Underneath the Hoard
Most people have watched or heard of television shows about Hoarding Disorder. Images of rooms packed to the ceiling with food wrappers, newspapers, clothes, old electronics, rotting food and even feces are the main sources representing a population that suffers from a very real and debilitating mental health disorder. Individuals with hoarding disorder struggle internally on such a deep level, but sadly the main focus falls on the most visible and shame-inducing symptom; the hoard.
Hoarding Disorder is a complex syndrome with many layers. It is now categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM 5) as an “obsessive compulsive-related disorder.” It encompasses executive functioning skill deficits, dysfunctional thinking, poor emotion regulation, high conflict family dynamics, unprocessed trauma and genetic/environmental vulnerabilities. Some common skill deficits seen in individuals with Hoarding Disorder include great difficulty with task initiation, planning and prioritizing, working memory, organization, emotional control and information processing. Furthermore, Hoarding Disorder often co-occurs with other mental health conditions, most commonly including Generalized Anxiety Disorder, Social Anxiety Disorder, ADHD and Major Depressive Disorder.
Effective treatment for Hoarding Disorder requires a team of professionals which can include therapists, psychiatrists, professional organizers and behavioral coaches. In more severe cases it requires additional resources from the community including but not limited to social services, protective services, the fire department, law enforcement, animal control and sanitation services.
There is a lot of stigma associated with individuals suffering from Hoarding Disorder. One of the most concrete ways this is illustrated in the media and society is through labeling people with Hoarding Disorder as “hoarders.” The most apparent example of this in the media is probably the title of the show Hoarders. This language tends to induce shame, taking awareness away from the internal suffering those with this condition experience and increasing focus on the hoard. “A person living with Hoarding Disorder” is a more compassionate way to reference individuals with this diagnosis. The less shamed these individuals feel, the more likely they are to stay connected with others and seek out treatment!
Erika Poladian, LMFT