A Word on Urban Hoarding - Hoarding Week


By Matthew DeMello

Photo by Sarah G.

In San Francisco, hoarding is no laughing matter. Through the San Francisco Task Force on Compulsive Hoarding and Cluttering, residents are provided with a multitude of resources for finding help if collecting precious items means their home is no longer a suitable living space. Since San Francisco is renowned for its smaller apartment spaces, the community takes the issue quite seriously.

Still compulsive hoarding, as it is known to psychology, is better known to the general public through reality shows on networks like A&E and TLC. As Michael Guase, Deputy Director of the San Francisco Mental Health Association told BTR’s Third Eye Weekly podcast in a recent interview, these shows have helped educate millions on a serious disorder but also created certain cultural stigmas that aren’t entirely helpful to those seeking help.

He tells BTR more on how San Francisco responds to hoarding as a community and where those affected can get help.

BreakThru Radio: Can you give us a brief, more official definition for hoarding for those of us who may only be familiar with how it’s regarded in pop culture?

Michael Gause: This year hoarding and cluttering was officially added to the DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, where it is defined as the acquiring and failing to throw out a large number of items that would appear to have little or no value to others and/or the cluttering of a person’s home so that it is no longer able to function as a viable living space, this also causes significant distress and impairment to work and social life. That’s the official definition.

BTR: Your organization spearheads the San Francisco task force on hoarding and cluttering, what is the difference between hoarding and cluttering or are those just terms used to describe more or less the same thing?

MG: It’s similar. The definition might be more that hoarding is keeping and saving things, whereas cluttering would be more related to things actually piling up in a living space. One thing I would add, that we’re working on, as a leader in support of hoarding and cluttering issues, is really looking at the language related to it. Part of our submission is to advance first person and empowering language and to reduce the stigma associated with mental health conditions. The words “hoarding” and “cluttering” themselves are pretty loaded and stigmatized, so we’re always looking to advance the field and to start calling things by a different title. One thing we bat around here a lot is perhaps shifting the dialogue and language to something more like “collecting and acquiring” that doesn’t have as much stigma attached, because hoarding and cluttering aren’t the nicest words.

BTR: Obviously, hoarding has come into our terminology largely through the popular A&E show, plus there was Hoarding the documentary from TLC before that. Do you think these programs have done more to help or hurt that progress, or done both in different ways?

MG: I think it’s a mixed bag in a lot of ways. I know a lot of folks who produced and worked on the shows. In one sense it has brought the challenges the individuals face into the spotlight, bringing a lot of attention to it, which on one hand has brought more support, advocacy and resources for individuals with hoarding challenges, but on the flip side of that, TV shoes are driven to be a bit sensational about ratings. So what you might see on the TV shows are very severe cases that aren’t necessarily reflective of most folks who deal with these kinds of challenges, and on a 30 minute TV show, a lot of details get edited out so you don’t see a lot of the behind the scenes stuff. So they have brought more attention, but they can be quite sensationalistic.

BTR: Do you see many cases of hoarding and cluttering in the San Francisco area specifically? Do you feel that this is an issue that San Franciscans are passionate about addressing?

MG: Yeah, I think that one thing in particular, here in San Francisco, is the Mental Health Association of San Francisco has been out in front of this for a long time — we had our 15th annual conference on hoarding and cluttering back in May and we’ve been doing work in this area quite some time before there were TV shows and a lot of attention being focused on this subject. That’s due in part to a couple of unique things, one is that San Francisco is a major city with a really high cost of living, so many people have only small living spaces. So they can be faced with hoarding challenges simply because they have no room for their stuff. Our efforts really started fifteen years ago when a group of advocates and people who were dealing with hoarding, wanted a safe place to go and talk about the challenges they were facing and find some support. That’s really how it all began. The support group continues today, that really paved the way for the efforts we’ve made since.

BTR: In speaking of environment and cultural stigma, there’s also the stigmatized idea in pop culture of having “first world problems.” Is hoarding more prevalent in more affluent cultures than less developed ones?

MG: That’s a great question. I don’t have the data to back that up, but from what I have seen from my connection to the field and from some international experts on the matter such as Randy Frost, David Madden Cole, and Gail Steketee, hoarding does seem to be focused more in first world countries, rather than third world countries. So it’s an interesting pose and there is a lot of research going in that direction. It has been very much something that’s been in the spotlight in the US but we’ve seen it a lot more in the UK and Australia now too.

BTR: Hoarding seems to be more concentrated in urban areas than rural areas. Is this simply because people tend to have smaller living spaces?

MG: That’s accurate; we have a lot of folks who get support services from us and from our pure response team here and the majority of them live in apartments or single rooms. But we also see it in family homes quite often.

BTR: So you don’t necessarily see it happening too often in mansions even if the affliction could ostensibly qualify?

MG: We do actually. We work with some people here who actually own their own house and when that gets filled up, they rent another space. The thing to remember here is that hoarding has been so sensationalized recently that people don’t see the other side of it. Sufferers can and do recover quite successfully from even the most severe hoarding challenges. For example, we have five staff members here who work part time who are pure responders and they have been in recovery from hoarding for several years themselves and they’re actually going out and providing one on one support to others dealing with it. That’s an innovative project we started a few years ago. It’s the first of its kind in the US. We have a team of responders who go out and meet with people free of charge, offer pure support and get them connected with other resources.