Home Counties Therapeutic Consultancy
(Buckinghamshire, Oxfordshire and Hertfordshire)
Hoarding Disorder is categorised in the Diagnostic Statistics Manual V (DSM V) as a condition where people collect things that are of little or no value. The part that is missing from this is that each person who hoards is different, requiring tailored treatment. It is increasingly being recognised that there are different types of hoarding disorder.
Currently, we are seeing a trend in Housing Associations, private landlords and councils increasingly dealing with this condition as an anti-social behaviour. Whilst it may constitute a breach of tenancy, it is not being recognised as a health condition that needs time and investment to resolve. The services country wide is limited with few people able to access services that will benefit them and their home (whether rented or owned). Here at Home Counties Therapeutic Consultancy we are treating individuals with this condition as individuals.
Consultant Director, Lorna Wykes shares a story from 15 years ago when she first encountered someone with a hoarding disorder:
I was helping an old gentleman with tidying up his home, alongside 3 other people. As we began tidying it became apparent that through no fault of his own, this gentleman hadn’t been able to take care of himself for some time. He had a co-occurring condition, namely alcoholism. The point at which my co-workers balked at what we were doing was when we began to find old bottles with urine in and plastic bags of faeces. In that moment it felt right to simply continue. I knew the shame he would feel if we mentioned it or showed any negative emotions, so I just continued. Did it solve the problem? Temporarily it did. With the knowledge and experience that I have today, I recognise that with any client with a hoarding disorder, will feel shame and self-loathing whether I mention it or not.
Hoarding disorder is categorised as such when the amount of belongings in a property exceed that which makes the living conditions untenable for that person and/or when it creates a hazard for other people, be that service engineers needing to access the property, potential fire and rescue crews in the event of a fire or neighbours living alongside the individual. It is not a choice. It is not a lifestyle decision. It is often painful and shameful for the person experiencing the condition and it becomes unmanageable long before they recognise it or are able to ask for help.
A current client that I am working with did indeed recognise that she had a “problem” and did search for help but to no avail. It was only when working with her during a period which a court case was instigated by her landlord did she make it clear to me that this was a longstanding concern for her. Having been turned away by many services and mistreated by some, she had been hesitant to mention it. What follows, is nothing short of time, hard work and patience on behalf of therapist and client. On our Facebook page, in June 2016 I recorded the victory in the court case where the Judge gave Home Counties Therapeutic Consultancy 12 months to work with this client using a plan that was formulated by our team. At the six month mark, her current Care Coordinator and the member of our local fire and rescue service came to visit the property. Both were astounded at the progress made and both teared up as they viewed the space and homeliness around them. I shared with them, with the clients’ permission the amount of valuable items that had been uncovered and stored in a more effective manner. This is an ongoing story and there will be a full and detailed report at the end of this piece of work.
Working with clients’ with a Hoarding Disorder may need to be a multi-discipline approach or it may simply our organisation working directly with the client. Both of the above clients have co-occurring conditions, albeit very different to one another. The approach in both cases described is an integrative using the many tools and techniques available to us as a team. I will leave the last word in this article to the second client that I have talked about.
My name is Emma and I live in Buckinghamshire. The key thing for me is that the therapist I’m working with recognised that there were other conditions that needed working with alongside. A lot of people have wanted to just come in and tidy but it’s not that simple. It’s working out and getting to the root causes. Home Counties are helping me with the practical physical tidying and helping me understand triggers for the condition and working on coping strategies for the long term. The psychological support has been as important as the practical support and this is the first time I have found a service that can provide both. It is not a straight line and I have been given the flexibility to manage at my pace. At times I have come across something that would trigger my emotions and it would take me a while to recover. Acquiring new things and difficulties in letting things go, are similar but different and need to be looked at separately. The non-judgemental attitude has been a big thing for me, as I have lot of shame and guilt around not being able to manage. The team working with me are making a huge difference in my life.
Lorna Wykes Dip, BSc, MSc