Have you an attic or a garage full of ‘stuff’? Boxes that have been put up there or out there years ago, just because the items in them might come in handy someday.

Irish Country Living asked Dr Fergal Rooney, principal psychologist with St John of God Hospital, Dublin why we do it, how we should tackle it, and how to know when the problem has veered into the more serious hoarding disorder.

He begins by making an important distinction between cluttering and hoarding. “These are two separate things. Many, if not all of us, will accumulate clutter to a greater or lesser extent.

“We allow things to gather that we don’t sift through and organise and discard when we need to do that. While our homes can become a bit disorganised and chaotic, this doesn’t fall into the category of hoarding.

“Hoarding is a very different phenomenon altogether. This is where collecting things has impacted on a person’s ability to live in their space and where their stuff has become quite a focus in their lives.”

Clutter

So, on the lighter side, why do ‘clutterers’ let objects pile up in our attics? There are three main drivers for this, he maintains.

“Firstly, you keep things because you have the space to do that.” Attachment is the second reason.

“We can have an attachment to various bits and pieces and be unable to make a decision about them in terms of holding on or letting go,” he says.

He gives a personal example of having stored a lot of boxes in his brother’s attic 25 years ago and of having to sort it recently.

“When I took it down and looked at it, I thought ‘what in the name of God did I hold onto this for’?” he says. “It meant nothing to me now as I had lost the emotional connections to the pieces.” Emotional imprints are what cause the holding on problem, he believes.

“Very often it’s the emotional imprint that makes us want to keep things. We can feel that we are being unkind to that emotion, that connection, if we simply discard the object.”

Dr Fergal Rooney, principal psychologist with St John of God Hospital.

The third reason is related to not wanting to be wasteful.

“We believe that the item will be useful in the future.” This last reason can be learned behaviour, he believes.

“It’s that idea of ‘waste not, want not’ that was drummed into many of us growing up. That becomes a value which drives this thing of ‘oh I might get some use out of that someday’.

The important thing in all this is being capable of having a clear out.

“Where people struggle is when they are not able to do the clearing out,” Dr Rooney says.

Decluttering should happen ‘on the hoof’, he advises. “We should get into a habit of doing it as we go, eg our post. You sort your junk mail from your important post, deciding very quickly what’s important and disposing of what isn’t.”

This is a really important cognitive piece of this whole dynamic, he says.

“That decision making ability is really important. If we could develop this preventative approach on an ongoing basis, it would mean that we are not left with all this stuff in the first place.”

Hoarding disorder

Recent research shows that those with a hoarding disorder don’t have this ability to differentiate between what’s important and what’s not.

“They cannot separate out what’s important from what’s not important, like the pizza leaflet from the car tax in the post, for example. Everything is put into the same bundle. Therefore for them, that bundle now has value.”

Serious hoarding is a problem for 1 in 20 people, according to US research, he states.

“The dynamics of what’s going on for the person with hoarding disorder are pretty complex.

"Until recently hoarding was seen as a subset of Obsessive Compulsive Disorder (OCD) but it’s now seen as a separate stand-alone disorder. It may mimic some symptoms of ADHD too and it can also happen for people who have difficulty with decision making.”

Those with hoarding disorder can feel that the stuff they gather is part of their identity.

“It can define who they are. They feel that their history is held in this. Sometimes when it becomes very extreme it can seem like the possessions are like their friends and that it would be a betrayal to discard them.”

When is it a problem?

This usually becomes a problem when the function of the person’s living space is impacted. “That’s when the person can’t sit on their sofa, make it from the fridge to the cooker to prepare a meal or use their bedroom functionally – because of all the stuff.

“The other hallmark is when the person has a real angst or difficulty in letting go.”

Dr Rooney, in his practice, comes across hoarding where the behaviour of gathering is causing problems in families.

“It could be compulsive buying or bringing stuff into the house and other family members are fed up with it.” Treatment involves a systemic approach, aimed at the family, but you can’t force anyone to sort out their living space, he believes.

“Very often people will be resistant because they have an intense fear of letting the stuff go,” he says, “so you’ve two very competing positions in the home.

We can feel that we are being unkind to that emotion, that connection, if we simply discard the object

"That’s why very often the ideal is that a therapist goes to the house and supports family members to intervene and try to negotiate a middle ground that will help start the process of letting go.”

What about cleaning a hoarder’s home if they were in hospital, for example? Is that a good idea?

“I would be cautioning people about a big clear out like that,” he says, “because when the individual goes back to the house, a lot of their sense of security will be gone. That’s because the person is invested in the stuff and there has just been an invasion of their space by someone who doesn’t appreciate the importance of it.”

Progressive disorder & treatment

Hoarding disorder is progressive and usually spikes from the age of 50 onwards, he states. “That’s because the volume of stuff has made the person’s space unliveable.”

Do people present with a hoarding disorder themselves?

“No, very often it comes to light when they present with anxiety or mood disorders. In the course of exploring that, the hoarding becomes evident.”

Hoarding disorder can be a very debilitating condition. There isn’t a medication that can address this but cognitive behavioural therapy (CBT) is the first line of therapy.

“It can help the individual to recognise the emotional connection they have to the material,” Dr Rooney says. “It also helps them test the validity of that to see if that is a rational attachment. It also looks at some of the belief systems around how and why they gather.

"It’s about trying to help them understand what underpins their behaviour so they can then begin to plan how they can change this behaviour.”

The therapy is very structured, he says, and involves homework from week to week. He estimates that 20 sessions are needed to get to the point where there would be a tangible change in the behaviour.

“It will also mean checking in with their therapist regularly after that in order to continue to manage it.”

Expert tips to declutter the attic

Decluttering should happen ‘on the hoof’. \ iStock

Hoarding is so hard and raises many different and complex emotions, including anxiety, shame and guilt. But there are things you can do to help yourself cope.

If you don’t know where to start, taking small steps can help you make good progress. Here are some of Dr Rooney’s suggestions to get started with the attic.

  • Decide that you’re going to do it.
  • Allocate a specific time, say a Saturday morning.
  • Enlist the help of someone, a friend or a relative, who doesn’t have the same emotional attachment to your things.
  • Be ruthless.
  • Donate or give away what you don’t want on that particular day. Don’t leave it until the following day.
  • Getting help

  • Presently, the treatment pathway for hoarding is going to your GP and a referral to community mental health services.
  • Aware’s Life Skills Online: Based on the principles of cognitive behavioural therapy (CBT), the Life Skills Programme is designed to help you learn more about how we think and how this can influence our actions in helpful or unhelpful ways.

  • The programme is comprised of eight modules which you can work through online in your own time from the comfort of your own home. You benefit from the support of an Aware trained volunteer Supporter for the first eight weeks, who you can choose to share your progress with. The next programme opens for registration on 21 October 2024 at 4pm. Check out aware.ie/programmes/life-skills-programme/
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