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How to Help Your Hoarding Client Break Free

4 tips to help your hoarding client get their life back

Hoarders may feel unable to declutter, out of control and hopeless.

Tony wanted me to see for myself.

I rang the bell. Fortunately the door opened outwards, because if it had been inward-swinging, it wouldn’t have opened at all. There was no floor to his house. Or if there was, it was impossible to see because of an all-enveloping ocean of… stuff.

Tony hadn’t been upstairs in five years because the staircase and upstairs were choked by the detritus of years. It seemed quite a large home, yet the stultifying stuff crammed in everywhere made it feel like the smallest of elevator cars.

“My TV is, I think, under there somewhere,” he said forlornly, nodding towards a Mount Fuji of ancient magazines.

As though reading my mind, he said, “I call that my own Mount Fuji!”

It was hard to sound professional moving around his house like a constricted penguin, so I suggested we meet at my office a few days later. This was going to be interesting.

Prefer to watch instead?

Hardwired to hoard?

Hoarding may be a natural instinct. After all, the last ice age only ended 10,000 years ago. Hoarding food for the deep winters was vital for survival.

But an instinctive need can sometimes turn into an all-consuming ‘greed’ – which is not to judge it harshly, because by greed I mean compulsion. A kind of ‘greed’ of the instincts.

So how do we know when hoarding has become a problem? Well, first we can distinguish between collecting and hoarding.

Hoarding versus collecting

Many people collect, whether it’s books, shoes, vinyl records, or vintage jugs.

Collecting may feel compulsive, but we can distinguish it from hoarding. Hoarding tends to be indiscriminate. The hoarder may keep just about everything they’ve ever owned, even when it no longer clearly serves a purpose. Hoarding also tends to severely impact the daily life and wellbeing of the person doing it.

Questions to ask about the ‘collecting’ include:

  • Is it organized, or chaotic? Tony’s ‘collecting’ was chaotic and random, with no organization whatsoever. Collectors, on the other hand, may be quite neat and tidy. (One guy I knew had arranged his hundreds of sci-fi books neatly in alphabetical order!)
  • Is it specific, or indiscriminate? Collecting tends to be specific, whereas Tony seemed to keep everything, even old tea bags!
  • Does the person feel in control of it? Hoarders may feel unable to declutter, out of control and hopeless.
  • Is it causing problems in the person’s life? Hoarding may interfere with relationships and pose health risks, such as fire hazards.

Sure, collecting might cause problems – if you pay a bit too much for that rare stamp, for example – but the kinds of problems and risks associated with hoarding disorder tend to be much more serious.

So what do we need to consider when treating hoarding disorder?

Tip one: Work out what might be causing the hoarding

Some hoarders may do so for quite obvious reasons. Other times you may need to dig a little deeper to get to the bottom of the problem.

Perhaps they have mobility issues and it’s simply harder to dispose of stuff. Maybe they have dementia or some other cognitive issue which makes organization difficult. Perhaps they have a psychotic illness such as schizophrenia or suffer from obsessive-compulsive disorder.

Hoarders may display maladaptive perfectionism and therefore have an intense fear of making the wrong decision or discarding something valuable. This can lead to a paralysis of decision-making, contributing to the accumulation of possessions.

We might ask our hoarding client if they’ve ever been diagnosed with any psychiatric condition, though generally they will tell you before you ask.

For many hoarders, emotional problems will be at the root of the issue.

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When did all this begin?

A good way to work out what may be causing any problematic emotional and behavioural condition is by determining when it actually began. Then we can try to see what needs the client may be trying to meet through the behaviour.

“Can you tell me when all this started?” I asked Tony.

He looked pensive, then a shadow crossed his careworn face.

He told me a story of woe and adversity. After a childhood of being passed from one foster parent to another, he’d married young. Tony’s young son had died 20 years ago, and soon after his wife had left him. He’d been battling depression and anxiety ever since.

The pattern of much of Tony’s life had been one of insecurity, loss, and trauma. In a life of loss, throwing things away can come to feel like simply more loss.

The next question I asked got us closer to the crux of the problem.

Tip two: What feelings come up?

I asked Tony what feelings the thought of decluttering all that stuff brought up for him. He told me it made him feel panicky and ‘exposed’.

If we reverse this, we can see that hoarding was helping him feel secure, protected, safe, and calmer. So it seemed that those were the needs he was trying to meet by hoarding.

If we look at it this way, we can see that it’s no wonder hoarders have a disinclination to throw stuff away. After all, it feels like that ‘stuff’ is what’s keeping them together!

Once we understand what needs a problematic pattern may be meeting (albeit in ways that damage the client), we can start to try to help them meet those needs in ways that are actually sustainable and healthy.

Tony needed to feel safe and secure, calm and hopeful, through healthy means rather than through the maladaptive drive to hoard so much stuff he couldn’t use his own house for proper living!

We set to work.

Tip three: Help your client deal with those feelings (and rehearse decluttering)

Tony had a horrific memory of seeing his son run over and killed by a car. He still suffered flashbacks and nightmares. It was clear he still suffered post-traumatic stress disorder from this 20-year-old tragedy.

I used the Rewind Technique to help lift the traumatic effect from that time. The flashbacks stopped, as did the nightmares. This profound shift helped generate hope in Tony.

I helped calm him naturally through therapeutic hypnosis and also had him hypnotically rehearse decluttering his home and letting go of all that stuff while feeling calm about it.

Once Tony was feeling better emotionally, he started to feel more confident and secure in himself generally. It became easier to start to think about detaching from the hoarding pattern.

It was now time to get practical.

Tip four: Release old wounds

I used the metaphor of releasing old wounds and burdens whenever I talked about throwing out trash Tony didn’t need. This effectively reframed the whole process.

Paradoxically, I suggested to Tony he start by adding more to his clutter! This surprised him.

The plan

Tony was to acquire and bring home a collection of large cardboard boxes.

Each day he was to set aside one box for stuff he could let go of, and one for stuff he felt he should keep. He was to fill both boxes, and afterwards remove the trash box from his house.

To (hopefully) make this easier for him, I ventured back into his house and helped him do this. You might volunteer that too, or see if you can organize for someone else close to the client to help them out.

Sometimes we had discussions as to whether he really needed to keep what he’d put into the ‘keep box’. But it was always his decision. I merely told him what I thought might be ‘throwawayable’.

I continued to see Tony in my therapy room throughout this process. I hypnotized him to rehearse feeling calm and powerful when ‘releasing’ old hurts – the ‘rubbish’ he no longer needed. I also suggested he could notice profound and therapeutic feelings of ‘letting go’, which he did as he began to clear out all the trash.

So we can:

  • Discover what might be causing the hoarding. When and under what circumstances did it begin? This may tell us what emotional needs the pattern is trying to fulfil for the client.
  • Help the client meet those emotional needs, whether for safety or security or whatever it may be, in more legitimate, healthy, and productive ways.
  • Discover what feelings come up when they imagine throwing out all the extraneous stuff they’ve accumulated. Is it fear? Sadness? Something else?
  • Help them deal with those feelings psychotherapeutically so the raison d’être of the hoarding starts to fall away.
  • Get practical. Help them form a plan to throw out the trash and not reaccumulate. If appropriate, help them with the actual clearing out or enlist the help of someone else.

I’ve found that hoarders often lead diminished lives in which they do less. We can more generally help the hoarding client connect with others and fulfil their emotional needs in healthy ways.

Hoarders often lead diminished lives in which they do less. As well as dealing with the behaviour directly, we can help the hoarding client connect with others and fulfil their emotional needs in healthy ways. Click to Tweet

After two weeks Tony could see the floor in every room of the house! After two months he had freed himself of 90% of the trash.

Sometimes he got scared again and felt he couldn’t let something go.

“That’s okay, Tony,” I said, “if you really need it, keep it! But a wise part of you will know whether you really need to keep it.”

He got a part-time job, began to go out socially and meet new people, and even started to invite others into his home. From his new, calmer mindset, he found that he no longer needed to rely on materialism to help him feel safe. He could meet his need for a sense of safety and security through the knowledge that he was becoming part of a wider social network.

During this time Tony was open with people about his former hoarding and, such are the coincidences the Universe sometimes ‘throws out’, met a woman who also was a recovering hoarder. Together they helped one another live clear, clean, and more organized lives.

Tony told me also that his mind felt “tidier, clearer, and cleaner”. He laughed as he told me that he guessed he’d finally conquered Mount Fuji.

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Mark Tyrrell

About Mark Tyrrell

Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

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