Signs of a hoarder

Contents

Hoarding: The Basics

I’ve always had trouble throwing things away. Magazines, newspapers, old clothes… What if I need them one day? I don’t want to risk throwing something out that might be valuable. The large piles of stuff in our house keep growing so it’s difficult to move around and sit or eat together as a family.
My husband is upset and embarrassed, and we get into horrible fights. I’m scared when he threatens to leave me. My children won’t invite friends over, and I feel guilty that the clutter makes them cry. But I get so anxious when I try to throw anything away. I don’t know what’s wrong with me, and I don’t know what to do.
This example is typical of someone who suffers from hoarding. Read on to learn more, including the differences between hoarding and collecting.

Understanding Hoarding

Hoarding is the persistent difficulty discarding or parting with possessions, regardless of their actual value. The behavior usually has deleterious effects—emotional, physical, social, financial, and even legal—for a hoarder and family members.
For those who hoard, the quantity of their collected items sets them apart from other people. Commonly hoarded items may be newspapers, magazines, paper and plastic bags, cardboard boxes, photographs, household supplies, food, and clothing.

Find out about animal hoarding.
Hoarding can be related to compulsive buying (such as never passing up a bargain), the compulsive acquisition of free items (such as collecting flyers), or the compulsive search for perfect or unique items (which may not appear to others as unique, such as an old container).

Symptoms and Behavior

Someone who hoards may exhibit the following:

  • Inability to throw away possessions
  • Severe anxiety when attempting to discard items
  • Great difficulty categorizing or organizing possessions
  • Indecision about what to keep or where to put things
  • Distress, such as feeling overwhelmed or embarrassed by possessions
  • Suspicion of other people touching items
  • Obsessive thoughts and actions: fear of running out of an item or of needing it in the future; checking the trash for accidentally discarded objects
  • Functional impairments, including loss of living space, social isolation, family or marital discord, financial difficulties, health hazards

Reasons for Hoarding

People hoard because they believe that an item will be useful or valuable in the future. Or they feel it has sentimental value, is unique and irreplaceable, or too big a bargain to throw away. They may also consider an item a reminder that will jog their memory, thinking that without it they won’t remember an important person or event. Or because they can’t decide where something belongs, it’s better just to keep it.
Hoarding is a disorder that may be present on its own or as a symptom of another disorder. Those most often associated with hoarding are obsessive-compulsive personality disorder (OCPD), obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and depression.
Although less often, hoarding may be associated with an eating disorder, pica (eating non-food materials), Prader-Willi syndrome (a genetic disorder), psychosis, or dementia.

Diminished Quality of Life

A lack of functional living space is common among hoarders, who may also live in unhealthy or dangerous conditions. Hoarders often live with broken appliances and without heat or other necessary comforts. They cope with malfunctioning systems rather than allow a qualified person into their home to fix a problem.
Hoarding also causes anger, resentment, and depression among family members, and it can affect the social development of children. Unlivable conditions may lead to separation or divorce, eviction, and even loss of child custody. Hoarding may lead to serious financial problems, as well.

Learn about staging an intervention.

Hoarding vs. Collecting

Hoarding is not the same as collecting. In general, collectors have a sense of pride about their possessions and they experience joy in displaying and talking about them. They usually keep their collection organized, feel satisfaction when adding to it, and budget their time and money.
Those who hoard usually experience embarrassment about their possessions and feel uncomfortable when others see them. They have clutter, often at the expense of livable space, feel sad or ashamed after acquiring additional items, and they are often in debt.

Hoarding Resources:

Fugen Neziroglu, PhD, ABBP, ABPP, is Director of the Bio-Behavioral Institute, in Great Neck, New York

The 5 Hoarding Levels

For immediate assistance with hoarding cleanup, contact Aftermath today.

According to the Anxiety and Depression Association of America, “Hoarding is the compulsive purchasing, acquiring, searching, and saving of items that have little or no value. The behavior usually has deleterious effects—emotional, physical, social, financial, and even legal—for a hoarder and family members.” A house or building impacted by hoarding can be dangerous and unhealthy for occupants and neighbors. Swift action is required to address the hoarding problem to ensure the health of everyone nearby.

5 Hoarding Levels

The National Study Group on Compulsive Disorganization created a Clutter Hoarding Scale as a guideline for professional organizers making their first few contacts with clients:

  1. Hoarding Level One: Clutter is not excessive, all doors and stairways are accessible, there are no odors, and the home is considered safe and sanitary.
  2. Hoarding Level Two: Clutter inhabits two or more rooms, light odors, overflowing garbage cans, light mildew in kitchens and bathrooms, one exit is blocked, some pet dander or pet waste puddles, and limited evidence of housekeeping.
  3. Hoarding Level Three: One bedroom or bathroom is unusable, excessive dust, heavily soiled food preparation areas, strong odors throughout the home, excessive amount of pets, and visible clutter outdoors.
  4. Hoarding Level Four: Sewer backup, hazardous electrical wiring, flea infestation, rotting food on counters, lice on bedding, and pet damage to home.
  5. Hoarding Level Five: Rodent infestation, kitchen and bathroom unusable due to clutter, human and animal feces, and disconnected electrical and/or water service.

Dangers of Hoarding Cleanup

Bioremediation and hoarding cleanup professionals are best equipped to clean and disinfect areas impacted by hoarding. Many people do not realize the health and safety hazards associated with hoarding cleanup in connection to biohazards. Possible biohazards include Hantavirus, Histoplasmosis, Staph bacteria including MRSA (Methicillin-Resistant Staphylococcus Aureus) and E. coli, just to name a few.

Who Gets Hoarding Disorder?

Hoarding disorder affects people of all ages and demographics. However, hoarding is more prevalent in older age groups, and the symptoms seem to intensify with age.

Hoarding can severely disrupt the daily life of the person ailing from the disorder and cause them to become reclusive. Aftermath’s hoarding cleanup professionals often find that hoarding is present in homes where an unattended death has occurred, typically older adults living alone. When an older person who suffers from hoarding disorder is isolated from friends and family, unattended death risk is greatly increased because there is no one to find the person immediately after he or she has passed away.

Hoarding Cleanup Services

Because of the potential health hazards associated with an unattended death, as well as the disturbing nature of decomposition, cleaning up a hoarding site where an unattended death has occurred should be left to a professional bioremediation company like Aftermath. At Aftermath, we understand that cleaning up after an unattended death is one of the most challenging situations a family can face. We provide unattended death and hoarding cleanup services 24 hours a day, 7 days a week. Speak to an Aftermath representative today for more information.

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Hoarding is the compulsive need to find and keep objects, animals or trash regardless of their value. Items commonly hoarded include newspapers, photographs, boxes, clothes, food, furniture, paper and plastic bags, appliances or electronics. Depending on how extreme a person’s hoarding is, the behavior can impact their physical or emotional health, relationships, financial and legal stability, and professional aspirations.

There is more than one type of hoarding disorder. There are different levels of hoarding that identify the severity of a person’s disorder. The National Study Group on Compulsive Disorganization created a clutter hoarding scale with five levels of hoarding. Understanding each level of hoarding disorder can help people understand how to help those affected by the condition.

Hoarding Level 1

The first level of hoarding is the least severe. The residence of a level 1 hoarder may include:

  • Light amounts of clutter and no noticeable odors.
  • All doors and stairways are accessible
  • No more than three areas with animal waste throughout the house.

Hoarding level 1 involves few signs that an individual has a hoarding disorder. The lack of clutter might hide the condition, but the individual may still have difficulty throwing away items and shop excessively for objects they do not need.

Hoarding Level 2

Hoarding level 2 requires a blocked exit from a person’s residence, one appliance not working for at least six months or the presence of a malfunctioning heating, cooling or ventilation system for at least six months. This level of hoarding involves additional clutter around the residence, specifically in two or more rooms, and narrow pathways through the home. There must also be at least a light amount of mildew in one bathroom or the kitchen. Other characteristics include:

  • Light pet odor
  • Pet waste on the floor
  • At least three incidents of feces in a litter box
  • Minimal fish, bird or reptile care
  • Evidence of household rodents
  • Overflowing garbage cans
  • Dirty food preparation surfaces

People within hoarding level 2 may avoid inviting people into their homes or show embarrassment due to the state of their residence. This level of hoarding may cause anxiety or a depressed state and lead to withdrawal from social interaction.

Hoarding Level 3

Residences within hoarding level 3 have visible clutter outside of the home, including items that are usually indoors (such as televisions and furniture). At least two appliances have been broken for six months, and one area of the house has light structural damage. The number of pets exceeds regulations, and animal tanks and cages are neglected. There is visible and audible rodent evidence, fleas, spider webs and narrow paths through the halls and stairways. Other characteristics include:

  • At least one unusable bathroom or bedroom
  • Small amounts of hazardous substances or spills on the floors or surfaces
  • Excessive dust
  • Dirty clothes, towels and sheets
  • Blocked electrical outlets resulting in tangled cords
  • Overflowing garbage cans
  • Odors throughout the house

A person within this level often has poor personal hygiene and weight issues due to an unhealthy diet. An individual in this level of hoarding may become dismissive or angry when approached by friends or family members about the state of their lifestyle.

Hoarding Level 4

Residences within hoarding level 4 have noticeable mold and mildew throughout the building, structural damage that is at least six months old, odors and sewage buildup. The number of pets exceeds regulations by at least four, and there are more than three visible areas with aging animal waste. The bedroom is unusable and rotting food is on surfaces. Other characteristics include:

  • Aged canned goods
  • No clean dishes or utensils
  • Beds with lice, or other bugs, and no sheets or covers
  • Excessive webs and spiders
  • Bats and other rodents audibly noticeable in the attic and walls
  • More than one blocked exit
  • Flammable substances stored in the living room

People within hoarding level 4 have poor hygiene and may not bathe for weeks. These individuals often have worsening mental health and focus their emotional energy on grandiose plans or nostalgic memories.

Hoarding Level 5

Hoarding level 5, the most severe type of hoarding disorder, involves severe structural damage to the residence. Broken walls, no electricity or running water, fire hazards, and visible rodents and other non-pet animals are a few of the characteristics of homes within hoarding level 5. Other signs include:

  • Clutter filling bathrooms and kitchen
  • At least four too many pets, per local regulations
  • Noticeable human feces
  • Rotting food on surfaces and inside a non-working refrigerator

People within hoarding level 5 often do not live at their residence due to the clutter but rather stay at a friend’s or family member’s house. They may also discharge their waste into bottles or buckets that remain inside the home. Individuals within this level of hoarding usually have noticeable symptoms of depression.

Aftermath of Hoarding

Hoarding can have severe consequences for not only the individual with the disorder but also their loved ones. Financial strain due to excessive shopping is one of the most common consequences of hoarding. Other effects include strained relationships and possible loss of housing due to eviction, depending on the severity of the disorder.

Children of people with a hoarding disorder may experience depression or another mental condition due to their living situation. Adolescents and teenagers may avoid social situations that involve inviting peers to their house because of their embarrassment about the state of the residence. Some children become resentful of their parents due to the unhealthy lifestyle they experience due to the hoarding.

Hoarding can also lead to substance abuse as a coping mechanism for the disorder. If your loved one’s hoarding has led to substance abuse, call The Recovery Village. Representatives are available to help people find the treatment they need. The Recovery Village’s rehabilitation centers specialize in addiction treatment and can address connected mental health disorders, including a hoarding condition.

“Levels of Hoarding: Some Guidelines for Recognizing the Problem.” Pittsburgh Post-Gazette. Published December 2, 2010. Accessed January 8, 2018.

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The growing awareness of excessive hoarding has sparked debate over the cause and definition of the mental illness.

Hoarding is the excessive collection of items, along with the inability to discard them, according to the Mayo Clinic. Hoarders can collect everything from old newspapers to clothes and furniture. Some even hoard pets, creating an unsafe and unsanitary environment for themselves as well as the animals.

When traumatic loss leads to treacherous gains

Those who have suffered a traumatic loss may be more likely to become hoarders than those who haven’t.

“Research is being done on hoarding among foster children because it has been noted that there appears to be a higher prevalence rate among them than among non-foster children,” said Elaine Birchall a social worker who counsels hoarders in Ontario, Canada. “Given the correlation with traumatic loss among adult hoarders, this isn’t surprising.”

Some people develop hoarding tendencies after experiencing a stressful life event that they had difficulty coping with, such as the death of a loved one, divorce, eviction or losing their possessions in a fire, according to The Mayo Clinic.

While the exact cause of hoarding is not known, having certain other disorders puts a person at a higher risk of also developing hoarding behaviors, Birchall told Life’s Little Mysteries.

Compulsive hoarding behaviors are more prevalent among people who also have obsessive compulsive disorder, anxiety disorders, personality disorders, depression, addictions, post-traumatic stress disorder, and those who have suffered a traumatic loss or are aging with mobility limitations, according to Birchall.

However, it is important to know that these disorders do not cause hoarding tendencies, Birchall said. For some, hoarding acts as a coping mechanism a conservative estimate of 2 percent to 2.5 percent of the U.S. population has a stress response that involves holding on to things because having more makes them feel safer and happier, according to Birchall.

Mental health experts also believe the disorder can be triggered by anxiety. In fact, this may lead to a change in the way the disorder is classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM; the handbook mental health professionals use when diagnosing patients) which is being revised.

Some hoarders seem to feel unable to process all of the things that are part of their daily lives and feel “anxious, overwhelmed and ashamed” as the piles of clutter accumulate around them, according to Birchall. These people are often perfectionists and worry about making the right decision about what to do with each possession. The stress of trying to make a decision becomes too much for them, to the point where they avoid having to decide altogether by simply keeping everything.

Still others fail to see their hoarding behavior as a problem, which makes treatment challenging, according to The Mayo Clinic.

A lethal collection

People with extreme hoarding tendencies can literally be putting their lives in danger. There are several reported cases of hoarders dying in their homes after piles of clutter collapsed, burying and trapping them underneath.

In one such case, a 62-year-old woman named Marie Rose suffocated to death in her Shelton, Wash., home after a two-meter (6-foot) high pile of clothes and debris collapsed on top of her in 2006, apparently while she had been looking for the telephone. According to news reports, it took police, with the help of her husband, 10 hours to find her body.

Animals are also unfortunate casualties of hoarding. For example, in 2005, 82-year-old Ruth Knueven was found to have a total of 488 cats 222 of which were deadin her two homes in Fairfax County, Va.

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Got a question? Email it to Life’s Little Mysteries and we’ll try to answer it. Due to the volume of questions, we unfortunately can’t reply individually, but we will publish answers to the most intriguing questions, so check back soon.

Hoarding: Understanding and Treating

Diagnosis and treatment of HD is possible. However, it may be difficult to persuade a person with HD to recognize the condition. Loved ones or outsiders may recognize signs and symptoms of HD long before the person with the condition comes to terms with it.

Treatment for HD must focus on the individual and not solely on the spaces that have become overrun with clutter. A person must first be receptive to treatment options in order to change their hoarding behavior.

Diagnosis

Someone seeking treatment for HD should first see their doctor. A doctor can evaluate HD through interviews with the person as well as their loved ones. They may also visit the person’s space to determine the severity and risk of the situation.

A thorough medical evaluation may also help diagnose any other underlying mental health conditions.

Cognitive behavioral therapy (CBT)

Individual and group cognitive behavioral therapy (CBT) may be the most successful way to treat HD. This should be directed by a medical professional.

Research has shown that this type of treatment can be useful. A review of literature indicated that younger women who went to several CBT sessions and received several home visits had the most success with this line of treatment.

CBT can be done in an individual or group setting. The therapy focuses on why someone may have a hard time discarding items and why they desire to bring more items into a space. The goal of CBT is to alter behavior and the thought processes that contribute to hoarding.

CBT sessions may include creating decluttering strategies as well as discussing ways to prevent bringing in new items to the space.

Peer-led groups

Peer-led groups can also help treat HD. These groups can be friendly and less intimidating to someone with HD. They often meet weekly and involve regular check-ins to provide support and evaluate progress.

Medications

No medications exist specifically to treat HD. Some may help with symptoms. A doctor may prescribe a selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor to help with the condition.

These medications are typically used to treat other mental health conditions. However, it’s not clear whether these medications are useful for HD. Some research has indicated that medications for ADHD may also be helpful for HD.

Helpful support

Supporting a person affected by HD can be challenging. HD can cause strain between the affected person and loved ones. It’s important to let the person with HD become self-motivated to get help.

As an outsider, it’s tempting to believe that cleaning out the cluttered spaces will solve the problem. But the hoarding will likely continue without proper guidance and intervention.

Here are some ways you can support a person with HD:

  • Stop accommodating or assisting the person with hoarding tendencies.
  • Encourage them to seek professional help.
  • Support without criticizing.
  • Discuss ways they could make their space safer.
  • Suggest how treatments may positively impact their life.

Brigitte Sire / Getty Images

Why do some people find it impossible to get rid of old newspapers and junk mail, and end up hoarding them instead?

New research suggests that hoarders have unique patterns of brain activity when faced with making decisions about their possessions, compared with healthy people. And despite the fact that hoarding has traditionally been seen as a symptom or subtype of obsessive compulsive disorder (OCD), brain activity in those who cannot de-clutter is also distinct from that of people with typical OCD, the study shows.

“Many things are unique and distinct about hoarding,” says Dr. Eric Hollander, director of the autism and obsessive compulsive spectrum disorder program at Montefiore/Albert Einstein School of Medicine in New York, who was not associated with the new research. He notes that the new study adds to the evidence that hoarding should be recognized as a specific syndrome that falls not under the standard definition of OCD — only about 18% of people with hoarding symptoms meet the full criteria for OCD as it is currently defined — but within a spectrum of related conditions. “ is a very interesting and important study,” he says.

Indeed, a separate diagnosis of hoarding disorder has been proposed for inclusion in the upcoming revision of psychiatry’s diagnostic manual, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

(MORE: Real-World Hoarders and Obsessive-Compulsives: A Conversation with an OCD Expert)

For the new research, published in the Archives of General Psychiatry, David Tolin of the Institute of Living in Hartford, Conn., recruited 107 people for brain scans using functional magnetic resonance imaging (fMRI). Forty-three people had hoarding disorder, 31 people had OCD and 33 participants were normal controls.

The participants were asked to bring a sample of their own junk mail or newspapers to the lab and were assured that researchers wouldn’t throw out anything they wanted to keep. The participants were also told that while they were having their brain activity imaged, they would be asked to decide whether to keep or shred these papers. Inside the scanner, the participants were shown images of either their own stuff — preceded by a slide identifying it as “Yours” — or images of junk mail and newspapers from the lab, labeled “Ours.” For each item, they had to decide whether or not to submit it to the shredder.

Not surprisingly, people with hoarding disorder chose to keep more of their own items than did those with OCD or those without a diagnosis. When they were faced with tossing or keeping their own items, the hoarders’ brain responses also differed from that of the other participants: they showed excessive activation in the anterior cingulate cortex, a brain region involved with decision-making, particularly in situations involving conflicting information or uncertainty.

Activity was also elevated in the insula, a region that monitors one’s emotional and physical state (it’s also involved in disgust, shame and other strong negative emotions). Together, these regions help assign relative levels of importance or significance to objects.

(MORE: A Better Way to Treat Obsessive-Compulsive Kids)

“Hoarders have great difficulty making decisions, especially around the value of their possessions,” says Michael Jenike, an OCD expert and professor of psychiatry at Harvard, who was not associated with the research. “This study is very interesting as it demonstrates that brain regions associated with monitoring for errors under conditions of uncertainty are activated when hoarding patients are deciding whether or not to throw out personal items.”

In other words, hoarders assign too much value to their possessions, making it difficult or impossible to decide to get rid of them.

Consequently, the study found that people with hoarding disorder took much longer to make decisions about discarding their possessions and felt more sadness and anxiety about these choices than did the other participants. “One of the characteristics of hoarding is that people feel this sense of discomfort if they feel like they may be giving away something that they could use in future,” says Hollander, explaining that patients often become greatly distressed or even angry if they are pushed to give up apparently useless or excess possessions.

Interestingly, however, when people with hoarding disorder made similar decisions about discarding junk mail that didn’t belong to them, they again showed unusual levels of activity in the anterior cingulate cortex and insula — but in this case, their brain activity was much lower than normal.

The paper’s authors note that the reduced activity is a “pattern reminiscent of that seen in patients with autism,” who are often disengaged from others and who, like hoarders, have rigid routines as well as obsessive behavior. The authors suggest that this lack of brain activity could be linked with the “diminished motivation and poor insight frequently observed” in patients who hoard; that is, it may be what allows them to live amidst overwhelming clutter and piles of junk, but fail to clear it out or even be bothered by it.

(MORE: Want to Make Quicker Decisions? Muzzle Your Brain)

Meanwhile, the hyperactivity in these regions may make them overly anxious about and attached to their own possessions, rendering them too overwhelmed to decide to change. Hollander compares it to a “check engine” light that keeps flashing on the dash for no reason. A healthy person might be able to disregard the alarm as irrelevant, but the hoarder becomes obsessively focused on it. “One problem with hoarding, and with OCD, is that when that alarm goes off, it becomes more and more important and the brain pays more and more attention to these signals.” says Hollander. “The specific concern becomes more and more salient and other routines and activities become less salient, and that’s what’s associated with functional consequences. Their lives get smaller and smaller.”

So, it’s not that hoarders are slobs or obsessive collectors. Rather, it’s that they have problems making the kinds of decisions about their stuff that others would consider reasonable.

Hollander notes also that the new findings could have important implications for the treatment of hoarding. A new type of transcranial magnetic stimulation (TMS), for example — a therapy that uses non-invasive electrical stimulation of the brain to treat depression — may work for people with hoarding disorder. Although the TMS currently used for depression doesn’t reach all brain regions, the new type may be able to affect the insula. “Because of the shape of the coil, it can penetrate more deeply into brain,” says Hollander. “This study suggests that if you want to treating hoarding, the insula would be a good target.”

MORE: Zones of Seduction: How Supermarkets Turn Shoppers Into Hoarders

Maia Szalavitz is a health writer at TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland’s Facebook page and on Twitter at @TIMEHealthland.

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What is hoarding disorder?

Many people collect things as a hobby or for sentimental reasons — from stamps to their kids’ teeth. However, some people’s compulsion to collect and keep things can have a negative impact on their everyday life.

Hoarding becomes a disorder when someone collects too many things and has difficulty letting go or throwing out things that are out of date or no longer functioning. Often, people who hoard have difficulty moving around their home because of the number of things they have accumulated. The person may even no longer be able to maintain or clean their home.

Complications of hoarding disorder

People who hoard often buy too much, so as to keep up with their compulsion, which can result in financial hardship and/ or relationship problems. Hoarding can lead to living in squalid conditions, which is a health hazard. Compulsive buying and hoarding has links to obsessive compulsive disorder (OCD) and depression.

Where to get help

Talk to your doctor or another trusted health professional if this is happening to you, and discuss your situation and how you are feeling. You can also call:

  • Mindspot (free treatment course designed to help people with compulsions learn to overcome their distressing obsessions) — call 1800 614 434.
  • ThisWayUp (trial treatments for compulsive behaviours) — call (02) 8382 1400.

The visible signs that a loved one has Hoarding Disorder (HD) can, in some cases, be pretty obvious. The large number possessions make it difficult to walk through rooms, it can be hard to locate items among all of the things, and/or it is impossible to use rooms as they were intended to be used due to the clutter. In short, the amount of clutter in your loved one’s home has completely taken over their life, and possibly your life too.

That said, extreme clutter does not happen overnight. It takes time for the amount of clutter to reach the level that your loved one can no longer live comfortably and safely in their home. There are early warning signs that your loved one may have HD, and the sooner you see these early signs the sooner you will be able to help.

Here are ten warning signs that your loved one may have HD.

  1. Your loved one keeps parts of the home (or the entire home) off-limits. People with HD often try to hide the clutter from others — they may close off areas of their home or try to keep others out altogether. They may fear that if you see the state of their home or certain rooms, you will demand they throw away possessions. They may also fear that you will touch or remove their possessions without their permission, and may therefore go to great lengths to keep you out of their space. If your loved one tells you that parts of their home are off-limits, or is overly concerned about others seeing inside their home, this may be a sign that they are struggling with HD.
  2. Your loved one insists on meeting you at your home or at the event. People with HD often feel uncomfortable having people in their homes. They may fear that you will discover the extent of the hoarding problem, or that if you visit you will take or accidentally damage their things. Or, perhaps they are just tired of arguing with you about the extreme clutter and the state of their home.
  3. You and your loved one talk a lot about the stuff. At first, your conversations with your loved one may be gentle and supportive. You might offer suggestions or advice on controlling the growing clutter, or you might offer to help clear things out. Over time, however, these conversations can become more heated and emotional if the clutter continues to grow. If you and your loved one are talking a lot about the stuff, particularly if these talks lead to conflicts, arguments, and/or hurt feelings on both sides, then your loved one may have HD.
  4. De-cluttering even a small area of the home is a major job that would take more than a few hours or days. Even a relatively small amount of clutter can pose an organizational nightmare to a person with HD. The inability to sort possessions efficiently may distinguish the person with HD from someone who is simply prone to disorganization and clutter. If a person without HD wishes to declutter a room or desk, for example, the person without HD can usually sort and organize the possessions efficiently. In contrast, a person with HD typically cannot organize, categorize, and make the many decisions necessary to declutter a space efficiently. The persons with HD often feels overwhelmed by the many ways they can sort, organize, or store an item and then stops the entire process. For this reason, even a loved one who is motivated to work on the clutter may fail without assistance and a lot of it.
  5. Your loved one often fails to pay bills. Your loved one may have bill collectors calling because of missed payments on house or credit card bills, even though they have the money to pay these bills. When you try to call your loved one, you may discover that the telephone company has disconnected the phone or that they are living without power or heat. The ability to pay bills promptly requires your loved one locating the bills, their checkbook, and stamps to mail the bills. Little tasks such as paying bills become big and overwhelming tasks when your loved one tries to do the task in a highly cluttered home.
  6. Your loved one is in debt because of excessive shopping or can’t seem to resist picking up free things. Another warning sign that your loved one may have HD is that they spend more money than they have or collect free things without a plan for their use. People with HD may not admit that they buy or collecting things they do not need, in part because they see these things as necessary or useful. You may see packages among the extreme clutter that have never been opened. You may find that your loved one has filled the pantry and closets with many more supplies than they can ever use, “just in case.”
  7. Your loved one has trouble finding things and resists storing things out of sight. Because of the quantity of stuff, people with HD often have trouble finding things. They may complain about misplaced purses or cell phones, and may arrive late to appointments because they could not find their toothbrush or clean socks. Adding to the problem, people with HD often insist on keeping all of their things in sight, usually in stacks from floor to ceiling or spread out over counters, tabletops, sofas, and the floor. People with HD are comforted when their possessions are in sight, and may resist storing things in closets, filing cabinets, or cardboard boxes.
  8. Your loved one puts off repairs to the home. As the clutter grows, your loved one’s home may fall into disrepair. Your loved one might complain about the leaky faucet or broken toilet, for example, but he/she will not let you fix anything. If the idea of calling a repair person or landlord is brought up, he/she may insist on cleaning the house first, but never get around to it – therefore the ceiling, refrigerator, radiator, etc. is never repaired. Over the years, you may watch as the home deteriorates and yet your loved one insists that things are not that bad.
  9. Your loved one’s garage is overflowing and/or he/she rents storage units. Overflowing closets and garages may be an early sign of HD. Your loved one may have asked you to store their things in your garage or home. Your loved one may also use their car to store items, or put them in the front/back yards of their home. Your loved one may pay to rent one or more storage units and always seems to be on the lookout for more space for their stuff.
  10. Your loved one will not let you touch or borrow their possessions. When you do visit your loved one’s home, your loved one may refuse to loan you a tool or other items even though they may have several of them. Your loved one may snap at you if you pick up one of their possessions or if you move something aside. You may have learned to keep your hands to yourself when you visit, and to stand rather than try to sit in the home.

If you think your loved one may have HD after reading these warning signs, to learn more about how to help a family member with HD. To find help for HD in your area, enter your zip/postal code in the blue Find Help box at the top of the page.

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7 Signs Your Friend Might Be A Hoarder

Many of us might believe that hoarding is a problem that only happens on TV; thanks to reality shows, the disorder is seen as a problem that afflicts only recluses or peculiar old people, whose hoarding habits escalate to the point where they become life-or-death issues. In the real world, however, hoarding isn’t a disorder that can only happen to “certain” people, and it isn’t a disorder that is always “obvious.” Though anyone can become a hoarder, the Anxiety And Depression Association Of America notes that it is typically seen among people already struggling with obsessive-compulsive disorder, attention-deficit/hyperactivity disorder (ADHD), or depression. The range of those disorders might give you an insight into how tricky hoarding is to treat, because it’s not a uniform behavior in response to a uniform problem. People hoard for many different reasons: to stop their anxiety or to feel safe; because they feel like it helps them avoid catastrophe; because it helps them cope with negative feelings. Basically, hoarding is not as simple as you might think it is.

If you do have a friend who you think may be at risk of hoarding, know that getting them help is not about just urging them to them clean their house; people dealing with hoarding have to treat their underlying mental health issues, not just tidy up.

And if you are helping a friend work through their problems with hoarding, make sure you get the help you need to support yourself through the process, too; if somebody close to you (or somebody with whom you share living space) has issues with hoarding, things are likely going to be fraught (or, at the very least, complicated), and it may be too much to handle on your own.

Here are seven signs of hoarding behavior that should definitely make you pay attention.

Check It Out: Stuff: Compulsive Hoarding and the Meaning of Things, $10, Amazon

1. They React Very Poorly When Asked To Clear Up

Requests (or commands from landlords or housemates) to clear out some of their stuff will likely be met with extreme, aggressive, or emotional reactions that read as out of proportion to the person making the request. They may avoid the issue, stonewall, react with dismissiveness or overt anger, but the outcome will be the same: they do not want to throw away their possessions, even if said possessions have no apparent use (and are making their life and living space difficulty to navigate). This is due to the strength of the psychological attachment that hoarders build towards their “hoard”.

2. They Seem To Acquire Many Belongings With No Obvious Use

One symptom persistently mentioned in the medical literature about hoarding is how the collected items may seem strange or “useless” to outsiders. This is part of what separates hoarding from collecting; hoarders will take home or keep anything from free flyers to unimportant magazines that went out of date three years ago; the items have no obvious use and aren’t for decoration or to complete a collection or project. Rather, it’s the physical act of having them, of storing them, that is the important element. Hoarders may also, according to the International OCD Foundation, develop the sense that inanimate objects have emotions of their own and don’t wish to be thrown away.

3. They No Longer Organize Their Stuff

The National Health Service points out that organization is one of the main distinctions between people who are “collectors” (you know, folks who have to own every single Barbie doll produced since 1960) and those who are actually hoarders: collectors organize, and often meticulously care for, their items. They’re conscious of where every item in their collection is, and are invested in maintaining its condition and order. Hoarders, on the other hand, may insist that they’re collectors, but hoarding doesn’t have an organizational principle; in a typical hoarding situation, things just pile up.

4. They’ve Become Reclusive Or Prefer To Meet Away From Home

When you think of hoarding, you may not immediately think about the social consequences, but according to the Mayo Clinic, social side effects are a part of the condition, not something that can be separated from it. If your friend is becoming seriously socially reclusive and refuses to leave their house, or, conversely, will only interact with people outside their home space (usually because of shame or embarrassment they feel about their conditions), it’s a sign to keep in mind.

Remember, however, that your friend may not necessarily draw a conclusion between their social habits and their hoarding habits; a study from 2010 about treating hoarding pointed out that “insight-related challenges” (the inability of hoarders to look at their own behavior rationally) actually make treating it with the same methods as other OCD conditions quite hard.

5. They Invest Strong Emotions In Possessions

We all have some objects we feel very strongly about — a pair of shoes we bought with the paycheck from our first real, adult job; a mug that reminds us over a wonderful trip we took. But the emotions that hoarders feel about objects are different.

The Clinician’s Guide To Severe Hoarding says that one of the biggest symptoms of hoarding behavior is “overvalued ideation;” in other words, hoarders have irrational ideas about the value of the stuff they have, hence their huge resistance to getting rid of it. The two most common methods of irrational valuing are giving objects massive sentimental weight, or believing they “may be useful someday,” both of which can be used to justify keeping huge amounts of items that are not useful, like out-of-date newspapers or outgrown clothing.

Another symptom that the Clinician’s Guide mentions is a sense of “inflated responsibility,” which means that a hoarder believes that they alone are responsible for deciding whether to keep or discard everything in their possession, and the responsibility paralyzes them. It’s hard to part with something when your head’s telling you that it might save you from a fire someday, or that it belonged to your Great-Aunt Nancy and thus can never be thrown away.

Dr. David Mataix-Cols at Help For Hoarders outlines a few other ways in which hoarders can be emotionally over-invested in their stuff. In the case of some people, he says, “hoarding accompanies a fear of contaminating/harming others if ‘contaminated’ possessions are discarded, or superstitious thoughts such as the unreasonable belief that throwing something away will result in a catastrophe of some kind.” That tends to be associated with fairly intense OCD, which is sometimes based around averting catastrophe with repetitive behavior.

6. Their Home Is Becoming Unsanitary

If you’ve noticed cockroaches, flies, rotting items, or other unhygienic conditions in your friend’s home due to their hoarding, it’s time to dismiss your doubts and try to help. An expert interviewed at Everyday Health noted that unsanitary living spaces — even they’re confined to just a few spots in the house or apartment — are a pretty crucial sign that the accumulation of possessions is getting out of hand.

The International OCD Foundation also notes that, in addition to unsanitary conditions, rooms that can no longer be used for their intended purpose (bedrooms for sleeping, bathrooms for washing) due to build-up of possessions are a warning sign of hoarding. Dirty conditions resulting in an inability to clean or remove food waste are a recipe for bad health, and should cause serious concern.

7. They Express Discomfort About Other People Interacting With Their Belongings

This is tied to feelings of over-attachment; the relationship a hoarder shares with their items is theirs and theirs alone, and they may react in strange ways when other people touch, interact with or even talk about their stuff. The Mayo Clinic lists “excessive attachment to possessions, including discomfort letting others touch or borrow them” as one of the leading signs of hoarding, which may seem strange to outsiders who think that the items hoarders accumulate seem to hav little value.

But that’s the key to understanding hoarding behavior; items that may look random or useless to us have been imbued with intense meaning by the hoarder, and we can’t begin to help a hoarder until we understand this.

Also Check Out: Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding, $9, Amazon

Images: Pexels, Giphy

Are you a hoarder? Check these 5 signs

For a long time hoarding was thought to be just a bad habit of messy, gluttonous or undisciplined people

But since hoarding was added to the Diagnostic and Statistical Manual (DSM-5) used by psychiatrists to diagnose mental illness, hoarding is now considered an obsessive-compulsive disorder.

  • Inside a hoarder’s home: Learning to unload the stuff and the stigma

“Now,” says Canada’s foremost expert on the relatively new psychiatric disorder, “we have a defined psychiatric condition which means that there’s a lot more time and energy and money invested in terms of understanding the problem, researching it and developing treatments for it.” Dr. Peggy Richter, a psychiatrist at Sunnybrook Health Sciences Centre and an associate professor of psychiatry with University of Toronto says, “Hoarding is not a symptom. Hoarding is a disease. It is a disorder of the brain.”Dr. Peggy Richter, a psychiatrist at Sunnybrook Health Sciences Centre and an associate professor of psychiatry with University of Toronto, is an expert on hoarding. (CBC)

Richter says, “Hoarding can range on a spectrum from very mild to very severe. At the mild end are people whose clutter would clearly be more severe than most of us would consider normal, very messy and very disorderly but might still be somewhat manageable.” At the other end “are people whose homes can be full literally up to the ceiling,” she says.

“One lady I’ve worked with lives in a little tunnelled-out area in her apartment which is otherwise full right to the ceiling.”

Up to four per cent of us could be hoarders, says Richter, who is also the head of the Frederick W. Thompson Anxiety Disorders Centre in Toronto.

“I think there’s still a great deal of stigma attached to mental health conditions in general,” says Richter.

This is a problem particularly for people who hoard, she says, because of the shame associated with hoarding. “That makes it all the harder to seek help and open up about it, even with people who care about them.”

I think there’s still a great deal of stigma attached to mental health conditions in general.– Dr. Peggy Richter, hoarding expert

She explains that hoarders can be anyone. “They can be you, me, your neighbour, your friend, so although many people may have a stereotype in mind from seeing some of the TV shows which really dramatized extremely severe cases of hoarding, in fact hoarding is very common.”

Because it’s a newly recognized disorder, says Richter, “there’s a lot about it we don’t yet understand.”

But there are enough commonalities to make a start at developing treatments.

“We see problems with time management, with organization, and that can often be misperceived by the person with the condition and those around them as laziness or lack of discipline. But the better we are getting to understand this disorder the more we’re realizing that these are real deficits in planning that happen for most of us very naturally and easily that really go along with the condition and need to be targeted with treatment as well.”

Five warning signs of hoarding:

This impedes your ability to function. You can’t find your keys, your purse, your wallet, your cell phone. You’re chronically delayed getting out the door because of looking for things.

A lot of us are chronically disorganized, but this goes farther. It gets in the way of your normal daily activities.

Unwillingness to allow anyone into your home

This happens when the clutter has become so bad that you are too embarrassed to let anyone else see it.

Most people suffering from hoarding feel tremendously isolated by their shame. When you do let people into your home, they’re taken aback by the clutter and comment on it.

‘Clutter blindness’

“Clutter blindness” blocks people from realizing how their home looks to others. Hearing concerns from somebody you trust is a good warning sign.

Being distressed about your belongings

Many of us enjoy collecting. But have your accumulated belongings become a burden rather than a pleasure? Do you have no way to display all the collectibles?

If so, this has probably gone beyond understandable, healthy collecting and become hoarding.

Compulsive buying or acquiring

Do you bring home too much stuff? Perhaps it’s shopping in person or online, or perhaps it’s collecting free stuff.

Realizing that you’re always coming home with more than you intended to pick up or with more than you need is a warning sign.

Another sign is that your purchases sit unused or unopened.

If you or someone you love thinks you need help with your hoarding habits, call the Visiting Homemakers Association and ask for the Volunteer Hoarding Support Program, 416-489-2500.

You may also call Frederick W. Thompson Anxiety Disorders Centre at Sunnybrook Health Sciences Centre in Toronto, 416-480-4002.

Outside the Toronto area, call your local community health centre.

4 Warning Signs of a Hoarder

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By H.G. McKinnis

In my early twenties, I lived with a hoarder I’ll call Mae. When I moved in, I saw she had loads of stuff, and I knew instantly she was a poor housekeeper. It wasn’t until I moved out, however, that I realized Mae wasn’t just a person who had a neatness deficit and a high tolerance for roaches. She was a classic example of agenuine hoarder.

We all like our stuff. We chose it, love it, and become attached. Any empty nester can tell you how difficult it is to move from a big house to a smaller one. It’s achallenge to throw out mementos and get rid of things that represent milestones, success, or investment. Not every person attached to their possessions is a hoarder, not even prodigious collectors. Hoarding, like other addictions and mental disorders, can’t always be recognized by outward appearances. Huge piles ofclutter may be a symptom, but they aren’t enough for a diagnosis without supporting evidence. Here are a few ways to recognize a hoarding problem and begin to find help.

  1. Inability to part with worthless, useless items
    A serious problem often starts out small. As I look back on my experiences with Mae, the warning signs were all present. Her tables and chairs were stacked with worn-out books, paper bags, and old mail. She bought food in bulk “to save money.” The food often spoiled in the refrigerator, but Mae refused to throw it out. Instead, she created a “compost pile.” While she claimed she was improving the soil in her backyard, she was really only creating aburgeoning problem with bugs. When I noticed she had three copies of the same book, I suggested she get rid of the copy with loose, brittle, and missing pages. She said she was afraid the tattered version might be hurt or destroyed if she didn’t protect it. I now know that rationalizations for holding on to useless items—and even garbage—are classic signs of a disorder.
  2. Insatiable desire for more stuff
    Mae made monthly donations to a neighborhood thrift store, usually consisting of clothing her children had outgrown and items she had recently acquired and with which she had not formed a bond. Whenever she made a donation, Mae also shopped at the thrift store for stuff she felt was “too good to stay in the store.” She usually came home with slightly less than she had left with and elated that she had “pared down.” Then she would order things from catalogs as a reward for good behavior. The result? More stuff. I now know that hoarders often have some awareness of their problematic relationship with possessions, but they can rarely make substantive changes without intervention.
  3. No problem getting rid of other people’s stuff
    Mae couldn’t part with her own junk, but she had no trouble at all giving away my belongings. “Oh, my friend needed it,” she said when my clock radio went missing. At the time, I couldn’t understand this behavior. Now I know that it’s quite typical of most . Studies on the brains of have shown that ownership is a key factor when they make decisions. The disorder stems from their unhealthy relationship with their own possessions, but not those ofothers. Mae was unable to get rid of her old books and trash, but had no trouble parting with her children’s belongings—and my stuff.
  4. Issues that threaten health and safety
    Hoarding problems tend to get worse over time. While stacks of newspapers or boxes of possessions may at first seem innocuous, tall stacks are ahazard. Hoarders have died in fires caused by their accumulations and suffocated under toppled piles. In Mae’s case, her papers and books housed acockroach infestation. She could see that the bug problem was out of hand, but threw a fit if I mentioned getting rid of any of the clutter. She had a story about the value and use she might get out of each and every item. It is always difficult to intervene, but if health and safety are at risk, remember that hoardersare incapable of making necessary changes on their own.

Because hoarding is a behavior but not a disorder in itself, it is wise to look into possible issues that contributed to it and seek appropriate therapy. Depression leads the list of underlying causes of hoarding, but trauma, family background, dementia, and many other factors may also be responsible. For help with hoarding itself, consider programs like Clutterers Anonymous or Buried in Treasures, twelve-step programs that are run and maintained by its members and uses the mentor approach. If the hoarder herself realizes that change is necessary, and she makes the effort to work with the program, she can develop a tolerance for bypassing unnecessary purchases. As a friend or family member, remember that understanding and compassion can go a long way to helping a hoarder improve.

H.G. McKinnis is the author of the forthcoming novel A Justified Bitch: A Las Vegas Mystery , a twisted tale of murder, hoarding and redemption. Learn more about H.G. McKinnis at AJustifiedBitch.com, on Twitter, Facebook and at Imbrifex Books.

Many people find it difficult to throw items away in case they might need them later or they are more valuable than they realized. Holding on to possessions we have no use for is a common human trait. However, when it becomes an enduring and distressing behavior, it may be a case of hoarding disorder.

Diagnosing Hoarding Disorder

The diagnosis of hoarding disorder is made when the following criteria are met:1

  • A persistent need to save items
  • Clinically significant distress, especially when discarding possessions (regardless of their actual value)
  • Clutter and non-functionality in the living space; if the living space is uncluttered, it is only due to third party intervention

Specifiers of the condition include excessive acquisition of new items, good or fair insight, poor insight, and absent insight/delusional beliefs. In addition, these symptoms are not caused or explained by another medical or psychological ailment.

Although hoarding disorder affects 2% to 6% of the population,1 many individuals do not seek treatment.2 According Dr Gregory Chasson, clinical psychologist and associate professor, Illinois Institute of Technology in Chicago, “Treatment ambivalence is the norm, not the exception. Survey research indicates that 85% of individuals with hoarding difficulties acknowledge a need for treatment, yet only about half of those individuals pursue help. Even then, nearly half of individuals with hoarding disorder refuse treatment from the outset, drop out of treatment once it is initiated, or have difficulty fully complying with treatment.”

A deeper understanding of the psychology behind hoarding is needed if treatment ambivalence and non-adherence are to be overcome.

Psychological Ownership Theory

According to Charlene Chu, PhD, assistant professor at Chapman University in Orange, California, “Psychological ownership3 is essentially the feeling ‘it is mine!’ The motives for psychological ownership, namely efficacy and effectance (a tendency to explore and influence one’s environment), self-identity, and a need to have a place within the environment find parallels with emotional attachment to possessions exhibited by individuals with hoarding disorder.”

“Individuals with hoarding disorder exhibit hyper-sentimentality, in which possessions are seen as part of the self, echoing the self-identity motive in psychological ownership, and the use of possessions as safety signals, echoing the motive to have a place/find personal security in psychological ownership,” Dr Chu explained. “In addition, hoarders exhibit a need for control over their possessions, which echoes the efficacy and effectance motivation in psychological ownership. Thus, hoarding may be an extreme form of psychological ownership when viewed through the lens of consumer behavior.”

Psychological ownership theory highlights the extreme ownership experience of a person who hoards, both in terms of the intensity of their feelings and the quantity of items they acquire. Individuals with hoarding disorder also tend to take extreme responsibility for the object — as a part of ownership — and often make statements that express their concern for the well-being of the object. This is a sign of adult anthropomorphism, which research has shown to be a good predictor of hoarding behavior.4

The Constructivist Approach

Victoria Barnes of Nottingham Trent University in the United Kingdom sheds light on 2 core aspects of hoarding disorder: valuing items and interacting with them. She interviewed 11 people who identified themselves as having hoarding disorder and found that their stockpiled possessions addressed various psychological needs. They were not seen as useless items, but rather as valuable items with which they interacted. Interviewees were proud to be valuing items that others might not appreciate. Indeed, they often saw themselves as “temporary custodians” of the items.5

Barnes is developing a theoretical model of hoarding based on some of the key reasons behind these behaviors:

  • Documenting personal history
  • Preserving the past
  • Holding on to the memory of loved ones
  • Relief of anxiety related to past material deprivation
  • Preventing feelings of isolation and loneliness
  • Physical security, with possessions acting as a barrier for intruders
  • Avoiding hurting the feelings of items (anthropomorphism)

Attachment Theory

Early anxious attachments can lead to the avoidance of human interaction and the replacement of human relationships with objects. Individuals with hoarding disorder often have excessive emotional reactivity, and negative emotions can be slow to decline in response to interpersonal stressful events. This brings to the forefront a lack of emotional regulation skills and the need to manage these emotions by acquiring more objects.6 As the number of traumatic or stressful events increases, so does the severity of hoarding.7

Treatment Pathways

While pharmacotherapy research has revealed some promising findings,8-12 cognitive behavioral therapy (CBT) remains the gold standard for hoarding disorder treatment.13

Chasson explains: “Three primary components of CBT for hoarding disorder are: (1) exposure and response prevention, (2) executive function skill development (eg, sorting and organization skill development), and (3) cognitive therapy techniques.” For the latter, the irrational value placed on objects shows information processing deficits that decrease with CBT.14 Cognitive rehabilitation with exposure/risk therapy has shown benefits, particularly in older people who hoard.15

“Treatment motivation is a primary consideration in CBT for hoarding disorder,” Chasson noted. “A harm reduction approach is often more palatable than a values-laden approach and preserves a patient’s motivation for change. For example, harm reduction would revolve around improving home safety (eg, removing papers from on top of the toaster), whereas a values-laden approach would instead focus on helping the individual because the home is ‘not the right way to live’ or ‘embarrassing.’”

Dr Chu recommends applying psychological ownership theory to understanding how to encourage consumers in general to dispose of possessions. She says, “As people with hoarding disorder are strongly motivated to feel psychological ownership, attempts to ‘decrease’ psychological ownership may not be welcome. Rather, methods that ‘extend’ psychological ownership, that allow one to maintain feelings of ownership even after discarding the object, may prove more effective. For example, taking photos of objects prior to disposal may help to sustain psychological ownership of objects.”3

Conclusion

Hoarding disorder is one of many conditions that have been trivialized over the years, but research demonstrates the very real distress that comes with the condition, both for patients and for family members. Fortunately, as the gap between psychiatry and psychology is bridged, more integrated and efficient treatment models are being tested.

  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Washington, DC: American Psychiatric Press, 2013.
  2. Chasson GS, Guy AA, Bates S, Corrigan P W. (2018). They aren’t like me, they are bad, and they are to blame: a theoretically-informed study of stigma of hoarding disorder and obsessive-compulsive disorder. J Obsessive Compuls Relat Dis. 2018;16:56-65.
  3. Chu CK. Psychological ownership in hoarding. In: Psychological Ownership and Consumer Behavior. Cham: Springer; 2018:pp 135-144.
  4. Burgess AM, Graves LM, Frost RO. My possessions need me: anthropomorphism and hoarding. Scand J Psychol. 2018;59(3):340-348.
  5. Kinman G. Revenge porn and hoarding. The British Psychological Society. https://thepsychologist.bps.org.uk/revenge-porn-and-hoarding. Updated May 14, 2018. Accessed July 23, 2018.
  6. Grisham JR, Martyn C, Kerin F, Baldwin PA, Norberg MM. Interpersonal functioning in hoarding disorder: an examination of attachment styles and emotion regulation in response to interpersonal stress. J Obsessive Compuls Relat Dis. 2018;16:433-449.

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