Hoarding Disorder: What's in a Name?

Many people struggle with what word to use when referring to excessive clutter and the people affected by it. The term hoarding or hoarder often brings to mind the worst of the worst crisis cases as seen on reality tv or the news. This being the overwhelming frame of reference, it is easy to see why the term hoarding and hoarder carry such a negative connotation. The TV shows are greatly responsible for the considerable amount of awareness being brought to this issue today and the resulting increase in supports and resources becoming available. At the same time, the severity of the cases on TV needed for the ‘reality factor’, may lead those that do have hoarding disorder to misidentify their behavior. Statements such as “My house isn’t that dirty..or infested…” or “My things are organized…” or “I can get out my front door…” or “My house isn’t like those on the TV show…” lead to the assumption that “I do not need help”.

First and foremost, it is important to understand that being called a hoarder is hurtful, primarily due to everything discussed in the first paragraph. There are a lot of terms that people prefer such as collector, clutterer, finder keeper, etc. That being said, it is a bit of a catch 22. If you are looking for help online for yourself or someone else, googling those search terms will not bring up relevant results. The search terms ‘hoarding’ and ‘hoarder’ bring up the most relevant supports and resources. Speaking for myself, I am fine with whatever term the person feels most comfortable with, especially prior to or in the early stages of mental health treatment. When someone is in the middle of a crisis, such as failing an inspection or under threat of eviction, or when they are just getting the courage to reach out for help, that is not the time to demand they admit they are a 'hoarder' or have hoarding disorder.

While I do believe that to solve the problem, you need to identify the problem, for people who have the insight to know they need help and the motivation to seek it, my preference is to allow them to come to that conclusion on their own time. This is done based on a thorough discussion of concrete and objective diagnostic criteria and research-based facts. Whether someone recognizes right away that they meet criteria for hoarding disorder or has difficulty fully identifying or openly coming to terms with it, they can still learn skills and strategies to work towards change. Either individually, or in a group, I encourage people to have an open mind while reviewing the diagnostic features, the mental component, the co-morbid mental health issues, the processing issues, and the effects of trauma and loss on their behavior. Rather than asking (or forcing) someone to admit to having hoarding disorder, or trying to argue the point, I instruct them to take note of what applies to them and what does not and continue to move forward. I would rather someone get help by calling it whatever they want to initially than to have them decide not to get help or not to continue treatment because they were being labeled something that they did not identify with at the time.

Marnie Matthews, LCSW is a clinical and crisis case management specialist in hoarding disorder and hoarding behavior, providing treatment for individuals struggling with hoarding, anxiety, and depression at the Nashville OCD & Anxiety Treatment Center.