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What is OCD-Related Hoarding?

Exploring the distinction between pure hoarding and hoarding that stems from OCD.

Often times people don't see how people with Obsessive-Compulsive Disorder (OCD) can also struggle with Hoarding Disorder (HD). Many people associate people with OCD as having tidy houses with nary an item out of place, who wash their hands repeatedly and are rigid with their schedules and routines. It should be noted that OCD affects 1 out of every 40 Americans.

In fact, OCD is when people are caught in a cycle of obsessions and compulsions. Obsessions include intrusive thoughts, images, or urges that cause anxiety or distress, and compulsions (repetitive mental or behavioral acts) that the individual feels driven to perform in relation to rules that he or she has created.

In the past hoarding was usually associated with OCD, but upon further research and study, Hoarding Disorder was pulled out and is now a stand-alone diagnosis according to the most recent Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Unlike OCD, HD it is not characterized by obsessions or compulsions. Hoarding thoughts are not repetitive in the way that OCD thoughts are and in fact HD is associated with positive feelings of pleasure and excitement when acquiring instead of OCD's anxiety and distress.

Here are some examples of Hoarding in the context of OCD to make things clearer:

  • Continually buying products in multiples of 4 because it's a person's lucky number.

  • Having stuffed drawers, closets and cabinets around the house filled with objects that are considered contaminated and can't be touched.

  • Buying every item in a department store a person touches because they don't want to contaminate others with their germs.

  • Saving endless stacks of papers because the person can only dispose of them by following a rigid set of rules which are difficult to follow (ie; papers must be in 8in high stacks tied with double knotted twine cut with the purple handed scissors).

  • Hoarding bizarre items such as rotten food, used diapers, and garbage.

People with OCD who hoard don't derive pleasure from the things that they acquire and save, on the contrary, they're saving them because of ritualistic beliefs or compulsions. For individuals with OCD keeping excess possessions becomes a way to temporarily manage intrusive and upsetting thoughts over cleanliness and health.

The best clinically-proven treatment for HD and OCD is Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP).

CBT teaches individuals to identify, assess and respond to their faulty thoughts and beliefs. It is based on the idea that distorted thoughts and maladaptive behaviors play a role in the development of a mental health disorder.

ERP exposes clients to situations and places that trigger his/her OCD symptoms. The goal is that over time the client is able to become desensitized to their fears. Repeatedly facing one’s fears and uncomfortable thoughts allow anxiety to gradually decrease.

With all this being said, I want to highlight the International OCD Foundation which has a robust website filled with resources for persons living with OCD and professionals. Please share with those who would benefit.

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