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Where are the lines drawn between the disease-stricken hoarders, the messy clutterers and the over-enthusiastic collectors? Dr. Barry Lubetkin, Phd, ABBP offers us insight on the distinction between a diagnosed disorder and a hobby or personality characteristic.

Hoarders and Clutterers and Collectors Oh My!!!

The Psychiatric problem of hoarding had been under diagnosed for many years .But recently with increased media attention(see several New York Times articles in the past four months),the

wildly popular reality TV show “Hoarders” and recent major advances in the diagnosis and treatment of this mental affliction, many more people are getting professional help.
It is important to point out that while many of us may have lived with and accepted clutter in our homes for our entire lives, being diagnosed as a hoarder requires that the clutter must seriously interfere with the quality of our lives and risk our safety. Navigating through dangerous paths in our home with furniture and garbage piled on either side, shame of exposure leading to living lonely isolated lives, or irrational superstitious beliefs that cleaning up or throwing out certain articles will lead to terrible consequences………these all will confirm the diagnosis.

The etiology of hoarding is multi determined…….a previous diagnosis of obsessive compulsive disorder, prolonged depression, unkempt,and chaotic childhood homes, have all been implicated. Even the well intentioned collector who has enjoyed his passion for saving and displaying his collections is sometimes at risk if other psychiatric disorders emerge and create a vulnerability to depression and indifference to caring for themselves or their living conditions.

Treatment involves a variety of interventions :Anti depressant medication,engaging family support during the clearing process, Cognitive Behavior Therapy to reduce anxiety and panic and designed to educate the hoarder on the irrational and superstitious thinking elements of the disorder,and guided practice in controlling their environment post treatment.

With less serious clutter collectors who feel their mess has gotten difficult for them to control, I suggest starting with small portions of the affected areas (one corner of the bedroom,piles of books and papers on the floor,etc), and slowly progress over time to prioritize what to throw out. Dividing your “stuff” into A ,B and C groups………must keep, maybe keep, must dispose, is often very helpful. Feel free to contact me at ibt104@aol.com for further advice.

 Barry Lubetkin, Phd, ABBP is co-director of the Institute for Behavior Therapy in Manhattan.  Dr. Lubetkin has written two widely acclaimed books. Bailing Out (Simon and Schuster and Prentice Hall Press) and Why Do I Need You To Love Me In Order To Like Myself (Longmeadow and Borders Press). In addition, his 3-disc audio series on treating insomnia Dr. Barry’s Sound Asleep has recently been published. 

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