emotionalDo You Know or Love A Hoarder? There is Help! By Ellen Kiesewetter, LCPC oarding has been a hidden disorder that individuals and their families have often silently struggled with, prompting shame, guilt, and isolation. In the same way, a few decades ago eating disorders remained largely hidden behind a screen of shame or privacy. Hoarding is now the latest behavior to spill out into public consciousness. Television reality shows (Hoarders and Hoarding: Buried Alive) bring snippets of hoarding behaviors to the general public which sensationalize this complex problem and can lead to a lack of awareness and compassion for suffering individuals and their families. Compulsive hoarding has been misunderstood and considered part of Obsessive Compulsive Disorder (OCD). Hoarding and OCD are similar, as there are obsessions and compulsions in both. In general, few hoarders experience negative or unwanted thoughts about hoarding, whereas this is the defining feature of OCD. The distress in hoarding occurs when a person is forced to discard, and it is much more grief-like than the anxiety typically seen in OCD. This year will invite a lot of changes with increased awareness and understanding in this area for professionals and the public as hoarding is now considered a separate disorder in the DSM-5 (The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition). Even as hoarding is now a separate disorder, there is no simple “case book” version of this complex ailment. Recent studies suggest that as many as 1 in 20 people have significant hoarding problems. The International Obsessive Compulsive Disorder Foundation’s (IOCDF) Hoarding Center identifies that hoarding consists of three connected problems: • Collecting too many items (acquiring) • Difficulty getting rid of items (discarding) • Problems with organization (disorganization) Page 14 — Healthy Cells Magazine — Peoria — June 2013 H These problems can lead to significant amounts of clutter which can: • Severely limit the use of living spaces • Pose safety and/or health risks • Cause significant distress and/or impairment in daily life The major feature of hoarding is the large amount of disorganized clutter that creates chaos in the home where rooms can no longer be utilized for their intended purpose. There is difficulty moving in the home with exits that are blocked or small “goat trails” (narrow paths) to navigate from room to room. Life inside the home becomes difficult to manage. Hoarding has been viewed as a physical health threat due to fires, falling, unsanitary conditions, and inability to prepare food. Other common problems associated with compulsive hoarding are: decreased quality of life, social isolation, conflict with family and friends, financial strain, environment creating health concerns, and other safety issues. Often times when family members are considering helping their parents downsize to a smaller home or to a senior living facility, they will identify the parent as a “hoarder” or a “pack rat.” It is important to distinguish that simply collecting or owning lots of things does not qualify as hoarding. Also, having cluttered storage areas, such as attics and basements, does not make someone a hoarder. The General Conceptual Hoarding Model developed by Gail Steketee and Randy O. Frost focuses on education of the interconnected and intricate factors that contribute to and maintain hoarding behaviors. These factors include: • Information processing problems • Personal and family vulnerabilities • Thoughts and beliefs about attachments to possessions • Emotional reactions These problems lead to avoidance in decision-making, discarding, organizing, and other situations that might trigger discomfort related to hoarding. This model offers an opportunity for the person and their family to see the complexity of hoarding and initiate understanding in the specific areas that need to be targeted to promote healing and foster change for the person and his or her living environment. An analogy would be that if there was a clogged drain in your home it would be important to find the origin and fix the problem. An example of using the Hoarding Model is a person who struggles with distractibility and attention problems with severe indecisiveness and difficulty organizing and categorizing (Information Processing). There is a family history of hoarding with the father and paternal grandmother where the person learned that acquiring is a personal reward and it is important to always be prepared with what might be needed in the future (Early Experiences). Beliefs about possessions may center on perfectionism and responsibility including that perfect decisions need to be made about discarding and acquiring due to a possible lost opportunity, being wasteful, or making a mistake (Beliefs/Attachment). The saved items maintain a connection to lost family and friends and discarding would be an additional loss. It is considered disrespectful to discard gifts from others. The person avoids the grief and sadness caused by discarding and procrastinates by being involved in other activities to avoid the distress related to dealing with the clutter (Emotional Reactions). Each of these factors contributes to the person’s struggle with hoarding behaviors. This model is developed jointly between the client and therapist, and assists with fostering a non-judgmental objectivity, as the client is in the role of a collaborator or detective in understanding and resolving the hoarding problem. It is intended for the person to use as a guide to understand his or her specific hoarding behaviors and how they impact the broader context of experiencing life. This separation for the person from the disorder is an effective treatment tool, as the behavior is the problem not the person. As the person focuses on building the model, it enables them to take the needed steps in distancing themselves from their hoarding behaviors and choose more rational versus emotional responses. That shift in a person’s mindset offers an opportunity for them to work together with others and take back his or her life. For more information on hoarding, please contact The Antioch Group at 309-692-6622 or www.antiochgroup.com. Ellen Kiesewetter has been a therapist for over 20 years and is a specialist in the treatment of OCD and anxiety related disorders. You can find her provider profile on the Antioch website or IOCDF (International Obsessive Compulsive Disorder Foundation) treatment provider page. Resources: Steketee, G. and Frost, R. (2007). Compulsive Hoarding and Acquiring Therapist Guide and Workbook. New York: Oxford University Press. Website: ocfoundation.org/hoarding (IOCDF Hoarding Center) BREATHE S L E E P L I V E W ell Illinois Institute of Conquer Snoring, Sleep Apnea, Headaches, & Fatigue with a comfortable oral appliance. SleepMedicine Dental (309) 243-8980 11825 N. Knoxville Ave. Dunlap, IL 61525 IllinoisSleepDoc.com Comfortable Alternative to CPAP Covered By Most Medical Insurances & Medicare Rod Willey, DDS, D’ACSDD (General Dentist) June 2013 — Peoria — Healthy Cells Magazine — Page 15