Hoarders, he says, succumb to forces within their brains such that the overflowing garbage in their homes isn't seen or isn't experienced as distressing, Abelson says.
"Whatever they see in terms of clutter doesn't seem to matter to them," Abelson says. "What matters is the fact that these things have importance to them and the loss of these things would trigger distress."
Those who suffer the most are family members of hoarders, he adds. "I have heard stories of hoarders whose children took to the streets in their teens because there was no more room in the home for them."
Children suffer because they can't have friends over, they have a sense of embarrassment, and they have some confusion about what is and isn't normal behavior, he says.
U-M researchers who have studied animals like squirrels that "hoard" food for the winter are now using insights from that work to study hoarding behavior and its neurobiology in humans.
Why people save to the point where it becomes maladaptive is the kind of question that can be applied to every psychiatric disorder because they are all exaggerations of adaptive traits, he says.
Hoarding is challenging and frustrating to treat, he says.
"There are no simple drugs that have an impact on it," he says. Therapy is helpful but challenging because it requires the person who needs treatment to be highly motivated.
"We basically set up a program of practice so that they can become desensitized to reduce the amount of pain they experience when they let go of objects," Abelson says. "If we make sufficient progress with that, we can help them ultimately clean out their homes, but it's a very challenging process."
If someone wants to help a person who hoards, they first need to assess if the person is willing to talk to a professional.
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