Compulsive Hoarding

CompulsiveHoardingAs a long-time hoarder of books (I will leave it to others to determine if I qualify as a “compulsive” one), I first reacted negatively to news that Compulsive Hoarding (CH) was to get its own listing in the new version of the Diagnostic and Statistical Manual of Mental Disorders, the “bible” published by the American Psychiatric Association. The DSM-5 lays out the official version of what to label — or perhaps, what to pathologize — among the various behavioural characteristics of women and men. No longer just a subcategory of “obsessive compulsive disorder” as it was in previous editions, CH is soon to become a stand-alone label.

Pharma-phobe that I am, I saw this slicing up as a way to provide yet another opportunity for the patent-extension of some existing medication — or, perhaps, for the creation of some new pill to stimulate the “throw-it-out” neurons in various brain areas someone has suggested might need activating in “sufferers.” Was this, as it seemed might be the case, just another addition to the long list of “problems” on which selling sickness is based to make ordinary quirks commercially profitable diagnostic entities? (See, for example, this blog on neural associations.)

Before reaching for a pen (and keyboard) to draft an angry tirade, I stopped to look further into the matter. And this was a wise delay, since I then read, with great relief — and surprise — that a non-pharmaceutical approach was recommended as the first-line treatment for CH. Moreover, this approach actually seemed (from available evidence) to be effective and safe — and cheap. And it was even an approach that one could take on one’s own without the need for expensive sessions with a psychiatrist or psychologist.

Apparently, by following exercises in “tolerance-building,” excessive collectors can learn to “resist the urge to acquire.” These successful changes could be obtained through cognitive behavioural therapy but they can also result by following the guidance — and exercises — in a book authored by the researchers who’ve studied CH and various approaches to “uncluttering,” Gail Steketee, Randy Frost and David Tolin. What’s also attractive about all this is that peer group support is encouraged for those who want to be do-it-yourself declutterers, and so the “treatment” might actually have positive “side effects.”

In their book, Buried In Treasures, Steketee, Frost, and Tolin lay out the exercises and homework that, if followed, may change one from a DSM-labeled CHer with a “problematic clutter” disorder to a restrained shopper/collector who will actually have floors on which to walk and furniture on which to sit without the need to first sweep away inanimate objects occupying the spaces. Or, in my case, without fear of a nocturnal concussion from being hit when one of the piles of books on the bedside table collapses.

Given how hyped pharmaceutical agents are despite their very limited effectiveness (and their invariably negative and underreported side effects), this book, or at least the approach it advocates, should be considered for (horror of horrors) some well-placed DTCA (Direct to Consumer Advertising): posted “success” rates of decluttering lessons do appear to be truly impressive, with symptoms reported to drop by “22% to 27%.” And “in one study, an inspector judged more than 70 percent of participants as ‘much’ or ‘very much’ improved after visiting their homes.” Not bad.

OKAY: I can already hear cynics saying (probably correctly) there are likely to be serious conflicts of interest, unblinded studies, sponsorship by book publishers, and all the usual caveats to warrant deep doubt about this research. But maybe we might be more lenient here and those, who like me, like “stuff,” can invest the $15 (Canadian) to buy a copy of the book — if it’s not available a local library. Actually, a much better idea: get the library to buy the book and then you can borrow it. This is likely to be much more appropriate, and itself an exercise in decluttering, especially for those like me for whom book hoarding is one of those collecting practices that needs to be given up!

But perhaps best of all: suggest that the DSM authors themselves take this advice and declutter their “bible” of all the medical labels given to the many “behaviours” (sorrow, joy, sadness, etc.) that make us human.

About the Contributor

Abby Lippman is a longtime feminist activist with special interests in women’s health and women’s health policies. Her academic bases are at McGill and Concordia Universities and her major current community commitment is to the FQPN where she is on the board and works closely with them in building an inclusive reproductive justice movement in Québec.