Sunday, May 13, 2012

The condition of compulsive hoarding has become topical on TV. Not surprising perhaps, as the irrational acquisition of seemingly useless objects appeals to the ‘rational’ and voyeuristic viewer, who cannot understand the point of it all, yet is drawn, as humans are, to the tragedy and the suffering it engenders.

But, I was impressed, and very moved, by Jasmine Harman’s recent TV documentary on hoarding, and how it has impacted on her life as her mother suffers from the condition, as well as the sensitive portrayal of the lives of other sufferers, in Britain’s Biggest Hoarders (http://www.bbc.co.uk/iplayer/episode/b01hllr3/Britains_Biggest_Hoarders/).

Hoarding is a hidden, and as a result under-recognised and under-treated, condition, which isolates both the sufferer and those close to them. Whether or not it is a variant of OCD remains controversial. Recent research suggests that compulsive hoarding is a separate syndrome, although it can coexist with OCD (Pertusa et al. Compulsive Hoarding: OCD Symptoms, Distinct Clinical Syndrome, or Both? Am J Psychiatry 2008;165:1289-1298).

The critical issue is that hoarding needs to recognised as a condition that requires treatment. And the good news is that therapy can help, as we saw in the case of Jasmine Harman’s mother.

What struck me most about the documentary was, firstly, how much sufferers struggle alone, often for a very long time, and secondly, the extent to which those close to them also suffer. Many compulsive hoarders live alone, but not all. The loyalty and sheer endurance of those who live and care for sufferers is extraordinary. In effect they are also sufferers, silent sufferers, and compulsive hoarding tests love and caring to a degree that many of us have never had to experience.

This is particularly challenging as hoarders, and this is the major difference between compulsive hoarding and OCD, are often in denial. In the BBC programme sufferers blamed lack of sufficient storage space, house design…. and other ‘irrational’ explanations for the accumulation of objects such as VHS tapes in a house where the VHS machine could not be accessed anyway due to the sheer volume of obstacles in the way…

But rational thinking, and our perception of how things should be, cannot explain hoarding away. Living with a mother who was a compulsive hoarder, Harman, as she grew up, questioned whether her mother loved her possessions more than she loved her own daughter. In the end, it is not as simple, as ‘x’ or ‘y’, but more about looking beyond the ‘pointless’ acquisition of objects, and understanding the thinking behind the process. Why hoard? Why accumulate ‘worthless’ stuff that is never used, and that creates health, economic and social destruction? There is no simple answer, but, as we follow Harman’s mothers journey through therapy, we hear about the association between hoarding and loss, and the perhaps subconscious role that possessions play in filling that void.

I was left thinking about the silent suffering that happens behind closed doors, about the challenge of compulsive hoarding, not just for the sufferers, but also for those who live with them and care about them and love them, notwithstanding.

I was also reminded of the power of television as a medium that has the capacity, in the right hands, to go beyond voyeurism, thereby facilitating a sharing of something that is authentic and human and humbling.

Advertisements