I keep it. More often than not, my priority is to let it go.
Lee
For me, it's hard to let something go if can think of many reasons to save it. I need just one good reason to let it go though.
Lee
The collecting and saving often helps to soothe the hurt in the short term, but cause new difficulties in the future.
Randy Frost
This makes it difficult to decide whether to keep or get rid of something.
standupcomedyfa
Randy, do you think that there is a link tween emotional pain and hording?
Randy Frost
We have seen some connection between trauma and hoarding. People who hoard have experienced more frequent traumatic life events.
Susan Kim
Randy, does that mean that an assessment test could be devised to diagnose the condition?
Randy Frost
Susan, Yes, we do have assessment tests that are pretty good at identifying the problem.
ferrisjabr
What are some of the problems or differences w/ information processing?
Randy Frost
There are problems with attention, much like attention deficit disorder as well as difficulties categorizing objects.
Randy Frost
We think people who hoard think in more complex ways. The have more elaborate thought processes about things they own.
ferrisjabr
Very interesting - what do those elaborate thought processes entail, beyond seeing meaning & value in objects?
Randy Frost
The elaboration of thoughts in hoarding are mostly about utility, opportunity, identity, and aesthetics.
standupcomedyfa
Randy- what do you mean by 'aesthetics'
Randy Frost
Regarding aesthetics, many people with this problem have a special appreciation of the aesthetic/artistic qualities of the physical world.
Randy Frost
In some ways, this aesthetic appreciation is like a gift, but it causes them to give everything a value and avoid getting rid of it.
Lee
Sometimes the aesthetics can only be appreciated by the owner. That's why I like to ask. I know what beauty is to me..
Kelly Banco
Do you find that hoarders rarely admit to the problem? Unlike someone with OCD for example, the people I've seen who hoard often never admit
Randy Frost
Kelly - interestingly, although it seems to some that they rarely admit the problem, most are aware of it and can talk about it.
Lee
Most people can see that their stuff is causing problems, even if they don't consider the stuff itself to be the problem.
Kelly Banco
What is your advice on how to approach someone I know who is a hoarder but will not even admit to it?
Randy Frost
Kelly - The best way to approach them is to focus on function. What can't they do because of the clutter.
Lee
Kelly, depending on circumstances, either asking someone why they have their things, or what they might lose if they keep them, is helpful for me.
alanhoyle
Is there evidence that the percentage of people who hoard varies by age cohort?
Randy Frost
While hoarding is more impairing in the elderly, it appears to affect younger people as well as older ones.
Lee
Most of the people that came to my Buried in Treasures Groups were over 40, averaging mid 50's. Up to 88 years old.
Lee
I also know of children who have overwhelming attachments to their stuff.
Randy Frost
The average age of onset for hoarding behavior is between 11 and 15 years old.
alanhoyle
Perhaps the younger simply haven't had the time or money to accumulate things to where it becomes impairing.
Lee
I was a collector as a child, but became more focussed on acquiring in my mid twenties.
Randy Frost
Yes, the behavior starts early, but it does not impair their lives until decades later.
Lee
I also couldn't accumulate much until I settled-down in one place. I left a lot of stuff behind as I moved about the country
ferrisjabr
Yes, it might have to do with available space & resources and how much control one has over one's environment
Randy Frost
Severe hoarding in children shows up more as emotional reactions to losing objects rather than clutter.
Lee
I think that the consequences become greater as we grow older too.
Susan Kim
It seems like the focus on hoarding is a recent phenomenon. Is there a reason why it is coming to our attention more now?
Randy Frost
Susan - It's not clear why hoarding is a focus now, but the TV shows may have a lot to do with it.
alanhoyle
Have there been studies comparing the nature vs nurture aspects?
Randy Frost
We know very little about things in early family life that lead to hoarding. We do know that attachments to people may be strained in childhood
Lee
Many people save things, and they serve a purpose, like safety, when young. Long after the danger is gone, the habits may remain.
Lee
Old solutions become new problems.
Lee
.........it's never just about the stuff, it's what it represents.
alanhoyle
Do professional interventions have significantly lower recurrence rates than semi-informed family/friend ones?
Randy Frost
We have a therapy for hoarding that works reasonably well, and the effects seem to be maintained afterwards.
Lee
A compassionate blending of the two seems most effective
Randy Frost
There is no research on family/friend interventions.
Susan Kim
Lee, how is hoarding addressed in your workshops?
Lee
We work on addressing the need to reduce acquiring before learning to discard. Then we work on letting things go.
Lee
Several factors give us an advantage in the process, like 'keeping our eyes on the prize.' Other factors
Lee
like difficulty making choices, can make it harder. We focus more on saving the best than discarding the 'worst.'
Lee
We want the process to lead to a life that affords us the space and time to enjoy those things and people that give us pleasure.
Lee
The clutter is the tip of the 'stuff-berg.' We appreciate the weight of what's beneath the surface.
Susan Kim
Is difficulty in making choices for hoarders confined to their possessions?
Randy Frost
Susan, No, usually there are problems making any kind of decision. We think they are trying to process too much information
Lee
Making choices is difficult in many aspects of life, including whether to acquire or discard something. It's an across-the-board challenge
Lee
Creating a list of decision-making questions has been helpful. Do I have room? Do I have one? Do I have a plan to use it? etc
Lee
The most important question that I ask myself is, 'Will owning this thing help me to overcome my clutter problem.'
ferrisjabr
All right everyone, this has been wonderful. We should wrap up the chat in the next 10 minutes
ferrisjabr
Any final questions for Lee and Randy?
Randy Frost
For more information, you can visit the International OCD Foundation website (ocfoundation.org). They have a hoarding center with more info.
Lee
ocfoundation.org also posts the facilitator's guide for the Buried in Treasures Workshop that we run.
ferrisjabr
I'd like to thank both Randy & Lee and everyone in the chat for joining us today
Randy Frost
Thank you Ferris. It was my pleasure to participate.
Lee
My pleasure as well. Great questions everyone. Thanks for the opportunity Ferris.
