Treatment for hoarding can be challenging


Q. My mother has always been a hoarder, but recently it has been worse. She fell over a pile of her junk last week and had to be hospitalized for injuries. How can I help her? She cannot afford therapy.

A. The problem of hoarding has become much more visible recently. With the publication of the Diagnostic and Statistical Manual (DSM-5) in May, hoarding is now classified as a mental health issue. According to David Tolin, Ph.D., author of the book “Buried in Treasures,” hoarding is a diagnosable disorder in 2-5 percent of Americans.

If the hoarding has caused an injury, as in your mother’s case, intervention is absolutely necessary. However, clearing away the debris will only help momentarily. She will simply start “collecting” again.

Hoarding is treated most effectively by a combination of psychotherapy and medication. You state that your mother cannot afford therapy. Before you make that assumption, call local mental health clinics. There are beginning psychotherapists who work on a sliding scale. Call a local university. They often have graduate students who work for experience alone.

Treatment for hoarding can be challenging and difficult. Hoarders hold on to their “treasures” for comfort and emotional need. Even when their illness becomes physically and emotionally dangerous, many hoarders refuse to acknowledge that they have a problem. Therefore, it is often difficult for family to intervene.

If you attempt to help your mother, I suggest you read “Digging Out: Helping Your Loved One Manage Clutter, Hoarding, and Compulsive Acquiring” by Michael Tompkins and Tamara Hartt. They make helpful suggestions that family members can follow without blaming or criticizing the hoarder.

I also suggest that you have your mother evaluated by her physician. The Selective Serotonin Uptake Inhibitors (SSRI’s), such as celexa, paxil, and prozac, have been extremely effective in curtailing the hoarding instinct.

Q. My life is miserable because I feel like I sin so much. Sometimes I curse, have bad thoughts and gossip. I pray several times a day. My minister tells me I’m a good person, but I still feel sinful. What can I do to get some relief from my pain?

A. Most, if not all, people occasionally curse, have bad thoughts and gossip. It’s called being human. However, few people worry excessively about these shortcomings.

From your e-mail, it sounds as if you are likely suffering from a form of Obsessive Compulsive Disorder (OCD) called scrupulosity, a pathological guilt about moral or religious issues. Many people who were raised in families where sin was frequently stressed begin to feel as if every unpleasant thought is a transgression. The consequences can be extremely painful since in religion absolute proof of forgiveness is attainable only by belief.

Regardless of how much you attempt to control your thoughts about sinning, you likely find that they return. When you ask someone for reassurance, you feel better immediately, but the doubts resurface quickly. Then you feel you must ask for reassurance again, and it becomes a vicious circle. Eventually, you may find that you are asking for reassurance several times a day.

Some ministers are trained to recognize religious scrupulosity. If your minister has the training, please speak with him or her about the seriousness of your problem.

You should also consult with a cognitive behavior therapist (CBT) to help you to recognize that your fears are out of proportion with reality and to teach you ways to alleviate some of your anxiety. It would also be helpful to speak with your family doctor about the possibility of medication.

To read more about scrupulosity, go to the OCD Foundation website. If you want more serious information about the condition, I suggest the book, “Triggered: A Memoir of Obsessive-Compulsive Disorder” by Fletcher Wortmann.

Nancy Ryburn holds a doctorate degree in psychology. She teaches psychology at Southeast Arkansas College and maintains a limited private practice in Pine Bluff. If you have questions pertaining to mental health, e-mail them to drnryburn@gmail.com. The questions will not be answered personally, but could appear in a future column. There will be no identifying information and all e-mails remain confidential.