What Is Compulsive Hoarding? What is compulsive hoarding? Compulsive hoarding includes ALL three of the following: A person collects and keeps a lot of items, even things that appear useless or of little value to most people, and These items clutter the living spaces and keep the person from using their rooms as they were intended, and These items cause distress or problems in day-to-day activities. How is hoarding different from collecting? In hoarding, people seldom seek to display their possessions, which are usually kept in disarray. In collecting, people usually proudly display their collections and keep them well organized. What are the signs of compulsive hoarding? Difficulty getting rid of items A large amount of clutter in the office, at home, in the car, or in other spaces (i.e. storage units) that makes it difficult to use furniture or appliances or move around easily Losing important items like money or bills in the clutter Feeling overwhelmed by the volume of possessions that have ‘taken over’ the house or workspace Being unable to stop taking free items, such as advertising flyers or sugar packets from restaurants Buying things because they are a “bargain” or to “stock up” Not inviting family or friends into the home due to shame or embarrassment Refusing to let people into the home to make repairs What makes getting rid of clutter difficult for hoarders? Difficulty organizing possessions Unusually strong positive feelings (joy, delight) when getting new items Strong negative feelings (guilt, fear, anger) when considering getting rid of items Strong beliefs that items are “valuable” or “useful”, even when other people do not want them Feeling responsible for objects and sometimes thinking of inanimate objects as having feelings Denial of a problem even when the clutter or acquiring clearly interferes with a person’s life Who struggles with hoarding behavior? Hoarding behaviors can begin as early as the teenage years, although the average age of a person seeking treatment for hoarding is about 50. Hoarders often endure a lifelong struggle with hoarding. They tend to live alone and may have a family member with the problem. It seems likely that serious hoarding problems are present in at least 1in 50 people, but they may be present in as many as 1 in 20. Are hoarding and obsessive compulsive disorder (OCD) related? Compulsive hoarding was commonly considered to be a type of OCD. Some estimate that as many as 1 in 4 people with OCD also have compulsive hoarding. Recent research suggests that nearly 1 in 5 compulsive hoarders have non-hoarding OCD symptoms. Compulsive hoarding is also considered a feature of obsessive compulsive personality disorder (OCPD) and may develop along with other mental illnesses, such as dementia and schizophrenia. What kinds of things do people hoard? Most often, people hoard common possessions, such as paper (e.g., mail, newspapers), books, clothing and containers (e.g., boxes, paper and plastic bags). Some people hoard garbage or rotten food. More rarely, people hoard animals or human waste products. Often the items collected are valuable but far in excess of what can reasonably be used. What are the effects of hoarding? Severe clutter threatens the health and safety of those living in or near the home, causing health problems, structural damage, fire, and even death Expensive and emotionally devastating evictions or other court actions can lead to hospitalizations or homelessness Conflict with family members and friends who are frustrated and concerned about the state of the home and the hoarding behaviors Is compulsive hoarding caused by past poverty or hardship? People who hoard may call themselves “thrifty.” They may also think that their behavior is due to having lived through a period of poverty or hardship during their lives. Research to date has not supported this idea. However, experiencing a traumatic event or serious loss, such as the death of a spouse or parent, may lead to a worsening of hoarding behavior. Can compulsive hoarding be treated? Yes, compulsive hoarding can be treated. Unfortunately it has not responded well to the usual treatments that work for OCD. Strategies to treat hoarding include: Challenging the hoarder’s thoughts and beliefs about the need to keep items and about collecting new things Going out without buying or picking up new items Getting rid of and recycling clutter. First, by practicing the removal of clutter with the help of a clinician or coach and then independently removing clutter Finding and joining a support group or teaming up with a coach to sort and reduce clutter Understanding that relapses can occur Developing a plan to prevent future clutter. How can I help a hoarding friend or family member de-clutter? Attempts by family and friends to help with de-cluttering may not be well received by the person who hoards. It is helpful to keep in mind: Until the person is internally motivated to change they may not accept your offer to help. Motivation cannot be forced. Everyone, including people who hoard, has a right to make choices about their objects and how they live. People who hoard are often ambivalent about accepting help and throwing away objects. Can’t compulsive hoarding be solved by simply cleaning out the home? No. Attempts to “clean out” the homes of people who hoard without treating the underlying problem usually fail. Families and community agencies may spend many hours and thousands of dollars clearing a home only to find that the problem recurs, often within just a few months. Hoarders whose homes are cleared without their consent often experience extreme distress and may become further attached to their possessions. This may lead to their refusal of future help. How do I have a conversation with my friend of family member who is ready to talk about hoarding? When a person seems willing to talk about a hoarding problem, follow these guidelines: Respect. Acknowledge that the person has a right to make their own decisions at their own pace. Have sympathy. Understand that everyone has some attachment to the things they own. Try to understand the importance of their items to them. Encourage. Come up with ideas to make their home safer, such as moving clutter from doorways and halls. Team up with them. Don’t argue about whether to keep or discard an item; instead, find out what will help motivate the person to discard or organize. Reflect. Help the person to recognize that hoarding interferes with the goals or values the person may hold. For example, by de-cluttering the home, a person may host social gatherings and have a richer social life. Ask. To develop trust, never throw anything away without asking permission. Are there medicines that can help reduce hoarding? Medicine alone does not appear to reduce hoarding behavior. Medicine may help reduce the symptoms. Medicine can be used to treat conditions that may make hoarding worse, like depression and anxiety. Article source: https://iocdf.org/wp-content/uploads/2014/10/Hoarding-Fact-Sheet.pdf

What is compulsive hoarding? 
Compulsive hoarding includes ALL three of the following: 

1. A person collects and keeps a lot of items, even things that appear useless or of little value to most people, and 
2. These items clutter the living spaces and keep the person from using their rooms as they were intended, and 
3. These items cause distress or problems in day-to-day activities. 

How is hoarding different from collecting? 

• In hoarding, people seldom seek to display their possessions, which are usually kept in disarray. 
• In collecting, people usually proudly display their collections and keep them well organized. 
  What are the signs of compulsive hoarding? 

• Difficulty getting rid of items 
• A large amount of clutter in the office, at home, in the car, or in other spaces (i.e. storage units) that makes it difficult to 
  use furniture or appliances or move around easily 
• Losing important items like money or bills in the clutter 
• Feeling overwhelmed by the volume of possessions that have ‘taken over’ the house or workspace 
• Being unable to stop taking free items, such as advertising flyers or sugar packets from restaurants 
• Buying things because they are a “bargain” or to “stock up” 
• Not inviting family or friends into the home due to shame or embarrassment 
• Refusing to let people into the home to make repairs 
  What makes getting rid of clutter difficult for hoarders? 

• Difficulty organizing possessions 
• Unusually strong positive feelings (joy, delight) when getting new items 
• Strong negative feelings (guilt, fear, anger) when considering getting rid of items 
• Strong beliefs that items are “valuable” or “useful”, even when other people do not want them 
• Feeling responsible for objects and sometimes thinking of inanimate objects as having feelings 
• Denial of a problem even when the clutter or acquiring clearly interferes with a person’s life 
  Who struggles with hoarding behavior? 
  Hoarding behaviors can begin as early as the teenage years, although the average age of a person seeking treatment for hoarding is about 50. Hoarders often endure a lifelong struggle with hoarding. They tend to live alone and may have a family member with the problem. It seems likely that serious hoarding problems are present in at least 1in 50 people, but they may be present in as many as 1 in 20. 
  Are hoarding and obsessive compulsive disorder (OCD) related? 
  Compulsive hoarding was commonly considered to be a type of OCD. Some estimate that as many as 1 in 4 people with OCD also have compulsive hoarding. Recent research suggests that nearly 1 in 5 compulsive hoarders have non-hoarding OCD symptoms. Compulsive hoarding is also considered a feature of obsessive compulsive personality disorder (OCPD) and may develop along with other mental illnesses, such as dementia and schizophrenia. 
  What kinds of things do people hoard? 
  Most often, people hoard common possessions, such as paper (e.g., mail, newspapers), books, clothing and containers (e.g., boxes, paper and plastic bags). Some people hoard garbage or rotten food. More rarely, people hoard animals or human waste products. Often the items collected are valuable but far in excess of what can reasonably be used. 
  What are the effects of hoarding? 

• Severe clutter threatens the health and safety of those living in or near the home, causing health problems, structural damage, fire, and even death 
• Expensive and emotionally devastating evictions or other court actions can lead to hospitalizations or homelessness 
• Conflict with family members and friends who are frustrated and concerned about the state of the home and the hoarding 

behaviors 

Is compulsive hoarding caused by past poverty or hardship? 
People who hoard may call themselves “thrifty.” They may also think that their behavior is due to having lived through a period of poverty or hardship during their lives. Research to date has not supported this idea. However, experiencing a traumatic event or serious loss, such as the death of a spouse or parent, may lead to a worsening of hoarding behavior. 
Can compulsive hoarding be treated? 
Yes, compulsive hoarding can be treated. Unfortunately it has not responded well to the usual treatments that work for OCD. Strategies to treat hoarding include: 

• Challenging the hoarder’s thoughts and beliefs about the need to keep items and about collecting new things 
• Going out without buying or picking up new items 
• Getting rid of and recycling clutter. First, by practicing the removal of clutter with the help of a clinician or coach and then independently removing clutter 
• Finding and joining a support group or teaming up with a coach to sort and reduce clutter 
• Understanding that relapses can occur 
• Developing a plan to prevent future clutter. 
  How can I help a hoarding friend or family member de-clutter? 
  Attempts by family and friends to help with de-cluttering may not be well received by the person who hoards. It is helpful to keep in mind: 

• Until the person is internally motivated to change they may not accept your offer to help. 
• Motivation cannot be forced. 
• Everyone, including people who hoard, has a right to make choices about their objects and how they live. 
• People who hoard are often ambivalent about accepting help and throwing away objects. 
  Can’t compulsive hoarding be solved by simply cleaning out the home? 
  No. Attempts to “clean out” the homes of people who hoard without treating the underlying problem usually fail. Families and community agencies may spend many hours and thousands of dollars clearing a home only to find that the problem recurs, often within just a few months. Hoarders whose homes are cleared without their consent often experience extreme distress and may become further attached to their possessions. This may lead to their refusal of future help. 
  How do I have a conversation with my friend of family member who is ready to talk about hoarding? 
  When a person seems willing to talk about a hoarding problem, follow these guidelines: 

• Respect. Acknowledge that the person has a right to make their own decisions at their own pace. 
• Have sympathy. Understand that everyone has some attachment to the things they own. Try to understand the 
  importance of their items to them. 
• Encourage. Come up with ideas to make their home safer, such as moving clutter from doorways and halls. 
• Team up with them. Don’t argue about whether to keep or discard an item; instead, find out what will help motivate the 
  person to discard or organize. 
• Reflect. Help the person to recognize that hoarding interferes with the goals or values the person may hold. For 
  example, by de-cluttering the home, a person may host social gatherings and have a richer social life. 
• Ask. To develop trust, never throw anything away without asking permission. 
  Are there medicines that can help reduce hoarding? 
  
  • Medicine alone does not appear to reduce hoarding behavior. 
  • Medicine may help reduce the symptoms. 
  • Medicine can be used to treat conditions that may make hoarding worse, like depression and anxiety.
    
    Article source: https://iocdf.org/wp-content/uploads/2014/10/Hoarding-Fact-Sheet.pdf 

8 Things Everyone Over 50 Can Toss Out While Spring Cleaning

Purging is good for the soul. Getting rid of stuff during the annual spring cleaning ritual makes us feel lighter, freer. Here are eight things anyone over 50 likely has and can be rid of. 

1. Your parents’ stuff.

There are three certainties in life: death, taxes, and that at some point you will clean out your parents’ home. Very often, their possessions become our possessions — and that’s not always such a good thing. It’s tough saying goodbye to the reminders from the past and of the people we love. But taking photos and writing down your memories are much more efficient — and clutter free — ways to preserve them. Plus you are only deluding yourself if you think your daughter will want your mom’s old dresser in her first apartment. Call a charity thrift store and see if they’ll pick it up.

2. Plastic storage containers.

Tupperware lids have a way of disappearing much the same as socks put in the dryer. If it doesn’t have a lid, get rid of it. And how many plastic storage containers do you actually need anyway? Do you rinse and save the container every time you bring home wonton soup? Does a pile fall out when you open the cabinet door?

It’s time to toss the ones you don’t use, the ones that partially melted in the microwave and the ones without lids. 

3. Old towels.

Even if you live near the beach, nobody needs as many towels as you probably have. By the time you reach midlife, you’ve likely moved around a fair amount. And since a fair amount of redecorating occurs each time we move, chances are you have towels in multiple colors to match all those bathrooms in all those places you lived. Toss them. You will never run out of towels even if you skim off the bottom 20 percent of the pile.

4. Old medicines.

Here’s a simple rule: If the expiration date has past, dump it. Old prescription drugs can actually be harmful to you. Many drugs lose their potency. The U.S. Food and Drug Administration requires that the active ingredient in a drug must be present in at least 90 percent of the amount indicated on the label. Tablets and capsules have the longest shelf life and may even linger on pharmacy shelves for up to five years. Liquids and injectables, like insulin, lose their potency much faster. Hence, the danger out-of-date drugs pose. If your medications are critical to managing your disease, don’t mess around and just dispose of the old med.

Be careful how you do this. You don’t want an animal to get into your garbage. For more information on how to dispose of old medicines, go here.

5. Odd socks and old underwear.

Missing socks do not return from the dead. And there are few of life’s annoyances that can be resolved as cheaply and quickly as tossing out stretched out bras and panties and just buying new ones. A six-pack of socks will save you hours of looking for a matching pair. And dumping the mismatched sock drawer into the garbage is pure awesomeness. No, you really won’t need them for sock puppets.

6. Books you loved but won’t ever reread.

There is something remarkable about having a home library. But the truth is, most avid readers just have book cases that are overflowing. If you are stacking books sideways on top of others, it’s time to figure out which ones you expect to re-read. We know: Books are like friends and when we make new ones, we don’t just discard the old ones. Consider re-homing them: The library may take them off your hands and if not, they are a thrift store favorite. Also, ever heard of Kindle?

7. Special occasion stuff.

Here’s a hard truth: Apply the “I have three minutes to evacuate, what am I taking with me?” rule. We can pretty much guarantee that the box in the basement with your grandma’s chipped china won’t be rushed out to the car. In fact, when did you even last look at it, let alone use it. Decluttering your life of unused possessions feels better than hanging on to stuff that you have a remote emotional attachment to.

8. Bratz dolls, Barbies, and baseball gloves from Little League.

Yes, your kids have grown up. Check eBay and you’ll see what your kids’ old toys are really worth now.

Need professional help?

Sometimes someone we know and love needs more help than we can offer them or they can offer themselves. Some hoarding situations accumulate dangerous bacteria and pathogens that can cause serious illness if not remediated properly. Contact us to see how we can get you or someone you love get your home back. 

Article source: http://www.huffingtonpost.com/entry/8-things-everyone-over-50-can-toss-out-while-spring-cleaning_us_56f30464e4b04c4c3761228a

Clearing the Clutter: Helping Those Who Hoard and Finding Personal Healing in The Process

I’m supposed to be working, trying to read an email from Amy, 
who contacted me looking for hope. Her mother’s world is being 
hammered by the cruel reality of uncontrolled hoarding. Like 
Amy, my mother is a hoarder, and my personal knowledge 
and experiences draw family members, friends, and even 
those who hoard to me for help, hope and even healing. 

I hear my girls’ laughter bubbling through their bedroom door
and down the hall as they play with their Fisher-Price dollhouse.
They are laughing and playing, and I can hear the clink of plastic
as they arrange and re-arrange the furniture in the dollhouse.
Although I know that I am supposed to be working right now,
I want so badly to just peek in and watch my daughters play.

In this moment, I am reminded of the bridge that adult children like myself represent. At one end of the bridge is a childhood filled with memories — no, nightmares! — of a home overflowing with stuff, detritus, treasures and trash. At the other end is the carefully protected joy of the next generation, our own children, who will never experience such an environment. For me, although my career has taken me into many hoarded homes and nightmarish childhoods like my own, I work hard to keep my children from these experiences. 

I sneak down the hall and look inside the door. Before me are two beautiful little girls in a bright, sparsely decorated room lying on the floor playing with a pink dollhouse. Their joy can’t cut through the numbness with which I have acquainted myself as an insulator. Instead of smiling, I am grimacing. Their laughter has drawn me into the painful memories of the past. 

The past is back again, and I wonder if I will ever heal enough so that those memories can’t find their way back anymore.

It must have been 1982, the last year that my presents were under the Christmas tree in the corner of the great room within the old townhouse. Growing accumulations of my mother’s craft supplies, papers, books, and random items prevented us from reaching the tree in the years that followed. The string lights we’d hung on it when it was first decorated, possibly two years prior, must have been of the highest quality. They faithfully lit up twice daily for nearly a decade, when we once again were able to reach the tree in its corner. 

That year, Mother assembled a dollhouse from a kit, placing it on a chair to the left of the tree. It was sad and sparse, almost an ironic symbol amid the clutter of our home. The whole of the miniature house was bland and naked, au natural, save for one wallpapered wall in its living room. Not a single part of the dollhouse, not the roof, exterior walls, door, floors or stairs were painted or decorated. Inside, there were maybe three pieces of furniture in it, and no dolls to play with. 

Mother intended for me to respond with glee to this wooden dollhouse. Instead, I’m quite certain my response was flat. This was not the house I’d dreamed of, where dolls would live amongst beautiful decorations and miniature pieces. It was not the home of dreams coming true amidst carefully chosen pieces, fabrics, and colors. I wanted a dollhouse that could be the home our house was not — a home devoid of stairs dripping with bags of forgotten treasures and “great deals,” beds surrounded by “supplies for a rainy day” that never came, and a kitchen with failing appliances that could not be reached for use anyway. 

Suddenly, my mood seems to have struck my daughter. Her giggles fade, turning to curiosity, “Mommy, are you okay?” I am retracted from this surreal visit back in time to the adorable little girls playing on the floor before me. For a moment.

The floor! I cannot remember once as a child lying on the floor to play with my dollhouse, or any other toy in my home. We had enough bare floor to navigate from one place to another, but never to sit down on, to play on, to sweep or vacuum. Perhaps this is why I never played with that dollhouse — a lack of floor space, and not the lack of furniture or dolls. 

In years long gone, my mother would brag about the effort she put into making that house for me, working into the wee hours to surprise me for Christmas. She was blissfully oblivious to the pain such gifts caused me until just a few years ago. It would have been easier if she had simply woken up to the pain growing up in our hoarded home had caused me, continues to cause me. Mother’s lack of insight is common in hoarding behavior — destroying relationships, childhood wishes and family dreams with a terrifying and haphazard deftness. 

In the past three years, my mother has become available to me in a way that I never thought possible. The mental health struggles that robbed me of a healthy childhood have been mediated by treatment and intervention. When I left my childhood home and Mother, I carried with me a piece of the chaos and the hoarding. I knew that someday Mother’s hoarding would become my problem, my responsibility, my burden to bear. Unfortunately, healing came long after her world fell apart and the struggle to clean up the hoard came. 

Healing comes slowly sometimes. It comes in bits and spurts. Nearly two years after we’d cleared out the hoarded house and moved Mother into a clean apartment, we began family counseling.

“I did everything I could to give you the best of everything, Punkin,” my mother told me during one session. “It was all about you.”

“It never felt like it was about me.” The boxes of my mother’s old clothes that blocked my toy box screamed out to me that my life was never about me. And if the stuff hadn’t spoken so clearly, my mother’s rage and screaming fits would have done the job adequately. “If only I hadn’t kept you,” she would accuse.

As an only child, I recognized the blessing that no other children had to face the same treatment. Being an only child meant that when it got really bad, there was no one else to share the weight of Mother’s anger and blame. Some days, I was the parent and caregiver. Often, I was the scapegoat. I spent other days balancing the roles of clown, enabler, and invisible child. I learned quickly that each of these roles had appropriate usages; I learned even more quickly that I couldn’t know which one was best. 

My familiarity with these multiple roles as an only child who survived the hoard is an asset today. I use this knowledge, familiarity, and intimate understanding to help the families and individuals our organization, Lightening the Load, supports as they overcome hoarding behaviors. This expertise is why individuals like Amy look for me, and the healing I’ve received is what I want to share with them: hope.

These various roles and the dysfunctional dynamic of the family affected by hoarding are at the heart of the film, Clutter (launching on iTunes and all other leading VOD platforms on May 8 ). Written by Paul Marcarelli, the film gives a fresh perspective of hoarding through the experiences of the Bradford family. The journey into not only the family home but the interpersonal relationships represents the shame-filled, dirty truth of family dynamics and the lasting effects of growing up with a parent who hoards. 

I recognize the struggles of these siblings as my own. The oldest Bradford child, Charlie, attempts to balance the contradictory desire to love his mother, make her happy, and fix her problem. Lisa, the middle Bradford child, is typical of the scapegoat and clown roles, a personal life marked by violence, chemical abuse, and dark humor. Yet none seem to free her from the effects of her mother’s hoarding. Penny, the youngest of the Bradford clan, rounds out the siblings. Beautiful and poignant in her role as the voiceless and invisible child, she attempts to fix her broken world and family through her dollhouse and home staging career, seeking to please those around her at any cost. I know these siblings and their roles intimately, personally. 

My children will not know these roles. Not ever. I will fight everyday to become the parent they deserve, and to protect them from this type of pain as best I can. I will instill in them the hope and knowledge that we can do more than simply survive; we can overcome and thrive. When I return to my desk, I respond to Amy’s plea for help with her mother’s hoarding and the family dysfunction, and I realize that my experiences have made the bridge between the past and the future strong and stable.

Dear Amy, before I tell you about how we might be able to help your mom, I want you to know one thing. Your mom has created this situation on her own. You are not responsible for it, no matter what she or others have told you. You didn’t make her become a hoarder, a clutterer, or a mother. The first step in the process is for you to know this. It isn’t easy. I have to acknowledge it myself on a daily basis. You’ve made it this far; you’re a survivor. But rest assured, there’s help, healing and hope available. We are here!

Article Source: http://www.huffingtonpost.com/ceci-garrett/clearing-the-clutter-help_b_5275896.html

Hoarding is a serious disorder – We can help!

Article Source: https://www.washingtonpost.com/national/health-science/hoarding-is-serious-disorder--and-its-only-getting-worse-in-the-us/2016/04/11/b64a0790-f689-11e5-9804-537defcc3cf6_story.html

By Sara Solovitch

Sandy Stark always loved pretty things. When she was a girl, she collected unusual rocks, birds’ nests, crooked sticks and dolls. As an adult, she gravitated to white ceramics and china, paperweights, kitchenware and art. Year by year, the treasures accumulated until the only way she could navigate her San Francisco apartment was through a narrow line of what she called “goat paths.”

That was when her two grown daughters swooped in and cleaned the place out. All her treasures, gone. On reentering her house, seeing it so sterile, so empty, Stark, now 71, says she felt traumatized. Almost immediately, she began reacquiring things — with a vengeance:

“You’re pulling everything in around you, building the hamster’s nest, building the wall. Part of it is for the high. It’s an addiction, sort of. But it’s also to fill a void. It fills a lot of void.”

Within 18 months, Stark, who was at one time so organized she supervised payroll for the Pacific Stock Exchange, could barely negotiate the way to her bedroom. Everywhere she turned, boxes. She was then going on 60, and her life had become defined by “the hoard.”

While the stockpiling of stuff is often pinned on America’s culture of mass consumption, hoarding is nothing new. But it’s only in recent years that the subject has received the attention of researchers, social workers, psychologists, fire marshals and public-health officials.

They call it an emerging issue that is certain to grow with an aging population. That’s because, while the first signs often arise in adolescence, they typically worsen with age, usually after a divorce, the death of a spouse or another crisis.

Hoarding is different from merely living amid clutter, experts note. It’s possible to have a messy house and be a pack rat without qualifying for a diagnosis of hoarding behavior. The difference is one of degree. Hoarding disorder is present when the behavior causes distress to the individual or interferes with emotional, physical, social, financial or legal well-being.

“If you aren’t able to use the stove and your refrigerator is stockpiled with expired items, if you’re so disorganized you aren’t able to file for Medicare or make a primary-care appointment, [hoarding] becomes a major problem,” says Catherine Ayers, a geriatric psychologist at the University of California at San Diego who has developed a cognitive behavior therapy for older people with the disorder.

Studies show that compulsive hoarding affects up to 6 percent of the population, or 19 million Americans, and it has been found to run in families. The rate is twice that of obsessive-compulsive disorder, the condition under which hoarding was listed until 2013 in the Diagnostic and Statistical Manual of Mental Disorders, the bible of the American Psychiatric Association. The DSM’s latest version now categorizes it as a separate mental illness.

Brain-imaging studies of hoarders have revealed abnormally low activity in the anterior cingulate cortex, which governs thinking and emotion. When these people are shown trigger images — such as pictures of objects being shredded and discarded — that area of their brain lights up and turns hyperactive.

Hoarding is “underdiagnosed and undertreated,” says Sanjaya Saxena, director of the Obsessive-Compulsive Disorders Program at the UC San Diego health system. “Though people realize it’s a problem, they never conceive of it as a medical disorder rooted in brain abnormalities.”

Awareness, though, is growing. In the past five years, more than 100 task forces on hoarding have sprouted around the United States and Canada. Most involve training and education — teaching clinicians and community figures such as firefighters how to recognize and deal with the disorder.

Many programs use a team approach that may include a landlord, a home-health nurse, a code enforcement officer, firefighters, a family member, a neighbor and a social worker.

“Unlike some other mental-health disorders, many people with hoarding do not seek treatment,” says Michael Tompkins, a San Francisco psychologist and the author of “Digging Out: Helping Your Loved One Manage Clutter, Hoarding and Compulsive Acquiring.” “They don’t recognize the consequences of their condition or the fact that it affects other people in their apartment building and community.”

Compulsive hoarding is associated in various studies with serious health risks such as household falls, obesity, respiratory problems (caused by dust mites and squalor) and poor medication compliance.

A 2012 study in New York found that 22 percent of people threatened with eviction and seeking intervention had a hoarding problem, and the condition has been associated with homelessness.

Among the most serious concerns is the potential for fire. A 2009 study in Australia found that hoarding-related fires ranked among the most deadly of all blazes, with 48 such fires responsible for 10 fatalities over a 10-year period.

“A lot of these people don’t use their front door; a lot of times they don’t use a door at all,” says Ryan Pennington, a paramedic and firefighter who maintains a website called Chamber of Hoarders and who lectures widely to fire departments about the issue. “Firefighters who crawl into these houses often don’t get the full force of radiant heat. Many times, they don’t realize how hot the fire really is until it’s too late.”

Medications — most commonly antidepressants — have been used with some success, but the primary approach to hoarding behavior is psychotherapy and harm reduction. Cognitive behavior therapy is also used, to teach people how to organize, prioritize and plan while working to ease their emotional attachment to the objects they have collected.

The most common acquisitions are clothes and books. But often the stockpiling includes items that people ordinarily discard: junk mail, food packaging, shampoo bottles.

“I call it rubble without a cause,” says Fred Lipschultz, 78, a retired physicist from the University of Connecticut. Over the years, he has hung on to the ticket of virtually every show and concert he has attended. He says he collects papers, plastic containers and quart-size jars. “It does pain me to throw away something that’s useful.”

But in the past few years, he has found help at the Institute for Compulsive Hoarding and Cluttering at the Mental Health Association of San Francisco. He has identified techniques, such as setting limits on how many containers he accumulates, to keep his hoarding in check. He uses a computer to digitize his mementoes, photos, theater tickets and papers. Once something has been scanned into his computer, he allows himself to toss out the actual paper.

Cognitive behavior therapy has its limits, however, said Randy O. Frost, a Smith College researcher who has helped develop a model used around the country to help hoarders address their emotional reactions to reducing their possessions.

“We’ve developed a treatment program, and it does work — but not as well as we’d hoped,” Frost says. “Between 60 and 80 percent of people are improved after treatment, with an average decrease in symptoms of about 30 percent.”

And relapse is common.

Stark says her own experience is “several steps backward while moving forward.”

She dates the beginning of her recovery to the time, about seven years ago, when she saw Tompkins on TV, discussing hoarding behavior and characterizing the people who suffer from it as perfectionists.

“And I thought: ‘That’s me! I’m not this lazy, dirty person! I have a problem.’ Half the relief was knowing that I had an issue I had to address. It was something I had a word for.”

Group therapy proved helpful, and eventually Stark became a member of a peer-led counseling group. But it wasn’t until she found a comrade — a “clutter buddy” — that she began her real recovery.

“It took me three years to accept her offer, and even then I cried as she came over the threshold,” Stark says. It was the first time in many years that she had allowed anyone inside her house.

Now her goal is to open her home to a host of friends. And she knows just how she wants to do it.

“I’m going to have an old-fashioned cocktail party,” says Stark, who loved entertaining before her hoarding began. “That’s my eye on the prize.”