Reader’s Question

I have been living with a hoarder for several years. Every room in our apartment is constantly cluttered. Sometimes there will be frenzied cleaning periods and the a room or two will look good for awhile, but for the most part our place is a mess.

I have told my partner to get rid of things but that rarely happens. I have also suggested they seek professional help but, they either say they’re too busy, or can’t afford it because they don’t have insurance right now.

Any suggestions?

Our Clinical Psychologist’s Reply

Although treatments of other variants of Obsessive-Compulsive Disorder (OCD) are moderately successful, intervening effectively with hoarding behavior has proven to be much more challenging. This is due to a variety of reasons, primarily:

• The hoarder rarely realizes the full negative impact of the behavior on their lives and the lives of others and therefore doesn’t appreciate the need for treatment.
• The hoarder typically experiences a rise in anxiety and other forms of emotional distress when the hoarding behavior is interfered with, and the increased anxiety often leads to even more intense urges to hoard.

Although medications, particularly the selective serotonin re-uptake inhibitors (SSRIs) have proven quite helpful in treating OCD in general, their effectiveness in treating hoarding behavior is generally regarded as less certain. Some individuals respond fairly well, whereas others do not. Cognitive-Behavioral Therapy (CBT) is the non-medical therapy of choice, but again its track record of success with hoarding is somewhat below what it is for treating other forms of OCD. Besides that, the treatment is typically multi-dimensional and requires a fairly solid commitment and active involvement from the person being treated.

One of the best ways to help your partner is to point out in a non-confrontational and clear manner the practical, negative consequences of the hoarding behavior and the negative impact it might be having on both of your lives. But if you want your partner to maintain motivation to address the problem, you’ll also want to be sure that there’s a suitable alternative available to satisfy the underlying needs and anxiety relief the hoarding behavior presently satisfies.

So, make it clear that you want to be of support and to help your partner find some more constructive and healthy alternative behaviors. You’ll also want to be fairly liberal in expressing your appreciation for and providing reinforcement for you partner’s efforts to moderate the hoarding behavior.