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Janice is a compulsive hoarder. For years chaos reigned in her flat, which was cluttered with things like baskets of un-ironed laundry and broken shelves. One day she read a newspaper report about compulsive hoarding syndrome.

“The scales fell from my eyes,” said Janice, who now heads the northern German branch of a group that calls itself Messies. “That’s me, I thought, and I’m not alone.” Support groups estimate the number of compulsive hoarders in Germany, which has a population of 82 million, at about two million.

“Compulsive hoarders generally collect useless things, are unable to discard them and finally lose track of them,” said Alfred Pritz, a psychotherapist and director of Sigmund Freud University in Vienna.

Hoarding is often a symptom of other psychological disorders such as psychosis. “Many compulsive hoarders are also depressive,” Pritz noted. Although it is commonly found in people who suffer from addictions or obsessive-compulsive behavior, he said, “compulsive hoarding syndrome essentially has its own clinical picture.”

When does disorganization become pathological? “It becomes problematic when it restricts the social life of affected persons to such a degree that they suffer because of it,” according to Pritz.

Compulsive hoarders suffer primarily from social isolation. “They don’t invite anyone over out of shame and they decline invitations,” Janice said. Their social contacts break off and they grow lonely.

Many also develop cover-up tactics. “A lot of them are elegantly dressed and very well-groomed. Some even have several flats or live in their car because there’s no more room for them at home,” she said. The pressure to keep up a facade is an additional burden.

It is not clear what causes hoarding but it is frequently linked to an attachment disorder. Compulsive hoarders try to compensate for their fears of separation and loss by developing an emotional attachment to the objects they accumulate.

“The objects can’t hurt them,” Janice explained. “They won’t abandon them and can’t disappoint them, and this gives compulsive hoarders a sense of security.”

Gross said treatment for compulsive hoarders should not be confined to behavior therapy because “that would fully ignore the emotional side of the problem and bring short-term success only.” There is no way around psychotherapy.

“It’s important that external behavioral changes lead in the long term to a restructuring of the inner chaos” of the compulsive hoarder, he remarked.

To achieve this, he said, the therapist and hoarder could select an area off-limits to clutter that is gradually extended to the entire home.  

DPA