OCD & Hoarding

Overview of OCD

What is OCD?

Obsessive-Compulsive Disorder (OCD) is characterized by obsessions and compulsions. Obsessions are a recurring pattern of distressing, unwanted thoughts and fears. Compulsions drive individuals to engage in their obsessions through repetitive behaviors. These obsessions and compulsions disrupt everyday activities and result in notable distress which may or may not be visible to those around them.

What is Hoarding?

Hoarding Disorder is characterized by the excessive acquisition and unwillingness to discard items, even if they are of little or no value. This behavior is driven by an intense emotional attachment to possessions and an overwhelming fear of losing something valuable or important.

OCD Symptoms

OCD symptoms are repeated and persistent behaviors over time. This can cause high levels of stress and anxiety in individuals. Individuals with OCD struggle with obsessions which lead to compulsions.

Symptoms of Obsession

• Needing things in a specific order/way
• Fear and anxiety 
• Intrusive thoughts that repeatedly enter the individual’s mind
• Themes to obsession such as contamination, harm to self or others, unwanted sexual thoughts, religious or moral scrupulosity, or a need for order/symmetry

Examples of Obsession

• Fear of germs, dirt, or disease avoidance of public places, or fear of touching objects
• Fear of doors being unlocked or appliances not turned off
• Distressing sexual images
• Preventing catastrophes, deaths, or accidents, even though one knows it is illogical to be able to do so
• High stress when objects are not in order or “just right”

Symptoms of Compulsion

• Repeating behaviors (often in response to the anxiety caused by obsessions
• Ritualistic (rigidly patterned) behavior
• Avoidance of certain situations (germs, words, numbers, etc.)

Examples of Compulsion

• Repeating phrases or words
• Time consuming and often ritualized handwashing/disinfecting
• Constantly checking (homework, locks, belongings)
• Repeated counting or avoidance of numbers or words

Hoarding Symptoms

Some common Hoarding Disorder symptoms may include:

• Excessively collecting a large number of items with little or no value
• Difficulty discarding possessions that are no longer needed due to the fear of needing them in the future
• Excessive clutter in living spaces such as blocked hallways and piled-up items
• Avoid having visitors due to embarrassment about the clutter
• Difficulty in maintaining relationships, work, or daily activities
• Lacking insight or denying the severity of the issue

Diagnosis & Treatments of OCD and Hoarding

How do I get diagnosed with OCD or Hoarding?

Psychologists can diagnose OCD and Hoarding. Often they will talk with you and administer a standardized assessment to determine the severity of your symptoms.

How do I get treated for OCD or Hoarding?

OCD can be treated through psychotherapy. Some methods your provider may use are Exposure Response Prevention, Cognitive Behavioral Therapy, Motivational Interviewing, and Family Therapy.

Exposure Response Prevention (ERP)

Exposure Response Prevention exposes individuals to anxiety-provoking situations while preventing compulsive behaviors. The goal is to help individuals confront their anxieties and learn to resist the urge to perform their typical responses. ERP is the gold standard treatment for OCD with the most promising results.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy focuses on helping individuals recognize unhelpful thought patterns and behaviors. CBT involves techniques where negative thought patterns are replaced with more balanced ones. This therapy has been well-studied and is typically used by professionals.

Motivational Interviewing (MI)

Motivational Interviewing is a client-centered therapy that focuses on enhancing an individual’s motivation to change their hoarding behavior. It can be particularly useful in the early stages of treatment when individuals may have mixed feelings or fears about doing more intensive therapies such as ERP.

Family Therapy

In many cases, family members are key to the success of supporting their loved one in behavioral changes in “beating” OCD or eliminating hoarding.  Therapy helps family members understand and learn how to support their loved ones.

Additional Help for OCD and Hoarding

OCD and Hoarding symptoms may worsen over time. It is highly encouraged to seek professional help from mental health experts as soon as possible.

To request an appointment with a provider, fill out this form.

Other Resources

Hoarding Basics (Anxiety and Depression Association of America)

About OCD (International OCD Foundation)

OCD Overview (NAMI)