Arpita Bose, a retired architect, is fully aware that she has way more things than necessary. Her kitchen storage is overloaded, she has enough crockery to host a wedding party, and there are items from her wedding, the birth of her children, their schooling and her childhood. Most of these are only around because of their “emotional value”, but she refuses to get rid of them.
Bose suffers from a classic case of hoarding disorder (HD), defined by the American Psychiatric Association as people who “have persistent difficulty getting rid of or parting with possessions due to a perceived need to save the items. Attempts to part with possessions create considerable distress and lead to decisions to save them. The resulting clutter disrupts the ability to use living spaces."
So why do people hoard, and what can they do to break this pattern?
A byproduct of history
Sanjana Prasad, a trauma-informed counselling psychologist and psychotherapist based in Bengaluru, takes us back in time to understand how history can influence hoarding among Indians.“Historically and collectively as a society, we have always operated from the notion that there aren't enough resources," she says, pointing out that this mindset seeps into everything we do, including our tendency to hoard.
According to Prasad, Indians hold a lot of generational trauma from the British Raj establishing their dominance and taking resources away from us, which we eventually “tackled” by pitting against each other, creating divides across our own society, and truly believing that survival was at stake. While the divide existed prior to us being colonised, it became more polarised post-British Raj. So much so that this meant stocking up for ourselves, even if that meant deprivation for someone else.“We’re essentially living through generations worth of trauma caused by the snatching away of resources, in little ways today like stashing away extra plastic bags in a plastic bag,” she states.
In short, our brains are constantly worrying about survival, which, in turn, causes us to hoard things.“The survival brain tells us that if we don’t hoard to the extent of depriving another, we’re unsafe," she says, pointing out that it often ends up in us looking for ways to keep things closer to ourselves.“It may be harder to let go in the fear that we may not be able to afford it again or that something bad may happen and we’ll need to be prepared for it. This could be one of the major reasons why as a society, we engage in hoarding behaviours more frequently,” she says.
Understanding the symptoms of hoarding
Hoarding Disorder (HD) has its origins in your genes.“Hoarding runs in families. Heritability (a measure of how well differences in people’s genes account for differences in their traits) is between 36% and 50%, and the remaining variance is attributable to non-shared environmental factors,” says Dr Alok Kulkarni, a senior consultant psychiatrist at the Manas Institute of Mental Health, Hubli.
According to him, people who meet the diagnostic criteria for HD experience persistent difficulty discarding or parting with possessions due to a perceived need to save the items.“There is distress associated with discarding them,” he says, pointing out that the most commonly saved items include newspapers, old clothing, bags, books, and paperwork. Discarding difficulties, he adds, are generally motivated by the perceived utility or aesthetic value of the items, a strong sentimental attachment to the possessions, the fear of losing important information, a desire to avoid being wasteful, or a combination of these factors. These difficulties result in the disorganised accumulation of possessions that congest and clutter active living areas and substantially compromise their intended use.
Sometimes it gets so bad that affected individuals may not be able to sleep in their beds, cook in the kitchen, or sit on the sofas in their living rooms.“The clutter often extends beyond the person’s actual home, with accumulation of possessions taking place in garages, gardens, vehicles, and even workplaces," he says, adding that these people may end up paying for private storage spaces or asking family members or friends to keep items in their homes.
And yes, too much stuff can put individuals at risk for fire, falling, poor sanitation, and other health risks, adds Dr Kulkarni.“Quality of life is severely impaired, and individuals with hoarding disorder have strained interpersonal relationships. Legal proceedings ranging from forced clearings to evictions may also be seen,” he says.
There are several common factors in the lives of people who are prone to hoarding, adds Prasad. For starters, they often feel like they don't feel like they belong. Hoarding helps them cope with this sense of unbelonging, he adds. As Dr Kulkarni points out, other medical conditions like traumatic brain injury, cerebrovascular disease, CNS infections such as herpes simplex encephalitis, and neurogenetic conditions such as Prader-Willi syndrome could trigger a need to hoard. A diagnosis of hoarding disorder can only be made after ruling out other medical conditions, including autism spectrum disorder or a neurodegenerative disorder such as Alzheimer’s disease, adds Dr Kulkarni.
How do I manage it
Dr Kulkarni is of the opinion that the intervention that has the strongest evidence base for HD is a multi-component psychological treatment that is based on a cognitive behavioural model. “This involves motivational interviewing to address ambivalence about therapy, educating about hoarding, goal-setting, organising, decision-making, and problem-solving skills training; exposure to sorting, discarding, and not acquiring; and cognitive strategies to facilitate these aforementioned interventions,” he says.
And yes, it helps work with a mental health practitioner to understand one's reason for hoarding, says Prasad, adding that it is important to dig into the past to gain insight on how this behaviour is manifesting in their lives.“Through therapy, trauma processing can be done to help these people move from their survival states to the “rest and digest” mode, which should automatically help them choose healthier ways to cope with difficulty in their lives going forward, and more importantly, breaking generational belief patterns that have solidified in their ways of working," she says.
Divya Naik is a Mumbai-based psychotherapist