As a coroner speaks about the dangers of excessive hoarding, STUART ARNOLD examines this strange compulsion and discovers why those that do it need to be better understood.

“Dealing with hoarders is about having the human touch”, says Nadine Field.

Ms Field, a consultant psychologist who works with hoarders and those suffering from Obsessive Compulsive Disorder (OCD), should know better than most why some people choose to fill their houses with junk and what makes them tick.

Over the course of 20 years she has treated a number of excessive hoarders, although she admits it remains relatively rare – about one per cent of her caseload.

Nonetheless up to three million Britons are estimated to suffer from some kind of hoarding disorder.

Psychologists regard hoarding as a “safety behaviour” and it is commonly treated with cognitive behavioural therapy, which involves gradually exposing the hoarder to the loss of the items they have amassed.

They are taught that losing possessions which are not particularly important can be tolerated, is perfectly safe and will not lead to dire consequences.

However intervention isn’t possible in all cases and it’s often only when complaints are made by a neighbour or a hoarder ends up in court that any sort of action is taken.

“We all hoard things. But the question for those with a problem is what can’t you throw away and why?” says Ms Field.

“People may feel that if they throw something away they are throwing something of their life away, whether it be a letter from a grandparent or a child’s drawing.

“They are trying to comfort and protect themselves. Your world closes in on you and gets smaller and smaller if you are a hoarder because you go to such extremes.”

Ms Field says a heavy-handed approach with excessive hoarders rarely works.

“It is a very complicated issue. Hoarders are often afraid and may even attack people who enter their home because they feel under threat,” she says.

“If you are the local council your only consideration is that this is terrible, it’s stinking, there are rats, and we have to clear this mess.

“That is not always the right approach. Many hoarders know rationally what they are doing is ridiculous.

“But you have to be quite delicate and use humour and be kind to them.

“You need to speak to that person and say ‘Let me help you clear it’ and ‘Do you really need this?’ “You are finding out why they so feel so vulnerable and why they are doing what they are doing. There is a human being at the bottom of this.

“Often nobody asks the question why, unless you are a psychologist.”

Last year US researchers suggested that hoarding disorder exists in its own right, rather than just being a symptom of OCD, as doctors have long believed.

This could give rise to a new classification of psychiatric disorder in its own right.

However Ms Field believes this is wrong.

“Hoarding disorder is an adjunct to OCD,” she says.

“If you are compelled to keep things ‘just in case’ you are effectively doing the same thing as OCD sufferers. It is on a spectrum.”

Dr Helen Nightingale, a clinical psychologist and a spokeswoman for the British Psychological Society, says she believes hoarding is a growing problem.

“It could be because as a society we have become more materialistic, but that is just one theory,” she says.

Dr Nightingale says the trigger for a hoarding problem could be an event which has disrupted someone’s life or a personal loss they have suffered in their childhood.

However she stresses that there isn’t always a trigger.

Interestingly Dr Nightingale suggests there isn’t an awful lot of difference between hoarders and those that may have a hobby simply collecting items.

“There is a very fine line between the two,” she says.

“When it starts to take over your life it is then that you are in trouble.

“The difference is a hoarder will have very high levels of anxiety. For example, they might have a fear of not being able to find something, or losing something.

“They may no longer engage with individuals and other aspects of their life and live alone.”

Ms Field gives the example of a client of hers who began hoarding after a divorce from his wife and the shock discovery that his daughter had been sexually abused.

His penchant was for books and 1950’s memorabilia which spilled out from his house into his garden and meant callers could not get through the front door.

“We looked at what he had got and laughed. He was so embarrassed,” she says.

“I said let’s just sift and sort what you need, no judgement involved.

“I also told him not to go and buy anything more – that was our deal. We eventually went through his whole house.

“His cat was horrified, but this approach worked.”

It’s this human touch that might be key to solving the problems posed by excessive hoarders.

ARE YOU A HOARDER?

If you answer yes to more than four of the following questions you may have a problem with hoarding...

:: Do you have difficulty using the rooms in your home because of clutter?

:: Do you have a problem discarding, recycling or giving away things that other people would get rid of?

:: Do you collect free things or buy more than you need or can afford?

:: Have you experienced emotional distress because of the clutter in your home?

:: Is your failure to get rid of unwanted items having an adverse impact on your work or social life or having an impact on a relationship?