Hoarding : an interpretative phenomenological analysis of participation in daily occupations in a cluttered environment

Occupations are the things that people need to and choose to ‘do’ every day. For a person with hoarding behaviours, the important occupation is collecting what they feel is valuable to them and storing the objects in their chosen environment. Despite this focus on collecting, individuals with hoarding behaviours still need to engage in other day-to-day occupations in the home and community. With up to 5% of the world’s population living in a cluttered environment (Frost, Steketee, Tolin, & Renaud, 2008; Grisham, Norberg, Williams, Certoma, & Kadib, 2010; Tolin, 2011), it is critical to better understand these individuals’ daily lives and how they engage in tasks and perform activities that make up their daily occupations. To date research on hoarding has focused on exploring the underlying neurobiology, cognitive processes and emotions of individuals who engage in hoarding behaviours. Functional impairments are also highlighted in this body of research. There is a paucity of research from the perspective of the person who hoards and therefore no knowledge regarding how they manage their daily occupations in a cluttered environment. Therefore, the aim of this study was to gain insight into what it is like to live in a cluttered environment and how people do the things they need to do every day. As such, this research took an occupational lens to understanding this phenomenon, and was underpinned by recovery principles, acknowledging the strengths and capabilities of people who exhibit hoarding behaviours and who live in a cluttered environment. Using a phenomenological methodology, specifically interpretive phenomenological analysis, in depth interviews were conducted with six people who were purposefully sampled on the basis of exhibiting hoarding behaviours and who live in cluttered home environments. Data analysis identified three superordinate themes: (i) Clutter and relationships and the relationship with clutter; (ii) “I may look like I’m doing nothing but really, I’m super busy”: The efforts of everyday life; and (iii) Organised disorganisation: Adapting the environment to get things done. Each superordinate theme had corresponding sub themes. Overall participants in this study revealed that their relationship with their ‘stuff’ and their collecting behaviours is a critical part of their identity. They all revealed an ability to develop deliberate and complex routines and strategies to perform daily occupations despite their cluttered homes. They have shown strengths in their capacity to organise spaces that have significant meaning and purpose within the overall disorganisation of their clutter. These findings provide the first insight into the lives of this group from their own lived expereinces. This research provides evidence for future research, practice and policy that incorporates the meaningfulness of daily life for people who exhibit hoarding behaviours. It also promotes their capabilities and strengths previously unacknowledged in research