How Do People with Hoarding Disorder Think About Their Possessions?

What you need to know

• People with hoarding disorder have different belief profiles about their possessions, which may explain why they have trouble discarding items
• Four main belief profiles were identified: identity expression, morality/responsibility, stability/predictability, and emotional attachment
• Understanding these belief profiles could help improve assessment and treatment of hoarding disorder

Understanding Hoarding Disorder

Hoarding disorder is a mental health condition where people have extreme difficulty parting with possessions, leading to cluttered living spaces that interfere with daily life. About 2.5% of people are affected by clinically significant hoarding.

People with hoarding disorder often experience distress when trying to discard items. They may also compulsively acquire new things, even when they don’t have space for them. This can cause problems with relationships, work, and day-to-day functioning.

Researchers have been trying to better understand why people hoard and what beliefs drive this behavior. This study aimed to explore the different types of beliefs that people with hoarding disorder have about their possessions.

Exploring Beliefs About Possessions

The researchers used a method called Q-methodology to examine beliefs about possessions in 32 adults with significant hoarding symptoms. Participants sorted a set of statements about beliefs related to possessions based on how much they agreed or disagreed with them.

The researchers then analyzed the patterns in how people sorted the statements to identify different “profiles” of beliefs. They also looked at other factors like trauma history, attachment style, and symptoms of conditions like depression and anxiety.

Four Main Belief Profiles

The analysis revealed four main profiles or categories of beliefs about possessions among people with hoarding disorder:

1. Expression of Identity

This was the largest group, accounting for 27% of participants. People in this group saw their possessions as extensions of their identity and personality. They felt their belongings communicated important things about who they are, including:

• Their past experiences and life story
• Their current interests and values
• Who they hope to be in the future

For example, one participant said: “I need to remind myself who I am… a lot of these things show aspects of myself.”

People in this group didn’t tend to have high levels of depression, anxiety or obsessive-compulsive symptoms. This suggests beliefs about identity may be a key feature of hoarding that’s distinct from other mental health conditions.

2. Morality and Responsibility

This group felt a strong sense of moral duty and responsibility toward their possessions. Key beliefs included:

• Objects need to be protected and cared for
• Discarding things is wasteful and morally wrong
• Items can be repurposed or recycled

As one person explained: “All objects that have been utilized for its original purpose can be repurposed into something completely different.”

This group tended to have higher levels of depression and anxiety. Many also had an anxious attachment style, suggesting they may seek approval from others.

3. Stability and Predictability

This profile involved beliefs about possessions providing a sense of stability and certainty. Key ideas included:

• Objects are reliable and unchanging, unlike people or life events
• Possessions won’t reject or abandon you
• Having familiar items creates a feeling of safety

One participant noted: “People are unreliable and often use other people to get what they want. Stuff doesn’t just walk away with no explanation as to why.”

This group didn’t have high levels of depression or anxiety, but did report more traumatic life experiences. The researchers suggest they may use possessions to avoid emotional pain or rejection from others.

4. Objects as Emotional and Meaningful Beings

The final group saw their possessions as having emotional content and meaning. They endorsed beliefs like:

• Objects can store emotions and memories
• Items have personalities or “souls”
• Possessions create connections to others and the world

For example, one person said: “Each thing, as well as the placement of things, has an emotional content.”

This group had the highest levels of emotional distress, including severe depression and anxiety. They tended to have a fearful-avoidant attachment style, suggesting difficulty with close relationships.

Implications for Treatment

Currently, the main treatment for hoarding disorder is cognitive-behavioral therapy focused on gradually discarding items and challenging unhelpful beliefs. However, this approach has only modest success rates.

The researchers suggest that understanding these different belief profiles could help improve treatment. For example:

• Someone in the “expression of identity” group may benefit from exploring how to express their identity in ways besides possessions
• The “morality and responsibility” group might need to address beliefs about wastefulness and work on decision-making skills
• Those in the “stability and predictability” category could focus on building relationships and tolerating uncertainty
• The “emotional attachment” group may need help processing trauma and developing healthier ways to connect with others

Tailoring treatment to someone’s specific belief profile could potentially lead to better outcomes than a one-size-fits-all approach.

Conclusions

• People with hoarding disorder have different types of beliefs about their possessions that drive their behavior
• Understanding these belief profiles could improve assessment and treatment of hoarding
• More research is needed to develop targeted interventions based on an individual’s specific beliefs and vulnerabilities

While this study provides new insights into hoarding disorder, it’s important to note some limitations. The sample was mostly female and from Western countries, so more diverse research is needed. The findings are also preliminary and need to be replicated in larger studies.

Overall, this research highlights the complex beliefs underlying hoarding behavior. By better understanding these beliefs, mental health professionals may be able to provide more effective, personalized treatment to help people overcome hoarding disorder.