Forcing hoarders to conquer clutter
Drs. Jamie Feusner and Sanjaya Saxena offer valuable strategies for treating compulsive hoarding disorder (Current Psychiatry, March 2005),
Encouraging these patients to regularly have visitors over to their houses also can be extremely therapeutic. This approach works on several levels:
- Patients would be embarrassed to have company see a messy home, so they will clean frantically before the visit.
- To avoid future all-night clean-ups, they will be motivated to prevent clutter from accumulating day-to-day.
- Social interaction with visitors provides support that reduces some causes of hoarding.
These visits force patients to be accountable and confront denial, much as Alcoholics Anonymous does for patients with alcohol use disorders. Even if the clutter is displaced to closets—as is often the case—it is still a major step forward. This approach requires a strong therapeutic alliance, but patients will receive positive reinforcement that sustains their progress.
Isaac Steven Herschkopf, MD
Department of psychiatry
New York University School of Medicine
New York, NY