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Authors: Gail Steketee

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From our observations, Internet-based self-help for hoarding is a novel method that might be a good way to provide help for hoarders who live in locations without adequately trained treatment providers, or a good first step for those reluctant to seek treatment. We recently began experimenting with in-person facilitated self-help groups with some success. Group members enjoy interacting with one another and seem to derive motivation to work on clutter from the experience. It is too early to tell whether this approach will be truly useful.

Our first efforts at treatment began more than a decade ago, and our methods have evolved over time with the help of what we have learned in the laboratory. Nevertheless, we still have a long way to go. When we started studying hoarding, there were no other research groups working on the problem. Now at least a dozen highly sophisticated research teams from around the world are studying all aspects of this behavior, including the neurobiology, neuropsychology, genetics, comorbidity, and treatment of hoarding. Undoubtedly the next decade will produce many more advances in our understanding of this intriguing human condition.

One of the challenges for this research will be to distinguish what is positive in hoarding from what is pathological. We wonder whether the attention to the details of objects indicates a special form of creativity and an appreciation for the aesthetics of everyday things. In the same vein, empathy with the physical world expands life's horizons and can give meaning by connecting us to the world and one another. More than anything, hoarding represents a paradox of opportunity. Hoarders are gifted with the ability to see the opportunities in so many things. They are equally cursed with the inability to let go of any of these possibilities, thereby ensuring that few of the imagined options can ever be realized. Hoarding seems to be a symptom of both positive and negative capacities among those who are so blessed and afflicted. With luck, researchers will be able to sort out this paradox and to help people take advantage of the opportunities and jettison the costs.

There have been dramatic developments in the public arena as well. More than sixty cities throughout the country have formed task forces to deal with hoarding problems. These task forces are made up of officials from fire, health, housing, elder services, and mental health departments, as well as people with hoarding problems. They encounter the most severe hoarding cases and individuals who often don't recognize the threat posed by their behavior. Many members of these groups are veterans of massive and expensive cleanup operations that failed, such as Susan in chapter 9. One of the longest-running and most successful of these efforts is the San Francisco Task Force on Compulsive Hoarding, run by the city's Mental Health Association. This task force recently released a comprehensive report on hoarding in the city. The report not only estimated the financial cost of hoarding to San Francisco service providers and landlords ($6.4 million per year) but also laid out a set of recommendations for more effectively dealing with hoarding cases. Their report was a joint effort by members of the task force, which included not only agency representatives but hoarders as well. The efforts of the task force also led to the establishment of the Institute on Compulsive Hoarding and Cluttering, the first organization of its kind. It provides public education about hoarding, training for service providers, support and therapy groups for hoarders, and advocacy to prevent homelessness due to hoarding. It also consults with other agencies and other communities about how to establish hoarding programs. We hope that this will be the wave of the future in dealing with hoarding problems.

Finding Help

If you or a loved one has a hoarding problem, here are steps you can take to get help.

• Find a therapist with experience treating hoarding problems.
Several professional organizations provide help in locating suitable therapists in your area, including the Obsessive Compulsive Foundation, the Association for Behavioral and Cognitive Therapies, and the Anxiety Disorders Association of America. Therapists who are registered with these organizations list their areas of expertise, including the treatment of hoarding. If you are seeking help for a loved one who refuses help, these therapists can help you find ways of interacting with your loved one that increase the likelihood that he or she will seek help on his or her own.

• Find a local hoarding task force.
Your community may have developed a hoarding task force. If you or your loved one is in trouble with the health department or other agency due to hoarding issues, a hoarding task force can sometimes help provide resources. These organizations are made up of people who are eager to find compassionate ways of solving hoarding problems, and they are less likely to make the mistake of seeking punishments or cleanouts as a first resort. The agencies involved in task forces are responsible for the health and well-being of all residents. Don't be afraid to ask for their help.

• Find a local hoarding support group.
Many task forces have started support groups or serve as clearinghouses of information about local support groups. If no groups exist in your area, consider starting one. To find people with hoarding problems to join the group, place a small ad in a local newspaper or community newsletter. Finding other people in your situation who live in your community may be a good first step on the road to your recovery. Our initial research on self-help support groups indicates that groups that use the protocol in our book
Buried in Treasures
can have a positive effect on members.

• Read one of the self-help books mentioned in this chapter.

• Read
Digging Out
by Michael Tompkins and Tamara Hartl.
This book outlines a harm-reduction approach for family members of people who hoard and is especially helpful when loved ones do not recognize that they have a problem. The authors describe how to construct a team of helpers to work with a loved one to help him or her recognize and seek/accept help for hoarding.

• Above all, try to maintain a positive and healthy relationship with a loved one who has a hoarding problem.
Keep in mind that the person's attachment to objects is something that he or she has little control over.

REFERENCE LIST

Prologue

Alighieri, D. (1954).
The Inferno
(J. Ciardi, Trans.). New Brunswick, NJ: Rutgers University Press, pp. 73–74.

Bank and Collyers declare a truce. (August 8, 1942).
New York Times.

Black, D. W. (2007). A review of compulsive buying disorder.
World Psychiatry, 6,
14–18.

Collyer hermit found dead in 5th Ave. hovel. (March 21, 1947).
New York Journal American.

Collyer home search 'nightmare' to police. (April 5, 1947).
New York Times.

Collyer home 'unsafe': Order for its demolition will be sought on Monday. (June 26, 1947).
New York Times.

Collyer mansion keeps its secrets. (September 30, 1942).
New York Times.

The Collyer mystery. (March 26, 1947).
New York Times.

Collyers get deed to home. (December 21, 1942).
New York Times.

Court fails to act on Collyer estate. (March 28, 1947).
New York Times.

Erskine, H. W. (1954).
Out of This World.
New York: Bodley Head, chap. 1.

Faber, H. (March 22, 1947). Homer Collyer, Harlem recluse, found dead at 70.
New York Times.

———. (March 25, 1947). Police fail to find Collyer in house.
New York Times.

———. (April 8, 1947). Body of Collyer is found near where brother died.
New York Times.

Frost, R., & Gross, R. (1993). The hoarding of possessions.
Behaviour Research and Therapy, 31,
367–382.

Frost, R. O., Steketee, G., & Williams, L. (2000). Hoarding: A community health problem.
Health and Social Care in the Community, 8,
229–234.

Garlington, S. W. (April 12, 1947). Exposes "Collyer fire-trap."
New York Amsterdam News.

Government gets Collyer property. (February 4, 1943).
New York Times.

Gray, C. (June 23, 2002). Wondering whether a park should keep its name.
New York Times.

Grisham, J. R., Frost, R. O., Steketee, G., Kim, H.-J., & Hood, S. (2006). Age of onset of compulsive hoarding.
Journal of Anxiety Disorders, 20,
675–686.

Haberman, C. (July 19, 2002). Name game is messy, really messy.
New York Times.

If Homer dies, I'll barricade the house so no one will ever get in—Langley. (March 22, 1947).
New York World-Telegram.

Kerby, K. (April 12, 1947). Believe Collyer house hides gold.
New York Amsterdam News.

Kivel, M., & Desmond, J. (March 25, 1947). Cops sift Collyer junk but fail to find hermit.
New York Daily News.

Kivel, M., & Neal, P. (March 29, 1947). Collyers' mansion sealed; cops keep a vigil over junk.
New York Daily News.

Kivel, M., & Patterson, N. (March 28, 1947). Find hermit arsenal; FBI in hunt.
New York Daily News.

———. (April 1, 1947). Start to clear Collyer house; Langley is ???.
New York Daily News.

———. (April 2, 1947). Homer Collyer buried—no Langley.
New York Daily News.

Langley Collyer reported going to Atlantic City. (March 30, 1947).
New York Herald Tribune.

Lewis, H. C. (August 7, 1942). Collyer brother emerges, talks, ends mystery.
New York Herald Tribune.

Lewis, M. (March 22, 1947). Homer Collyer dies amid junk, brother Langley can't be found.
New York Herald Tribune.

———. (March 25, 1947). No trace of Collyer is found as police chop through roof.
New York Herald Tribune.

———. (March 26, 1947). Collyer house search shifted to top floors: Police quit basement for fear of collapse.
New York Herald Tribune.

Lidz, F. (2003).
Ghosty men: The strange but true story of the Collyer brothers, New York's greatest hoarders.
New York: Bloomsbury.

———. (October 26, 2003). The paper chase.
New York Times.

Merge, M. (November 19, 1942). Collyers pay off $6,700 mortgage as evictors smash way into home.
New York Times.

Mockbridge, N. (March 21, 1947). Collyer recluse found dead: Police crash old mansion, hunt brother.
New York World-Telegram.

———. (March 24, 1947). Fantastic junk pours out of old mansion.
New York World-Telegram.

Mortgage on recluses' home is foreclosed, but legendary brothers still hide within. (August 5, 1942).
New York Times.

Mueller, A., Mueller, U., Albert, P., Mertens, C., Silbermann, A., Mitchell, J. E., & de Zwaan, M. (2007). Hoarding in a compulsive buying sample.
Behaviour Research and Therapy, 45,
2754–2763.

Newman, A. (July 5, 2006). "Collyers' Mansion" is code for firefighters' nightmare.
New York Times.

Neziroglu, F., Bubrick, J., & Yaryura-Tobias, J. A. (2004).
Overcoming compulsive hoarding.
Oakland, CA: New Harbinger.

Nobel, A., & Patterson, N. (March 22, 1947). One Hermit Collyer dead, hunt 2nd in ghosty house.
New York Daily News.

Order ejects Collyers: Court gives control of Fifth Ave. property to bank. (October 2, 1942).
New York Times.

Owen, R. (March 30, 1947). Something for O. Henry: Story of the Collyers.
New York Times.

Rent house for junk taken from Collyers. (March 30, 1947).
New York Daily News.

Samuels, J. F., Bienvenu, O. J., Grados, M. A., et al. (2008). Prevalence and correlates of hoarding behavior in a community-based sample.
Behaviour Research and Therapy, 46,
836–844.

Steketee, G., & Frost, R. (2003). Compulsive hoarding: Current status of the research.
Clinical Psychology Review, 23,
905–927.

Subpoena flushes Harlem recluse; Collyer in court to press charge. (July 24, 1946).
New York Times.

The Talk of the Town. (April 5, 1947).
The New Yorker,
pp. 24–25.

3rd search starts at Collyer house. (April 1, 1947).
New York Times.

Thousands gape at Collyer house. (March 24, 1947).
New York Times.

200 bid spiritedly for Collyer items. (June 19, 1947).
New York Times.

Where's Collyer? $1,500 reward. (March 30, 1947).
New York Daily News.

1. Piles upon Piles

Fromm, E. (1947).
Man for himself: An inquiry into the psychology of ethics.
New York: Rinehart.

Frost, R. O., & Hartl, T. L. (1996). A cognitive-behavioral model of compulsive hoarding.
Behaviour Research and Therapy, 34,
341–350.

Frost, R. O., Steketee, G., Tolin, D. F., & Brown, T. A. (March 2006).
Comorbidity and diagnostic issues in compulsive hoarding.
Paper presented at the annual meeting of the Anxiety Disorders Association of America, Miami, FL.

Tallis, F. (1996). Compulsive washing in the absence of phobic and illness anxiety.
Behaviour Research and Therapy, 34,
361–362.

2. We Are What We Own

American Psychiatric Association. (2000).
Diagnostic and statistical manual of mental disorders—text revision
(4th ed.). Arlington, VA: American Psychiatric Association.

Apartment floor collapses from weight of old magazines. (February 8, 2005).
Mainichi Shimbun
(Japan).

Arndt, J., Solomon, S., Kasser, T., & Sheldon, K. M. (2004). The urge to splurge: A Terror Management account of materialism and consumer behavior.
Journal of Consumer Psychology, 14,
198–212.

Associated Press. (May 24, 2007). The rise of the "McMansions."
Daily Hampshire Gazette.

Beaglehole, E. (1932).
Property: A study in social psychology.
New York: Academic Press.

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