First, let me say, I found it very sad and pathetic; her whole life, Mother stressed over getting organized, but accepted no help, nor self-reflecting as to the causes.

Several years before my moving to care for Mother, I attended a week-end seminar to gain more understanding, finding hoarding is one of the most difficult character traits to correct or help. I still find the research fascinating.

One study in particular remains with me. Therapists were assigned to people who hoarded. They daily helped the person understand the behavior and reasoning behind the obsessive need to keep things, and helped the client to organize and remove items. Even with intensive therapy and interventions, the clients all returned to hoarding.

Stages that may be observed, although not in all cases
– Clutter, but no concern
– Deteriorating hygiene, possible hoarder
– Extreme disorganization, likely disorder in life activities
– Excessive clutter & behavior, consider contacting a professional
– Severe unsanitary conditions, hoarding diagnosis

Diagnosis (American Psychiatric Association)
Hoarding disorder is a mental health problem that a doctor can diagnose using the following criteria:
– Persistent difficulty discarding or parting with possessions, regardless of their actual value
– Difficulty due to perceived need to save the items and to the distress associated with discarding them
– Difficulty discarding possessions resulting 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 (e.g., family members, cleaners, or the authorities)

Assessment includes questions such as:
– Do you have trouble parting with possessions (such as discarding, recycling, selling or giving away)?
– Because of the clutter or number of possessions, how difficult is it to use the rooms and surfaces in your home?
– To what extent does your hoarding, saving, acquisition and clutter affect your daily functioning?
– How much do these symptoms interfere with school, work or your social or family life
– How much distress do these symptoms cause you?

Mental health professionals may also ask permission to speak with friends and family to help make a diagnosis or use questionnaires (rating scales) to help assess level of functioning.

Causes
Hoarding is a fairly recent psychological classification and causes are still being researched. The neurobiology of hoarding disorder is a newly burgeoning field and it is premature to draw firm conclusions.

It could be the result of: trauma, depression, anxiety, or even OCD. A stressful life event, such as the signification illness or death of a loved one can worsen symptoms of hoarding.

Hoarding appears to be more common among individuals with a family member who also has a problem with hoarding.

Treatment
It is important to note that hoarding disorder is a chronic condition and it is unlikely the person will be completely cured of hoarding tendencies.

The person may be unable to express, face, or resolve difficult experiences. Hoarding may help cope with mental problems and help distract from significant anxiousness or fear.

The literature suggest that CBT (cognitive behavioral therapy) has shown some success for hoarding disorder, teaching people to gradually discard items, lessen distress and perceived need to save these possessions. With proper treatment, individuals may learn to manage their symptoms and improve their quality of life.

Helping
Know there is a difference between clutter and hoarding. Collecting: possessions are part of a larger set of items which do not limit active living areas in the home. Whereas in hoarding: possessions are disorganized, accumulate around living areas and piles prevent rooms from being used.

You can listen and try to understand, remembering that most hoarders struggle with the fear of not having something when they need it, and to get rid of hoarding causes deep anxiety.