‘Hoarding is a coping strategy, which has got out of hand’

What sparked your interest in the psychology of hoarding?

My dad was a bit of a hoarder. He was kept in check by my mum. The spare bedroom and garage were absolutely crammed with rubbish or, as he may have said, 'things that might come in handy', such as rusty nails. I'm interested in what drives some people to collect a particular item, like books, and other people to hoard rubbish.

What is the definition of a hoarder?

The clinical definition of hoarding is when a person has so much stuff it starts to impair their day-to-day functioning. So, if you can't use your kitchen sink, if you can't use your toilet, if you can't sleep in a bed, or if you can't navigate your way around your home safely, then it's an issue. 

What's the difference between collecting and hoarding?

Collecting is focused. You will collect a thing, and you'll know all about that thing, you'll cherish it, maybe put it on show and often you'll have a very sociable life because you'll be speaking to other collectors. In our studies, we find collectors usually have low anxiety. Hoarding is different in that it's generally the keeping of anything and everything; it tends to be things that people have bought; often clothes, newspapers, books, magazines and records, but, to the extremes, people can hoard human waste, rotten food or animals.

But if you have a big house it is probably well hidden.

Yep, nobody cares then as you may not be impacting anybody. You may even be classed as a lovable, eccentric. If you live in a one-bedroom flat and if that flat is council-owned and neighbours complain, or if there are children being impacted, then the authorities will get involved. But a lot of hoarding is hidden. It costs councils a lot of money to deal with and so if stuff isn't spilling out into the street and causing a problem for somebody else, then it's unlikely to be dealt with.

There appears to be a stereotype of a typical hoarder, do TV programmes, like 'The Hoarder Next Door' aggravate this?

I have very mixed views about them to be honest. I have been invited on these programmes as an expert, but it's never felt quite right. I've spoken to the hoarding support groups we run to ask them their views and although a lot of them say they are accurate and it raises awareness of the issue, there is an element of it being car-crash telly. It's a bit voyeuristic. It's like saying, 'look at that crazy person' and it could stigmatise people further. 

What causes someone to hoard?

Although we can't be 100% certain, we're convinced that trauma and uncertainty play a part in many people's stories. When children have experienced uncertainty, they learn that they can't rely on adults. Their caregivers may have been in prison, be absent, maybe neglectful or abusive. Or their parents may have been wonderful but have died when they were young. Often people hoard because they have become attached to objects. Objects don't hurt you or leave you.

What support is there for people who hoard?

Unfortunately, the only support often comes in the form of treating the surface problem, which is decluttering. A lot of energy is focused on persuading people to get rid of their clutter and stop them getting more stuff. That's effective to a certain point, but nobody's treating the issues that could have caused it. It's like having a burst water pipe, and just taping over it. If we can go to the root of the problem, which could be unresolved grief, trauma, abuse or neglect, then that may be more helpful in the long term. 

It sounds like treatment could be challenging and time-consuming. 

There is no cure and CBT only helps in about 25% of cases. Each case is unique. You need a whole host of different people involved from housing officers, environmental health officers, social workers, fire service, police, and psychologists who understand hoarding behaviours – the current BPS guidelines on hoarding are the most up to date and accurate reflections and have been generated by consultation with key experts.

How receptive are people who hoard to getting support?

The people that come to the support group we run are very pleased that it's there. Initially, they may be hesitant as they have experienced shame around their behaviours. Once they realise it's a safe space then the shame lessens. Our members have lost friends and family members because of their hoarding. They're embarrassed, they might smell depending on what things are being hoarded. Often people are very isolated and lonely. They're delighted to come to the sessions, and when people start to talk, they've all had similar experiences: problematic childhoods, abuse, neglect, grief. Hoarding is a coping strategy, which has got out of hand.

You're now researching digital hoarding. Can you tell us more?

It's particularly prevalent now, especially in the workplace. We've found that often people may feel forced to become digital hoarders. They may come back from holiday with hundreds of emails in their inbox and only a few are useful, but they keep them anyway, 'just in case'. They may feel they need 'evidence' of something, so they don't get into trouble. But just like with physical hoarding, there are different types of digital hoarders. Some people feel driven to it; the modern workplace is making digital hoarders out of us all. But there are people who hoard their own digital stuff. And that's typically music and photographs. We've found some links between physical hoarding and digital hoarding. If a person's a digital hoarder, they often physically hoard. 

What's the problem with digital hoarding if you can still move around your house?

It causes people a lot of anxiety. You can waste hours rooting around for stuff or a specific file and worry about losing it. And there's an environmental issue of course. Storing all these digital photographs and files, uses carbon. Storage centres are getting bigger and bigger and using more and more electricity; just to keep people's stuff. Many of us have ten different versions of pictures of the same night out and think, 'I'll just keep them all.' 

Tell us about other types of hoarding. 

There are people who hoard animals and they are very hard to research as they do not generally engage with anyone. The only experiences they've had with people are often when they are taking their animals from them. The definition of animal hoarding is, very simply, having more animals than you can look after – and that's in terms of feeding, health and space. If you have a huge house and a lot of cats, it's not so much of a problem. But, if you live in in a in a two-bedroom flat with 30 cats, and there's mess on the floor, and some animals are ill or dying, you're clearly not able to look after those animals. In our survey of cases in the UK we found the average number of animals that an animal hoarder keeps is over 40, and its typically cats and dogs. This is a similar figure to data reported in other countries.

Other people who hoard tend to anthropomorphise belongings. We spoke to a woman who would walk past a charity shop and feel sorry for items that hadn't been bought so would bring them home. I have a PhD student who is looking at grief-related hoarding now. People whose parents have died, and they can't bear to part with any single item. 

There's also a distinction between wet and dry hoarding. People who hoard dry things like newspapers, magazines, tend to live in an untidy, but relatively clean environment. Other people hoard bottles of urine, even though their toilet is working.  A social worker from one of our groups worked with a woman who didn't wash and kept her own poo in little packets. But once she had an opportunity to talk about why she felt the need to do this, it turned out she'd had a very abusive past and had been sexually abused. Her strategy was that if she lived in such a repulsive way, potential attackers may not come near her.

So, in many ways, there's a rational coping strategy behind such behaviour.

Yes. It looks crazy, but it's rational to them. Everyone has got their own unique version of a coping strategy to help them navigate through life. Even though it may be potentially chaotic and problematic we need people who can see past that kind of initial repulsion and be curious as to why they may be doing what they're doing.

You created the Hoarding Research Group in Northumbria, to help communities and professionals understand the condition a lot more. What are your hopes for the future?

I think we're helping people understand that hoarding is a complex mental health issue. People are not being awkward or weird or eccentric and they need support. My hope is that we can do more research into what causes hoarding behaviour. What is it about a traumatic, challenging childhood that may cause some people to hoard but not others?

And when we've got more research evidence, I think we're then in a very strong position to say to the government, 'look, this is the problem. This is how it's been caused. This is how it's manifesting and this is what we can do to make it a lot better. We can't cure it, but we can really help'. We need a national support programme, With a multi-agency team of social workers, housing officers, mental health practitioners and support workers. 

And I suppose that comes down to money…

It would save money in the long run. In our research back in 2017, we found that the average hoarder in council accommodation can cost the council approximately £15,000 pounds a year. If it's a complex, legal case, if there are children involved, it can cost around £50,000 per case. Animal hoarding is more complex and there are vet's fees so that's also around £50,000 a case. Estimations on how many people who have a hoarding problem range between 6% and 20% - if we called it at 10% then that's a lot of money. If we invested this money in advance and had a safeguarding pathway that helps people live a happier life and doesn't even cost so much, it's kind of a no-brainer.