Can CBT help with hoarding/clutter?

Collecting, saving and the storage of items is evolutionary and part of the adaptation and survival instinct of humans. When we think of our ancestors and long harsh winters, dry summers and food scarcity, hoarding enabled people to get through lean times. These habits were passed down through generations. With the introduction of the ‘consumerist society’ and acquisition of ‘wealth’, our beliefs have shifted toward the notion of our sense of self and its relationship with materialism. The ideology powered by corporate advertising of ‘the good life’ and one we should aspire to has led to an obsession with materialistic acquisition .

The human desire to collect and store is therefore not a new concept, however, the phenomenon of hoarding has been estimated to affect between 2% and 5% of the population. The American Psychiatric Assosiation Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines the disorder independently from other disorders to which hoarding was previously ascribed e.g. Obsessive Compulsive Disorder (OCD). The definition and classification of ‘Hoarding Disorder’ in the DSM-5 and has the following diagnostic criteria:

  1. Persistent difficulty discarding or parting with possessions, regardless of their actual value.
  2. This difficulty is due to a perceived need to save the items and to distress associated with discarding them.
  3. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (eg, family members, cleaners, or the authorities).
  4. The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining an environment safe for oneself or others).
  5. The hoarding is not attributable to another medical condition.
  6. The hoarding is not better explained by the symptoms of another mental disorder (eg, obsessions in obsessive-compulsive disorder, decreased energy in major depressive disorder, etc).
  7. Specifiers
    1. With excessive acquisition
    2. With good or fair insight
    3. With poor insight
    4. With absent insight/delusional beliefs (Source: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

There are many consequences to hoarding behaviours such as social isolation, strained relationships, problems with landlords and neighbours and the financial problems this behaviour can create.

These are now regularly documented on TV as we view with incredulity and revulsion at the different levels of severity of hoarding behaviours. This can lead to a negative portrayal of people with these behaviours thus stigmatising them and therefore may lead to people feeling shame and not seeking help and support for their persistent difficulties.

There are many reasons why people develop hoarding behaviours. Depression, or other mental health disorders such as OCD or Schizophrenia. It might also be related to trauma or sometimes when someone has had a very deprived childhood and there was a lack of material objects. The hoarding behaviour can serve as a function for people: to make them feel safe or manage panic and anxiety.

There is support for people who want help and support for their behaviours. The main treatment is CBT and can take commitment and motivation to reach their goal. One tool which can be used in conjunction with therapy is the H.O.A.R.D Acronym Tool (Sing & Jones, 2012). It is a treatment strategy designed to help individuals understand their hoarding issues and develop motivation.

Help is also on hand. We are in the process of setting up a weekly drop in support group for people wishing to overcome hoarding. The group will be facilitated by a CBT Therapist who will provide also provide a structured session once a month. People can refer themselves to the group and or by support workers, social workers etc. Due to Covid restrictions, participants will have to provide details for track and trace and the room can hold 6 people.

The proposal is for the group to meet at CFINE 2-4 Poynernook Road Aberdeen AB11 5RW. Every Thursday from 1.30pm until 3pm. For further information call Jenny on 07907 473894 email