HOARDING, COMPULSIVE SHOPPING AND OTHER "INVISIBLE ADDICTIONS"
They live in every community in the nation, and are a part of every extended family. In recent years, they’ve even begun making regular appearances on unscripted television shows such as Clean House, Obsessed, and Animal Rescue.
Sometimes they’re referred to as eccentric, strange or weird:
- Your mother’s uncle, whose “collection” of old newspapers and magazines looks more like a fire hazard than a tribute to days gone by.
- The friend who can’t seem to stay out of the stores or off the online retail sites, even though her shopping sprees have put her on the brink of financial ruin and her apartment looks more like a warehouse than a living space.
- The heartbreaking couple you saw on the news last night – the ones who, the health department discovered, had been keeping dozens of animals in their tiny, filthy house.
Hoarding animals and obsessively accumulating objects of no apparent value are two types of relatively common behavioral compulsions that appear to straddle the line between out-of-the-ordinary activities and mental illness.
In an effort to determine what types of extreme actions constitute a mental health concern, an international group of mental health experts met Oct. 1 and 2 in the Ontario (Canada) Science Center to talk about hoarding and other types of compulsive behaviors – commonly misunderstood obsessions that a Sept. 22 Canwest News Service article termed “invisible addictions.”
Misty Harris, who wrote the Sept. 22 article, reported that October’s “Many Faces of Addiction” conference was designed to bring about “the proposal of clinical criteria defining where normal indulgence ends and disordered behaviour begins.”
The challenge, according to Canadian addictions counsellor Anne McLaughlin, is that unlike chemical dependency, "process addiction" tends to have few detectable symptoms, with the behaviour either taking place in secret or being dismissed by family and friends as normal activity.
"It can be very isolating," says McLaughlin, who treats both sex addicts and their partners. "If someone drinks or takes drugs, at least it's visible."
Hoarding & Obsessive Collecting
The “invisible addiction” label may be valid as a means of identifying behaviors that don’t result in intoxication or other obvious forms of impaired motor functioning. But anyone who spends quality time in the presence of a person who cannot control behavioral urges will soon see that the disorder is far from invisible.
For people who are addicted to gambling, sex or the Internet, for example, their compulsions are made visible by financial problems or the inability to participate in normal healthy relationships.
But when it comes to hoarders or obsessive collectors, the evidence may be even more obvious – and, to many people, much more difficult to understand.
According to the website Understanding Hoarding, the following three primary attributes of compulsive hoarding were established in a 1996 article by R.O. Frost and T.L. Hartl, both of whom were then affiliated with the Smith College Department of Psychiatry:
- The acquisition of, and failure to discard, a large number of possessions that appear to be of useless or of limited value
- Living spaces sufficiently cluttered so as to preclude activities for which those spaces were designed
- Significant distress or impairment in functioning caused by the hoarding
In addition to these three diagnostic criteria, Understanding Hoarding also noted that most compulsive hoarders also possess four common personality traits:
- Indecisiveness
- Perfectionism
- Procrastination
- Avoidance
“Severe cases of hoarding may truly devastate a person's life if no help is sought,” the website reported. “[Hoarders] feel shame and this shame will gradually evolve into isolation.”
What Compulsive Hoarding Looks Like
In an article on the website of the Obsessive Compulsive Foundation (OCF), Karron Maidment, Program Coordinator/Behavior Therapist of the UCLA OCD Intensive Treatment Program, describes the experiences of the estimated 700,000 to 1.4 million Americans who are afflicted with compulsive hoarding disorder:
Hoarding is defined as the acquisition of, and inability to discard worthless items even though they appear (to others) to have no value. Hoarding behaviors can occur in a variety of psychiatric disorders and in the normal population, but are most commonly found in people with obsessive-compulsive disorder (OCD). …
Compulsive hoarding is not just an enthusiast's passion for collecting stamps, dolls, or baseball cards. … People with compulsive hoarding syndrome may have immense difficulty throwing anything away, from the oldest paper clip, to a used food container, to an out-of-date newspaper, for fear that they might need those items in the future.
Their homes are often full of stuff that the rest of us would call "junk." The most commonly saved items include newspapers, magazines, old clothing, bags, books, mail, notes, and lists.
Though most hoarders amass apparently useless objects, some people who have the disorder become obsessed with animals, bringing dozens – or in some cases more than 100 – dogs, cats or other creatures into their house. Overwhelmed by the logistical challenges of caring for so many animals in a space that was not designed for such a large-scale operation, animal hoarders put their own health and the health of the animals they have “rescued” at risk.
Defining the Problem, Addressing the Disorder
Though Frost and Hartl’s standards have achieved widespread acceptance, hoarding (like sex addiction, chronic shopping compulsions, Internet addiction and several other obsessive behaviors) has not yet been recognized by the “bible” of the mental health community, the Diagnostic and Statistical Manual of Mental Disorders (DSM).
However, that may soon change.
One of the reasons for the October conference in Ontario was to discuss the possible inclusion of disorders such as these in the next DSM edition, which is scheduled to be released in 2012.
"Pathological gambling is in the DSM … and it really sets up a precedent for these other behavioral addictions," Toronto psychotherapist Edith Townsend told Canwest News.
Even without DSM recognition, compulsive hoarding has been treated via a variety of techniques, including medically assisted therapy (often involving selective serotonin reuptake inhibitors such as Prozac or Paxil) and cognitive behavioral therapy (CBT).
CBT appears to be the most effective approach, though treatment for compulsive hoarding is a notoriously slow process.
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