Hoarding was once a subtype of OCD

The Kitchen – surrounded by clutter, she’s left a 10-inch area to eat her meals

As recently as 2013, a hoarding was a subtype of OCD, but now it’s its own category (DSM-5). OCD was definitely prevalent, and all to evident in this home I recently visited in the Bay Area.  In this case, this person has good insight and recognizes that obsessive-compulsive disorder (OCD) is showing up in her apartment by way of too much stuff. She told me she felt like she is “buried alive with stuff, like a ball and chain around me.” She reached out to me for help, and with the sound of my voice, she told me, “you’re comforting my heart”. Yes, there’s a lot of work to be done, but I know I can improve the her health, safety, and quality of life with patience and compassion.

The bedroom, filled to the max with more bagged clothes. She only sleeps on top of her bed.
Self described “germaphobe”, she bags all her clothes to “protect” them.

“Need” is a Powerful Word

What do you really “need” to keep?  Sorting your stuff can be overwhelming and cause a lot of anxiety.  To put what you really “need” to the test, Michael Tompkins, PhD, a licensed psychologist and board certified in behavioral and cognitive psychology, and author of many books regarding hoarding, suggests when you sort your stuff, ask yourself these three powerful questions:

  1. Is my SAFETY at risk?
  2. Is my HEALTH at risk?
  3. Is my FINANCIAL welfare at risk?

When you ask yourself these questions you may find that you really don’t “need” as much as you want to keep.  He also suggests, if an item is broken – let it go.  If you have others (usually many) – let it go.  If you don’t repair “it” in a month or two — let it go!  Other sorting tips suggested by Tompkins, is to use a three box sorting system:  HARD to toss; MODERATE to toss; and EASY to toss. By practicing these sorting tips, you will build a level of tolerance, which leads to less anxiety.

Hoarding and Cluttering, Think Outside the Boxes: Innovation in Action

The 18th International Conference on Hoarding and Cluttering, sponsored by the Mental Health Association of San Francisco, was held at Cal  Berkeley, March 22-23, 2018.  This two day conference was enlightening, enriching, and educational! I learned about new research and techniques that will help my clients who suffer from the mental disorder of Hoarding.  As a part of my studies with the Institute for Challenging Disorganization (ICD) to earn my credential as a Certified Professional Organizer in Chronic Disorganization (CPO-CD®), I was honored to meet Dr. Chia-Ying Chou, who has worked with 130 individuals with Hoarding Disorder.  Her emotional and informative presentation on Experience Compassion Focused Therapy for Hoarding, was an uplifting, refreshing new approach for treatment of hoarding disorder.  She has been co-developing this new treatment protocol for this mental illness called, Compassion Focused Therapy (CFT), with other experts in hoarding.  I was fortunate enough to spend 30 minutes with Dr. Chou, a related professional, to talk about ICD and how Professional Organizers like me, who work with clients with hoarding behavior, can work collaboratively.   Together, we can both help support our clients who have Hoarding Disorder.         

I was also lucky enough to learn from Michael Tompkins, PhD – a licensed psychologist, who spoke on Three Essentials Coaching Skills:  Sorting, Making Decisions, and Follow Through as it relates to people who hoard.  He explains, “People who hoard lack several skills that are necessary to declutter their living environments, effectively.”  To start the process of sorting, he suggested the use of three boxes, labeled   1) Impossible to let go; 2) Moderately impossible to let go; 3) Easy to let go.  To demonstrate this process, audience members sorted their purse or wallet, using the three categories above. We examined our “rules” for putting the items into each of the three categories.  Then we were challenged to ask ourself:  Do we really need these things? By letting go, is my “safety at risk?”; Is my “health at risk?”; and, is my “financial welfare at risk?”  When we applied the three questions, our perspective of what was “impossible” to let go changed to “easy”. This was a powerful, yet basic demonstration on the value we place on material things that we think we “need”.  

The Rewards of Organizing

My featured image is of a client’s dining room table. Look really hard…Do you see the table in the room in the above picture?  Probably not, but the light hanging over her dining room table will give you a hint.  “Hoarding Disorder” is now recognized in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a mental disorder.  This is a serious disorder and one that I learn more about every time I have a session with any of my clients who have hoarding behavior, and from my studies through the Institute for Challenging Disorganization (ICD).  Recently, I administered the ICD Clutter Quality of Life Scale (CQLS) to my client. The CQLS is designed to measure inward, or subjective, consequences of clutter from the individual’s perspective. The CQLS highlights the various dimensions of clutter impact on quality of life like: Livability of Space, Emotional, Social, Financial. Although my client clearly has hoarding behavior, interestingly enough, she did not consider herself as a person who hoards. However, after taking the CQLS, she now understands the impact her hoarding behavior has on various aspects of her life, especially the livability of space, emotional and social aspects.  We have spent many, many hours together over the past year. Though she is making progress, she admits she is very vulnerable to backsliding.