Compulsive hoarders need to tidy up inner chaos

By Martin Faber Dec 19, 2011, 3:06 GMT

Berlin - Janice is a compulsive hoarder. For years chaos reigned in her flat, which was cluttered with things like baskets of un-ironed laundry and broken shelves. One day she read a newspaper report about compulsive hoarding syndrome.

'The scales fell from my eyes,' said Janice, who now heads the northern German branch of a group that calls itself Messies. 'That's me, I thought, and I'm not alone.' Support groups estimate the number of compulsive hoarders in Germany, which has a population of 82 million, at about two million.

'Compulsive hoarders generally collect useless things, are unable to discard them and finally lose track of them,' remarked Alfred Pritz, a psychotherapist and director of Sigmund Freud University in Vienna.

Psychologist Werner Gross more broadly defines the syndrome as a problem of organization: 'Compulsive hoarders have difficulty structuring their daily lives both spatially and temporally.'

They would like to tidy things up but are unable to. 'Their behaviour isn't due to laziness,' Pritz said. 'While they often accomplish great things in their occupations, they can't cope at all with small, everyday tasks.'

Only a minority of people who hoard things end up cluttering their homes to capacity, which is the final stage of the syndrome. 'The homes become uninhabitable,' Gross said.

Hoarding is often a symptom of other psychological disorders such as psychosis. 'Many compulsive hoarders are also depressive,' Pritz noted. Although commonly found in people with addictions or obsessive-compulsive behaviour, he said, 'compulsive hoarding syndrome essentially has its own clinical picture.'

When does disorganization become pathological? 'It becomes problematic when it restricts the social life of affected persons to such a degree that they suffer because of it,' according to Pritz.

Compulsive hoarders suffer primarily from social isolation. 'They don't invite anyone over out of shame and they decline invitations,' Janice said. Their social contacts break off and they grow lonely.

Many also develop cover-up tactics. 'A lot of them are elegantly dressed and very well-groomed. Some even have several flats or live in their car because there's no more room for them at home,' she said. Keeping up the facade is an additional burden.

It is not clear what causes hoarding but it is frequently linked to an attachment disorder. Compulsive hoarders try to compensate for their fears of separation and loss by developing an emotional attachment to the objects they accumulate.

'The objects can't hurt them,' Janice explained. 'They won't abandon them and can't disappoint them, and this gives compulsive hoarders a sense of security.'

Gross said treatment for compulsive hoarders should not be confined to behaviour therapy because 'that would fully ignore the emotional side of the problem and bring short-term success only.' There is no way around psychotherapy.