How can a child of a hoarder (COH) best communicate their feelings to the hoarding parent (HP) so that they’ll open to listening, rather than feel attacked? As COH’s we want to be heard and many times don’t feel like we are.
A: Relationships between individuals who have hoarding difficulties and their children are frequently strained as a result of the hoarding; therefore having a productive discussion about the problem can be challenging. In order to most effectively communicate with a hoarding parent, it is important to: (1) Get educated. Take a step back from the problem and learn about the disorder. Education is a powerful tool. (2) Keep emotions in check. Feelings of anger, resentment, sadness, embarrassment, and frustration which are commonly experienced by family members can unintentionally sabotage an attempt to have a meaningful conversation with a loved one who hoards by overwhelming them, resulting in conflict. (3) Focus on the present situation and the potential for an improved future, rather than dwelling on the past. (4) Speak reasonably with your loved one from a position of love, support, and concern for them. (5) Educate your loved one and offer resources for assistance. (6) Allow your loved one to maintain control of decision-making, whether it be the decision to seek assistance or in the process of making decisions about possessions. This will minimize their potential for defensiveness and maximize their capacity to benefit from building this underdeveloped skill.
Per the previous question, have you found that sitting down with an organizer specializing in hoarding or a therapist can help a family make a breakthrough?
A: Professionals such as psychologists who have specialized experience in the treatment of hoarding or in family therapy can be quite helpful in facilitating meaningful discussions between family members. This can help to maintain the focus of the conversation, keep it present and future oriented, move toward improving insight, and avoid the common pitfalls that typically lead to further conflict and lack of progress.
Do you often see situations in which a hoarder’s mental status must first be addressed? In real life (not the TV shows) are therapists present for a clean up?
A: Assessing the individual’s overall emotional functioning and mental status is very important at the outset of treatment. Co-occurring psychopathology is common with compulsive hoarding which poses an added challenge to their treatment and to improving their living conditions. For example, 60% of these individuals meet criteria for major depressive disorder. Other conditions that commonly co-occur include social phobia (30%), generalized anxiety disorder (25%), and obsessive compulsive disorder (15%-17%). These problems also need to be identified and treated in order to effectively treat the hoarding problem and maintain improvement. In treatment, therapists who specialize in the treatment of hoarding frequently do go into homes. In my own practice, some of the therapeutic “clean-up” work is done in the office and some of the work is done in the home. Most often, my clients are seen in the office with some of their belongings. They are then assigned homework in the home. Home-based sessions are also scheduled in order for the therapist to gain a rich understanding of their difficulty as well as to most effectively work through the process of sorting, applying coping skills, and applying decision-making skills in the home.
What are two baby steps a child of a hoarder could take to help their hoarding parent?
A: (1) Gently speak to your loved one with respect and from a position of concern for their safety and well-being. (2) Get educated in order to provide them with education about the problem and how to seek help.
Any tough love tactics one can use? Does it make sense to use tough love with a hoarder or does that just make their resistance deepen? Are there any specific situations in which it will work?
A: Resistance to treatment is common. “Tough love” should be used with caution; these tactics can be counterproductive and can increase resistance to assistance at any given time or in the future, further damaging the relationship. The only “hard line” I recommend is to ensure that a family member is safe. If there is a serious concern for the safety or health of an individual, the situation may require reporting to an authority that can serve to protect the individual(s). If there is no significant concern for safety, it is important for family members to form an empathic, united front from which to discuss the problem with their loved one in a direct, yet supportive manner to communicate the seriousness of the problem and the behaviors as well as the shared desire to improve their loved one’s quality of life.
Many COH just don’t go to their HP’s house and that’s the repercussion they must feel from the hoarding. Is it right to give parents repercussions so that they feel like they’ve hit bottom? Can you compare this to alcoholism in that way?
A: Children of individuals who have difficulties with hoarding must make their own decisions about their own safety and well-being. For example, an adult child may not feel it is safe or desirable to have their four year-old child visit the hoarded home of a grandparent. If such decisions are made, it is important that they be made with the safety and well-being of others in mind and should be communicated to the loved one who hoards as such. It is never a good idea to make such decisions in order to punish the individual who hoards or to “force” insight. Doing so is very unlikely to help an individual “feel like they’ve hit bottom,” and will most likely to create further interpersonal conflict, negative feelings, and resistance to assistance. I have discussed hoarding as it compares to substance abuse elsewhere. If interested in reading further about that, visit: http://www.thecenterforemotionalhealth.com/CEH_Blog/Entries/2010/2/25_Hoarding__Compulsion_vs._Addiction.html
Or is it like Al-Anon when they say to take care of yourself and don’t worry about the HP. You might have to distance yourself and be okay with it. What if you have guilt from distancing yourself and also that your parent is living in the hoard when you are in a comfortable, functioning home?
A: It is important to take care of oneself. If a child is not educated and comfortable with his/her feelings, decisions, and efforts to help a loved one who hoards, they are not likely going to be effective in doing so. Hoarding effects family members. If a family member finds him/herself struggling with their own feelings, it is important for that individual to seek assistance with that. Seeking counseling or therapy in this case is recommended for one’s own well-being.
Do you ever work with someone and know right away if they will succeed or not? What tips you off?
A: It is impossible to predict with 100% certainty the likelihood of a client’s treatment potential. That being said, treatment potential can be guesstimated by considering factors such as social/family support, level of insight, motivation, the presence or absence of co-occurring psychopathology, and the ability of the individual to reflect on his/he own process and consider alternatives (i.e., cognitive flexibility).
Are there people that you think can’t be helped effectively.; that are too deep in their own situation?
A: Certain difficulties can pose additional challenges to effective treatment such as poor insight, limited mobility, health problems, serious co-occurring psychopathology, lack of motivation, lack of social support, isolation, and cognitive rigidity, to name a few.
What’s the oddest thing you’ve found in a hoard or a hoarder has told you?
Oddity is relative. I’ve seen all sorts of things.
Dr. Deibler is the Founder and Director of The Center for Emotional Health of Greater Philadelphia in Cherry Hill, NJ an outpatient treatment facility specializing in the treatment of obsessive-compulsive spectrum disorders.
Dr. Deibler holds a doctorate in Clinical Psychology with a concentration in Health Psychology/Neuropsychology. She has gained experience at some of the finest institutions in the nation, including the National Institute of Mental Health at the National Institutes of Health, National Institute of Neurological Disorders and Stroke, Children’s National Medical Center, and the Kennedy Krieger Institute at Johns Hopkins University Medical Center. Dr. Deibler provided clinical services at the National Center for the Treatment of Phobias, Anxiety, and Depression. She served as Director of Behavioral Sciences at the Temple University School of Dentistry and served on the clinical faculty at Temple University Schools of Medicine and Allied Health as well as Temple University Children’s Medical Center.
Dr. Deibler gained specialized behavior therapy experience in the treatment of Obsessive-Compulsive spectrum disorders at the nationally-recognized Behavior Therapy Center of Greater Washington. She also completed a three-year fellowship researching Trichotillomania and Obsessive-Compulsive Disorder at the National Institute of Mental Health.
Dr. Deibler has published scientific research in peer-reviewed journals and has presented clinical training seminars and research findings at national and international meetings. She has appeared on A&E’s , CBS News, ABC News, It’s Your Call with Lynn Doyle, and CBS’s Swift Justice with Nancy Grace and has been interviewed by news sources such as the Philadelphia Inquirer, Philadelphia Daily News, US Magazine, Connecticut Post, and Suburban Family Magazine.
www.thecenterforemotionalhealth.com
