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When stuff is the drug: How to treat hoarders

August 24, 2014
by Megan Combs
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Hoarding is a disorder that's been around for quite some time, but recent emphasis from televisions shows has shot it into the spotlight over the last 10 years. 
 
Terrence Shulman, JD, LMSW, ACSW, CAADC, CPC and founder of The Shulman Center for Compulsive Theft, Spending and Hoarding, discussed hoarding and its treatment at the National Conference on Addiction Disorders (NCAD) on Aug. 23 in St. Louis. 
 
"Hoarding is not being able to get rid of anything that has seemingly no further value or use," Shulman said. "Some people recognize it's a problem, but they don't want to do anything about it and aren't embarrassed."
 
The difference between clutter and chronic disorganization is that in most cases the person has the ability to clean it up or will allow someone else to clean it up for them, Shulman said. Hoarders have an emotional attachment to their items and are unwilling to clean or get rid of items. 
 
"For hoarders, stuff is like a drug," Shulman said. "They get a high or rush from accumulating the stuff. They don't want to get rid of their stuff because for many of them, it's like giving away a piece of themself."
 
He said 5 percent (or roughly 15 million) of Americans are suspected hoarders, according to 2010 census reports. 
 
Some consequences of hoarding include isolation, loss of financial control, loss of relationships, mental health decline, safety/health and legal issues and more. 
 
"Hoarding can go on for so long before anyone even considers change," Shulman said. "It's not like gambling money away and realizing you need help. Usually something has to come to an end before people realize they have a problem."
 
Shulman said he's had clients come to him because they have to move and they realize they have so much stuff to move and they don't know what to do with it. Others get into legal trouble with city code violations.  
 
Hoarders are typically 50 years are old, and some have been hoarding for at least 20 years, Shulman said. The youngest reported case was a 13-year-old. Most of the time, hoarding is a reaction to loss, trauma or a life-changing event, Shulman added.
 
Some misconceptions about hoarders are that they are financially disadvantaged, unskilled,  unemployed, uneducated, out of touch with reality and/or they live in bad neighborhoods. But this is not always the case.
 
"Sometimes people hide their hoarding in storage units and spend thousands of dollars a year to keep their stuff there," Shulman said. "When I ask people how they would feel if some natural disaster came along and wiped out their stuff, many of them say they would feel relieved."
 
So how do you treat someone who won't get rid of stuff? Shulman offers these suggestions:
  • Encourage them to sign up for support group meetings
  • Suggest finding a therapist specialized in hoarding
  • Assess the patient for co-occurring disorders 
  • Help them find a peer supporter or life coach
 
If a hoarder is ready to get rid of some of their stuff, Shulman offers his clients these suggestions:
  • Start with the easiest area first
  • Set a timer for 15, 20 or 30 minutes and sort through stuff for that amount of time, then take a break
  • Set mini-deadlines and use a calendar to chart progress.
  • Use a professional cleaner or organizer depending on the degree of hoarding
  • Use the OHIO rule: If you've "Only Handled It Once," let it go.
For more NCAD conference coverage, follow @NCADcon on Twitter.   
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