No-Pills Anxiety Buster, Part 26

By Dr. David H. Rosmarin

Western culture in general, and American culture in particular, tends to value material acquisitions. Particularly during the current time of year–the holiday season–swarms of people crowd shopping malls and retail outlets in order to purchase and acquire new things. While material advancement can potentially lead to greater convenience and enhanced relationships, for some people it is literally a death trap called Hoarding Disorder.

Hoarding Disorder is characterized by excessive acquisition and unwillingness to discard large quantities of objects that cover the living areas of one’s home and cause significant distress or impairment (to oneself and/or others). Hoarding Disorder is associated with health problems, decreased productivity, and difficulties in relationships with friends and family members. Further, in some cases, Hoarding Disorder can create tangible physical threats to one’s safety, including increased risk of fire, risk of falling, and sanitation risk.

Previously, Hoarding Disorder was considered to be driven primarily by anxiety–it was thought that patterns of excessive acquisition and unwillingness to discard were “compulsive” and maintained by fear. Recent research, however, indicates that Hoarding Disorder is associated with many other factors, one of which is poor insight into one’s condition. Many hoarders do not even recognize that they have a problem. Recent research suggests that increasing awareness on the part of hoarders about the extent of their hoarding and its impact on their lives is an essential part of treatment. Simply recognizing one’s challenge is a necessary first step towards digging out of the mess.

Whether you do or do not have Hoarding Disorder, this teaches us a valuable lesson. Struggles are unavoidable in life. As human beings, we will experience challenges that necessitate changing our patterns of thought, behavior, and emotion. When this occurs–in any context and at any period of time–the path to change starts with awareness. Just recognizing that one is experiencing a difficulty that must be attended to can be the most important step. v

David H. Rosmarin, Ph.D., is an instructor in the Department of Psychiatry at Harvard Medical School and Director of the Center for Anxiety in Manhattan, a clinical-research facility with a focus on the Jewish community. He can be reached at

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