"But what if I need it someday?"

What is compulsive hoarding?
Compulsive hoarding is the accumulation of and inability to discard items that (to others) appear to have no value, such as plastic water bottles, slips of paper, unread mail, and magazines. Compulsive hoarders are not necessarily those who have a passion for collecting stamps or baseball cards. Nor are they the frugal and careful who save old furniture or appliances because they think "with a little paint it'll be as good as new." Nor are they those who save newspapers and bottles to recycle because they are concerned about the environment. Compulsive hoarders might do all these things, but to the extreme. They have immense difficulty throwing anything away, from slips of paper, to plastic forks, to stacks of unread mail or newspapers, for fear that they might need those items in the future, or that they hold some special opportunity. Their homes are stacked with what others would call "junk" such that they cannot sit on their chairs, sleep on their beds, or even use their kitchens or bathrooms. The most commonly saved items are newspapers, magazines, old clothing, bags, books, mail, notes, and lists.

Although hoarding (or cluttering) can be a symptom of other disorders, it is usually a subtype of obsessive-compulsive disorder (OCD).

Cognitive-behavioral model of compulsive hoarding
Current cognitive-behavioral conceptualizations of compulsive hoarding view hoarding as the result of one or more of these four deficits:

• Information-processing deficits including deficits in decision making, organizational skills, and memory. Compulsive hoarders often fear making mistakes, and as a result, they often avoid or postpone making decisions. Even the smallest task, such as washing dishes or checking mail, can take a long time because it has to be done "just right." If something is to be filed, it must be filed under the "perfect" category. If something is to be given away, it must be given to "just the right" person or organization. The net result of these high standards and the fear of making a mistake is that compulsive hoarders avoid doing many tasks, such as reviewing the mail and making decisions about what to do with each item; the result is that the mail (and other things) pile up, and the hoarder is unable to tackle the problem, including beginning the process of throwing away;
• Problems in forming emotional attachments compulsive hoarders believe that their belongings are a part of them, so discarding an item is like discarding a part of themselves;
• Behavioral avoidance the net result of poor decision-making skills and the need for perfection. Compulsive hoarders avoid not only the decision to discard an object, but also what to do with the object once they have it. Because of their desire for perfection, compulsive hoarders frequently take a long time to do even small chores. An inordinate amount of time may be spent "churning" - moving items from one pile to another but never actually discarding any item nor establishing any consistent organizational system; and,
• Erroneous beliefs about the nature of possessions beliefs about the necessity of maintaining control over possessions, beliefs about responsibility for possessions, and beliefs about the necessity of perfection. For example, a compulsive hoarder will think, "This is too good to throw away," "This is important information," "I will need this later," "This should not be wasted."

We all have these thoughts from time to time, but those with compulsive hoarding syndrome have them more often and have more anxiety and distress associated with them. If they have any doubt at all as to the value of an object -- no matter how trivial, compulsive hoarders will keep it -- just in case. The default is always to keep.

Cognitive-behavior therapy for compulsive hoarding

• Decreasing clutter;
• Improving decision-making skills; and
• Improving organizational/sorting techniques.

Treatment interventions used include decision-making training, exposure and response prevention, and cognitive restructuring.

Additional resources

Web links:
The Anxiety Disorders Association of America
The Association for Behavioral and Cognitive Therapies
The Obsessive-Compulsive Foundation

Books:
For links to purchase these books and others, please go to Self-Help Books for Adults

Neziroglu, F., Bubrick, J., & Yaryura-Tobias, J. A. (2004). Overcoming compulsive hoarding: Why you save and how you can stop. Oakland, CA: New Harbinger.