When your possessions own you : A literary review about hoarding, treatment methods and shame

Hoarding disorder is a mental illness that affects about 2-5 % of the population. The most prominent symptoms of hoarding disorder are the inability to discard things and the excessive acquisition of possessions. The home becomes cluttered, often to the point where one no longer can use the rooms for their intended purposes. For example, one can no longer sleep in the bed or use the kitchen for cooking because of the clutter that takes up space. People with hoarding disorder often experience shame because of their disability and as a consequence they withdraw from social engagements and risk isolation. The purpose of this study was to give a literary review of treatment methods for hoarding disorder and their efficacy in Swedish, but also to show the impact of shame on treatment effect through Thomas Scheff’s theory of shame. The primary treatment method is Cognitive behavioral therapy designed especially for hoarding disorder, and has been tested in different forms such as individual-, group-, and internet based treatment. New treatments using Compassion-focused therapy and Acceptance and commitment therapy have also been developed. Studies on hoarding disorder and shame have shown a correlation between shame, symptom severity and identity. These new treatments address the shame experienced and they can hopefully increase the efficacy rate for hoarding treatment. Important factors for treatment progress were, among others, continued high motivation, frequent contact with clinician and a supportive family. A surprising result was that one study showed almost equal result in treatment led by a non-professional as a professional. More research is needed to further develop effective treatment