Hoarding Disorder. The hidden illness.
If you are looking at this page, then I'm guessing you are worried about a loved one who you believe could be a hoarder. You have my sympathy. I've had a lifetime of living with a chronic hoarder (my mum) and never understood why our home was so cluttered and messy, or why I would get into trouble if I tried to tidy up, or throw out the rubbish. I've experienced the shame and humiliation when people see your home, felt the "doorbell dread" and I've cursed the do-gooders who suggest throwing it all into a skip when she's not there. I've begged, bullied and even tried to bribe mum into clearing out the house and I don't have any easy answers for you.
Some of you may have given up, or distanced yourself from the situation. Perhaps you feel unable to help, or that your efforts are unappreciated or that you are less important to the hoarder than their possessions. At times, trying to work with a hoarder is soul destroying; it requires patience and often feels like swimming against the current. It is exhausting and takes an emotional toll on friends and family members who are so emotionally invested in the situation.
Now that Hoarding Disorder has been recognised as a condition in it's own right by the DSM-V (American Psychiatric manual of mental disorders), there is hope that the UK may follow suit, which could in turn mean that more funding becomes available for research, and effective treatment plans developed. In the meantime, family and friends are left to try and help those struggling with hoarding problems.
That is not to say there is nothing you can do. How much will depend on your situation.
Your needs are just as important as theirs. It is easy to focus on the hoarder as they are seen to be the one with the “problem”, and yes they might feel anxiety when discarding possessions, but you might also feel anxiety about being forced to live in a home which is filled to the brim. It is vital that you have your own space to escape to somewhere in the home.
You could ask the hoarder to see their doctor about it, and offer to accompany them for moral support, or if that is not an option, see your own doctor and ask them to refer you to someone who can give you a family therapy session at home.
During this session, everyone who lives in the home can agree on some house rules. It is important to ask the hoarder to make suggestions and get them on board otherwise the rules won’t be effective. If you prefer, a trusted friend could act as mediator.
Some suggested rules: Communal areas will be kept clear and free from clutter, items left in communal areas can be moved to their owner’s room, newly acquired items go into each individual's own room, new items in communal areas must have everyone's agreement, or be on a one-in-one-out basis, items left in communal areas without agreement may be removed from the home after a warning etc.
This is a very difficult situation, because all you want to do is help them, but there really is little point embarking on a clearing mission without the cooperation of the person who hoards because it will do nothing to solve the long-term problem, will probably make them worse, damage your relationship, leave them feeling violated and victimised and in worst case scenarios, could even end up with the hoarder feeling suicidal or being sectioned for their own safety.
It is better to let them know that you will support and help them when they are ready to clear the house, and in the meantime you can maintain your relationship outside of the home.
The situation is even more difficult if there are children or animals living in the house. You have a responsibility towards them. I'm not necessarily suggesting having them removed, but a little more pressure can be applied, although even the threat of having children removed is often still not enough to unlock the hoarder from their crippling feelings of anxiety.
For our family, nothing we did ever worked, until mum agreed to try psychological treatment and antidepressant medication. Although the problem is by no means solved, we have been able to start clearing together and my youngest brother has been allowed to return home. This won't be the solution for everyone, there may be some other catalyst or crisis, which is a turning point, and once they ask you for help, you need to strike while the iron is hot.
Important things to remember when working with a hoarder are; consistency, respect, trust, encouragement, patience, immediate removal of items which have been allowed to go (more tips on Self Help page).
Don't take all the responsibility on yourself, share the burden between a few of you. In some cases, hoarders may be entitled to "direct payments" to pay someone to help them. The NHS & Mental Health services can provide more information and psychiatry / psychology treatments which are essential.
A large space to spread things out and sort through is very useful, and we found a company called www.stuffusell.co.uk who collected the items that mum didn't want to keep, and sold them for her. Items that couldn't be sold were either donated or recycled, and this made the process much easier for mum, by minimising the number of decisions she had to make, and the amount of follow up action she had to take.
Finally, one a space is clear, regular help will be needed to maintain it.