Carol Mathews - Recognizing and Treating Hoarding Disorder

Advance Praise

Dr. Mathews has written an extraordinary book on hoarding disorder. In Recognizing and Treating Hoarding Disorder , she includes not only what its like for the person who has it, but what its like for the family members. She introduces you to what happens in the brain areas that cause this disease and treatments that can work. This hopeful book is a must-read for professionals as well as patients and families who suffer from this disorder.

Louann Brizendine, M.D. , Neuropsychiatrist, Clinical Professor, UCSF, Marc and Lynne Benioff Endowed Professor of Psychiatry

Too few clinicians can clearly recognize hoarding disorder or know the options available to treat and manage the condition. In this clear and comprehensive book, Dr. Carol Mathews covers all the important bases. Readers will find guidance in identifying hoarding disorder, assessing the condition, and current treatment options and their efficacy. Dr. Mathews takes up other important features of the condition, notably the effect of hoarding behaviors on friends and family members, its presentation in youth, and features of animal hoarding. I highly recommend this book to anyone who wants to understand this condition and how to help those who suffer with it.

Michael A. Tompkins, Ph.D. , ABPP, author of Digging Out: Helping Your Loved One Manage Clutter, Hoarding, and Compulsive Acquiring and Clinicians Guide to Severe Hoarding: A Harm Reduction Approac h

For people living with HD, stuff is just the tip of the proverbial iceberg. Dr. Carol Mathews book, Recognizing and Treating Hoarding Disorder: How Much is Too Much? , dives beneath the surface to examine the complexities of this often maligned and misunderstood mental health challenge. In a sea of misinformation, stigma, and shame, this book provides the science and sensitivity needed to navigate safely to a life less cluttered.

Lee Shuer , recovering finder/keeper and co-founding member of Mutual Support Consulting, LLC, coauthor of The Buried in Treasures Workshop Facilitators Guide and WRAP for Reducing Clutter

Dr. Mathews delivers an important book that is a must-read for anyone interested in learning about hoarding disorder. Her work integrates the most contemporary research on epidemiology, etiology, assessment, and treatment of hoarding disorder while also producing a book that is accessible for a broad audience. Information is delivered in a manner that one can see the application readily and use the insights in their own practice or care of individuals struggling with hoarding.

Scott Mackin, Ph.D. , Neuropsychologist, Professor In Residence, Department of Psychiatry, University of California San Francisco

A NORTON PROFESSIONAL BOOK

Recognizing and Treating Hoarding Disorder

How Much Is Too Much?

CAROL A. MATHEWS

Note to Readers: Standards of clinical practice and protocol change over time, and no technique or recommendation is guaranteed to be safe or effective in all circumstances. This volume is intended as a general information resource for professionals practicing in the field of psychotherapy and mental health; it is not a substitute for appropriate training, peer review, or clinical supervision. Neither the publisher nor the author(s) can guarantee the complete accuracy, efficacy, or appropriateness of any particular recommendation in every respect. As of press time, the URLs displayed in this book link or refer to existing sites. The publisher and author are not responsible for any content that appears on third-party websites.

Copyright 2021 by Carol A. Mathews

All rights reserved

First Edition

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ISBN: 978-0-393-71357-2

ISBN: 978-0-393-71358-9 (eBook)

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This book is dedicated to all of those who suffer from problematic hoarding, and to their families, friends, and loved ones.

CONTENTS

This work would not have been possible without the scientists and clinicians who have led the way. Many thanks to the thought leaders in this field, and in particular to Randy Frost and Gail Steketee, who are mentors and role models for so many of us. Thanks also to all of my colleagues in the hoarding field, who continuously work to advance scientific knowledge, and to improve the lives and health of those with hoarding disorder. Finally, my deepest heartfelt thanks to Lee Shuer and all of the individuals and families who work so tirelessly to educate the public about hoarding disorder, decrease stigma, and advocate for the rights of people and families who are impacted by hoarding.

Recognizing and Treating Hoarding Disorder

We all have heard the statements, Shes a pack rat or Hes a hoarder, but how many of us really know what that means? While literary references to hoarding can be found as early as the 14th century, and hoarding behaviors have likely existed since the beginning of humankind, hoarding disorder (HD) was only officially recognized by psychiatrists and other health care professionals as a discrete psychiatric illness in 2013, with the publication of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM - ) by the American Psychiatric Association.

A BRIEF HISTORY OF HOARDING

From the fourth circle of hell in Dantes Divine Comedy , circa 1320 A.D., through the Great Depression and World War II, the term hoarding referred specifically to the accumulation (and often the hiding) of money or objects of value, and was considered to be a form of greed. In Dantes fourth circle, the Hoarder/Waster was a creature who consisted of two people merged into one: One of whom collected and hoarded coins, which the other then spewed or wasted (Alighieri, 1472/1995r). In the play Henry VI , Shakespeare refers to hoarding several times, as in the following speech by King Henry (Shakespeare 1623/1995r):

Didst thou never hear

That things ill got had ever bad success?

And happy always was it for that son

Whose father for his hoarding went to hell?

Despite these notable examples, references to hoarding in books and other media were relatively few until the 1930s, when the food and economic scarcity and bank instability resulting from World War I, the Great Depression, and World War II led to the hoarding of gold coins, as well as food and other rations. Hoarding during this time was so prominent that both the Canadian and the U.S. governments banned it (). Presidents Herbert Hoover and Franklin Delano Roosevelt called out the hoarding of money and rations in their radio addressesHoover publicly denounced what he called traitorous hoarding, saying, The battlefront today is against the hoarding of currency. Roosevelt went even further by issuing an executive order forbidding hoarding (Hoover, 1934).