My last post concerned itself in part with the place of hoarding in the classification of anxiety disorders. At present, it is still a dimension of ‘pure’ OCD, but that may change, for the reasons I indicated. To illustrate the dramatic conditions in which hoarding patients may have to live, I present you some photographs taken in the living rooms of some of these people.
These photos make a few things abundantly clear: hoarding is a very serious condition. Most often, hoarders shut themselves off from society as much as possible, if only because they can’t receive visitors. But there are other huge problems: one’s personal administration may be so out of order, chaotic, that bills aren’t paid in time; and because in many situations of hoarding, decayed food rests attract molds, flies, cockroaches, mice, and rats, patients descend into a condition of poor health, with infections and/or allergic reactions.
Because of all of this, financial problems may loom on the horizon, and in the end, if the house is rented, a hoarder may be driven out of his/her house by legal action, and end up on the street. Additional problems are sometimes substance abuse, and occurrence of comorbid disorders such as social phobias or depression.
A few remarks have to be made to end this section:
- hoarders often live in a fragile balance: they can’t clean out the mess they are in, but on the other hand the manage to mantain an upper limit as to the volume of their excess stuff. They live in a sort of cave, in which they just are able to make their way to the toilet, kitchen, and bed in a very struggling fashion. They know their particular tiny paths through all their rubble;
- hoarders are typical procrastinators. This is because they often really imagine cleaning sessions and then continuous order and structure in their lives… but the real work is postponed. They see a dirty cup on a table, have good intentions to wash it, but the thing is: they have a wrong representation in their mind about how long it will take to do that to perfection – and as a result the cup doesn’t get washed. The same goes for collecting ordinary trash and put it in a garbage sack, and put it outside. In very serious cases, they want to trawl again through all the stuff in an already closed sack, to check whether nothing of value was inadvertently thrown into it; an awful and repulsive enterprise, which, you guess it, gets postponed to the next day, the next week, and so on;
- one can think: but is a help in the household of a hoarder not a good idea? The answer is: no, apart from the extra costs that that may entail. If the condition of hoarding itself is to be treated, then some form of behavioural therapy may be applied, possibly with the aid of medication (antidepressants, anti-obsessional substances).