There isn't a simple, effective treatment for compulsive hoarding. There aren't any drugs that specifically target and reduce hoarding behaviors. However, hoarding often appears alongside other mental health disorders like depression, anxiety or OCD, and treating those illnesses with medications can be one way to help manage hoarding [source: Hale].
Effectively fighting compulsive hoarding requires a team effort that includes the hoarder and their family. Psychotherapy, or talk therapy, is a primary form of treatment for hoarding. The best course of talk therapy treatment is known as cognitive behavioral therapy (CBT). It works to modify the cycles of thought and behavior that are causing the hoarder to have problems. The CBT needs to be adapted specifically for hoarding, and the treatment course can take from six months to a year. Medications can also be added, particularly if the hoarder also has anxiety or depression.
"In order to help control the professional costs of therapy, and better promote development of the types of environmental supports that can keep up skills use after the active treatment stage, we include behavioral family therapy/coaching and also often involve a professional organizer who is familiar with hoarding," Hale says.
One element of the therapy involves the hoarder learning to identify and challenge his thoughts about buying and saving things, as well as practicing getting rid of them. This can move on to learning how to organize things, and getting help on deciding which things to get rid of before, hopefully progressing to successfully clearing out and completely decluttering large amounts of the hoard.
Focusing on the benefits clearing out the hoard will hopefully change the hoarder's thought patterns, decision-making and coping skills. For example, instead of worrying about needing a stockpile of clothing someday and what might happen if they don't have the clothing, hoarders can instead focus on using the cleared room to grow plants or invite friends over to play cards. Breaking down these barriers can reduce their isolation and increase social involvement.
Even with a full course of treatment, compulsive hoarding has a tendency to reoccur, especially without ongoing support from family members and during times of stress. It's a difficult and insidious mental health problem to treat, so maintaining ongoing treatment is critical.
Author's Note: How Hoarding Works
Hoarding is a fascinating disorder to me for a few reasons. First, it's weirdly familiar to us, since it's rooted in natural behaviors we all exhibit. I think everyone at some point feels that strange attraction to material things. Plus, it's a bit unsettling to hear the echo of incredibly distant evolutionary adaptations and recognize in humans the behaviors found on far-off cladistic branches. But it's also incredible to watch our understanding of a disorder change and unfold. As frustrating as it is that we don't understand hoarding enough to cure it, research and the experience of therapists keeps bringing us closer.
- Anderson, SW. "A neural basis for collecting behaviour in humans." Brain, Jan. 2005.
- Arkowitz, Hal and Lilienfeld, Scott. " Hoarding may have evolutionary origins." Salon, Sept. 6, 2013. (Nov. 20, 2017) https://www.salon.com/2013/09/06/hoarding_may_have_evolutionary_origins_partner/
- Ayers, CR et al. "Age at onset and clinical features of late life compulsive hoarding." International Journal of Geriatric Psychiatry, Feb. 2010. (Nov. 20, 2017) https://www.ncbi.nlm.nih.gov/pubmed/19548272
- Bergstrom, TC. "On the evolution of hoarding, risk-taking, and wealth distribution in nonhuman and human populations." Proceedings of the National Academy of Sciences, July 2014. Nov. 20, 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113914/
- Duenwald, Mary. "The Psychology of...Hoarding." Discover, Oct. 1, 2004. (Nov. 20, 2017) http://discovermagazine.com/2004/oct/psychology-of-hoarding
- Frost, RO and Gross, RC. "The hoarding of possessions." Behavioral Research and Therapy, May 1993. (Nov. 20, 2017) https://www.ncbi.nlm.nih.gov/pubmed/8512538
- Gothelf, D et al. "Obsessive-compulsive disorder in patients with velocardiofacial (22q11 deletion) syndrome." American Journal of Medical Genetics, April 2004.
- Hale, Lisa. Founding Director of the Kansas City Center for Anxiety Treatment. Email interview, Nov. 15, 2017.
- Herring, Scott. "Collyer Curiosa: A Brief History of Hoarding." Criticism, Spring 2011.
- New York Daily News. "Inside the Collyer brownstone: The story of Harlem's hermits and their hoarding." (Nov. 20, 2017) http://www.nydailynews.com/new-york/collyer-brothers-brownstone-gallery-1.1187698?pmSlide=1.1187676
- Park, Madison. "Drowning in junk: Hoarding called a public health issue." CNN, Aug. 5, 2010. (Nov. 20, 2017) http://www.cnn.com/2010/HEALTH/07/29/hoarding.mental.behavior/index.html
- Pittsburgh Press. "Langley kept faith with bother to the end, died under junk near him in their 'castle'." April 9, 1947. (Nov. 20, 2017) https://news.google.com/newspapers?nid=1144&dat=19470409&id=plMbAAAAIBAJ&sjid=10wEAAAAIBAJ&pg=4740,2938272
- Samuels, J et al. "Significant linkage to compulsive hoarding on chromosome 14 in families with obsessive-compulsive disorder: results from the OCD Collaborative Genetics Study." American Journal of Psychiatry, March 2007. (Nov. 20, 2017) https://www.ncbi.nlm.nih.gov/pubmed/17329475
- Samuels, Jack et al. "Prevalence and Correlates of Hoarding Behavior in a Community-Based Sample." Behavioral Research and Therapy, June 2008. (Nov. 20, 2017) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2483957/