Facta #2

COMPULSIVE
HOARDING
Diogenes syndrome:
The unbridled compulsion to accumulate
The case of the Collyer brothers, which is reported in
this FACTA issue, is a classic example of pathological
accumulation, the compulsion to gather things and the
extreme difficulty to get rid of them. Preliminary studies
on Compulsive Hoarding (or Pathological Collecting)
are relatively recent. Only at the end of the last decade,
in the UK, that the first group therapy for people who
suffer from this evil took place. [I know this looks weird,
but: …the UK, did the first group therapy for people who
suffer from this evil take place] Over the last few years the
traces of typical compulsive collectors were detected, the
problems they usually face, the possible probable causes
of this behavior, and even a neurological map of them.
Depression, anxiety, attention deficit and hyperactivity
disorder are common symptoms in people who develop
this obsessive-compulsive disorder. The highest incidence
occurs among older people, who are no longer commonly
attended by family and thus can transform their homes
into tight deposits of everything.
Also known as Syllogomania, Disposophobia or
informally as Packratting, compulsive hoarding has direct
and indirect risks associated with it, such as diseases that
can arise with the dirt (respiratory problems caused by
dust) or brought by rats, cockroaches and related animals
attracted to waste, as well as the risk of fire and, in the
most extreme case - the example is of the Collyer brothers
- the risk of being crushed by the debris. According to
some current medical thought Compulsive Hoarding can
not yet be considered a clearly configured mental disorder,
and many accumulators may have no other symptoms
of obsessive - compulsive disorder. Nor do they often
recognize a disorder in themselves.
Homes of compulsive accumulators may have rooms
totally blocked by stuff and, therefore it is normal for
these people to avoid and even prevent visits, becoming
increasingly isolated. Compulsive Hoarding can be divided
into specific variants, so to speak, such as bibliomania, in
which the focus of attraction are is books, catalogs and
texts in general, or Animal Hoarding, which deals with
the obsession with pets.
Researcher David Tolin, from the School of Medicine at
Yale University, wanted to find out what happens in the
brain of these accumulators by using images obtained with
fMRI. In this work, he and his team diagnosed the problem
as an "excessive acquisition and the inability to discard
objects, resulting in a debilitating disorder." The tests
showed that the accumulators had important differences in
the brain, both in the anterior cingulate cortex, associated
with attention and the ability to concentrate, and in the
anterior lobe, linked to risk assessment and the importance
of stimuli and emotional decisions.
The collectors subjected to Tolin's experiments showed a
lower processing capacity of brain activity in these regions
at the moment of making decisions, often motivated by
uncertainty about the outcome. The conclusion was that
they do not necessarily need to keep what they have
because they love their belongings. In fact, they avoid
making decisions about what to do by extreme fear of
making a mistake by choosing to throw anything away
(because they think they may need it later).
Besides the emblematic case of the Collyer brothers,
there are others - which also have been the subject of
documentaries and TV shows - such as the man who
had a compulsion to save information: magazines, books,
newspapers, all scattered through the rooms of his home.
He came to scour the garbage regularly to see if there
were any writings that could be recovered and saved. But
Compulsive Hoarding is not exclusively linked to waste,
junk or things of no use. There is a recorded case of a
woman who was a hoarder - consumer, i.e. the stuff that
messed the rooms of her house was almost entirely the
result of her purchases. Quite without necessity, but moved
by an ungovernable desire, she would buy everything. The
report, which focused on the drama of the woman, showed
that the stairs that led to the second floor of her house had
been blocked by the objects, and in the living room it was
necessary to find paths among the mountains of stuff,
most still sealed and with tags.
It is worth mentioning also the story of another woman
who said she did not think she accumulated things but
instead she was "saving" them. The detail is that her father
was a garbage man and had always brought home objects
found in the streets, which denotes a kind of hereditary
compulsive hoarding. Already in advanced age, with five
children raised and already independent in life, living
alone, she justified her hoarding by saying the objects
kept her company. She and her husband - an alcoholic
hospitalized several times for schizophrenia - were
expelled recurrently from the places where they lived by
neighbors troubled with the rubble that spread across the
yard and with the stinking animals the garbage attracted.
These cases are not as rare as one may think, and rightfully
so they have been worthy of attention, both by the scientific
view as by the sphere of entertainment. Characters who are
compulsive accumulators, real or fictitious, already populate
the literature, films and even television. The focus of the
approach is what naturally ranges from humor to drama.
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