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Overcoming Compulsive Hoarding

Overcoming Compulsive Hoarding. Fugen Neziroglu, Jerome Bubrick, Jose A. Yaryura-Tobias.
New Harbinger Publications, Inc. 2004, 150 pages.

This is a self-help book for people who hoard. It is very easy to read. But you're not supposed to just read this book. The authors provide a structured treatment program designed to change your thoughts, feelings and behaviors about your possessions. The book includes a series of exercises designed to help you on your journey of recovery. You will also need a notebook, pen, pencil, eraser and flashcards.

The book begins by defining hoarding and providing a self-assessment exercise. The first chapter explains the differences between a hoarder and a collector,and describes types of hoarding behavior and related conditions. It also examines biological and sociological aspects of hoarding.

Next comes a look at why you save. Understanding this is the key to changing your hoarding behavior. There are three categories of saving behaviors. The authors also describe common traits of hoarders, although the number of traits you identify with does not indicate the severity of your hoarding.

Reasons to seek treatment are discussed next, including quality of life issues, involvement of the legal system, and the effects of hoarding on family members. This is followed by treatment options: cognitive behavioral therapy (CBT), which forms the core of the treatment program in Overcoming Compulsive Hoarding, and motivational strategies. One of the exercises in this chapter is to identify your self-talk - what you think, feel and do when you enter each room in your house that has clutter. The authors also list some situations in which you may want to seek professional help, and some of the medications available.

Now we get to the active treatment phase. The authors introduce the concept of automatic thoughts and ask you to identify situations that lead to having automatic thoughts. Automatic thoughts are very possibly - in fact, quite likely to be - bogus thoughts or, in CBT-speak, cognitive distortions. The types of cognitive distortions - and how they can relate to hoarding - are explained. Then you return to the 'identify your self-talk' exercise I mentioned above and identify which type (or types) of cognitive distortion you believe each thought to be.To test the validity of your automatic thought, the authors provide six questions. For example, if your automatic thought is "I am a loser because my house is such a mess", question five is: If a friend or family member had the exact same thought, how would you respond? If the automatic thought fails the six-question validity test, it's a cognitive distortion.

Once you've identified your automatic thoughts, challenged them, and discovered they are bogus, you're in a position to substitute something else: a rational response. This is all about being your own best friend or coach, instead of your own worst critic. Or, as Celeste would say, "Quit hitting yourself over the head"! This might be hard at first, but it gets easier with practice. To help, you can make flash cards, with the automatic thought and type of cognitive distortion on the front, and the rational response on the back. You can use these cards when you are cleaning (to help make decisions about what to keep and what to discard) and out shopping (to limit the amount of stuff you bring home).

One thing I particularly liked about this book is that you are fully two-thirds of the way through it before any instructions for cleaning up the clutter appear. This says to me that the authors keep the "stuff" in its proper place - it's the hoarder who is important, not the things hoarded. Having said that, the Cleaning Up the Clutter chapter offers practical advice on how to actually do it. Try to stop bringing new stuff in to the house as much as you can, carry out some practical preparations, then take it one step at a time:

  1. Select a target area
  2. Assess the items in your target area
  3. Begin the cleanup using the three-and-a-half box technique
  4. Maintain the gains you've made
  5. Target a new area

I do have one reservation about the cleaning part of the program. One of the boxes is the 'Save' box, for items that you want to save but that are not appropriate for permanent placement inside the target area. The example given in the book is the stapler found when cleaning the target area of the kitchen table. The authors stress that you are not to remove anything from the Save box (which gets put in a temporary storage space) until the treatment program tells you to. On page 94, they want you to sign this promise:

I promise to remove things from the boxes in the temporary storage space only when the treatment program tells me to. I will not randomly take things out of these boxes.

(sign your name here)

But the treatment program doesn't give you permission to touch the 'Save' boxes until you've cleaned up at least 80% of the areas you wanted to clean. Now, for anything more than a mild hoarding problem, this could take months, and that's a long time to be unable to use all the household items that were out of place when you started!

The authors recommend that you do this cleaning-a-target-area process by yourself. These are your skills you're developing, not someone else's.

Once you do get permission to open the 'Save' boxes, you open them one at a time, and put things away one at a time. Now is the time to decide on an appropriate place (NOT necessarily the perfect place) for your possessions.

The final chapter is titled 'Enjoying your home and preventing relapse'. The authors emphasize the importance of maintaining the previously cleaned areas and provide guidelines for weekly, monthly and twice-yearly routines. There's even some ideas for providing a new décor for your house, in case it looks a little spartan now that the clutter look is passé.


Consider the automatic thought that you're a loser because you have clutter. Is this thought absolutely 100 per cent true? Are you really a loser because you have clutter? If so, then you are suggesting that there is no means of measuring your self-worth other than whether or not you have clutter. How then would non-hoarders measure their self-worth? Certainly not all nonhoarders are "winners" simply because they don't hoard. Logic tells us there are many ways besides hoarding status to measure self-worth, including your compassion for others, trustworthiness, sense of humor, and so on. As you can see, the thought of being a loser is just a thought. Your thoughts are not automatically true simply because they enter your mind. ~ Overcoming Compulsive Hoarding