lhe story of the Collyer brothers became the most shocking case of hoarding disorder of the 20th century, when The New York Times On March 22, 1947, he published the news of the strange deaths of Homer and Langley Collyer.
According to the report, the police received an anonymous tip alerting about a putrid smell coming from the eccentric brothers’ house. The police were already accustomed to neighbors complaining about the brothers’ peculiar behavior. So the police didn’t take long to arrive. But when they tried to get to the house they found with the doors and windows being blocked by immense piles of newspapers. Which forced them to dig for hours. After hard work, they found Homer’s lifeless body, trapped in the middle of stacks of newspapers that reached to the ceiling (Vago, 2016).
After 18 days of intense searching, the police managed to find the lifeless body of his brother Langley. He was just 10 feet from where Homer had been found, buried under a mountain of newspapers and his body being eaten by rats. The forensic examination ruled that he had died a month ago. Langley was probably crushed to death, a victim of the own explosive traps that he had built to ward off intruders and snoops (Vago, 2016).
The Collyer brothers’ home contained more than 100 tons of materials that the brothers accumulated: newspapers, posters, grand pianos, books, flower pots, Christmas trees, picture frames, chandeliers, mannequins, clocks, etc. As a result, his property was considered dangerous to health and was destroyed, although in its place a park was built that today is simply called the (Herring, 2011; Maeder, 2017).
Their unusual customs
In 1917 the Collyer brothers stopped using the telephone and in 1928 they did the same with gas and electricity since, according to Langley, it simplified their lives (Weiss, 2010).
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The Collyer brothers’ home contained more than 100 tons of materials that the brothers accumulated
Although some media reports that the brothers never left their property and Langley was only seen sneaking out at night to look for food and rummage through the garbage, they were not always like this. Both graduated from Columbia University; Homer studied maritime law and Langley Engineering and Chemistry, as well as playing piano. After his mother died, Homer worked as a lawyer and Langley sold pianos. They both taught in Sunday schools. They had a very active social and work life (Vago, 2016).
However, in 1933 Homer suffered hemorrhages in the back of his eyes, which caused him terrible blindness. Langley quit his job to take care of his brother and, little by little, they distanced themselves from their social life. Langley lived dedicated to his brother and tried to cure him with a special diet that consisted of consuming 100 oranges a week. He also kept all the newspapers so that his brother could catch up when he regained his vision (Vago, 2016).
Because of repeated robbery attempts, Langley built a series of booby traps, tunnels, and traps to ward off intruders. And, upon realizing that his neighbors were trying to watch what was happening inside his house, he bought the property next door and left it empty to ensure his privacy (Vago, 2016).
Facts about hoarding disorder
Hoarding disorder was considered part of obsessive-compulsive personality disorder and was often called compulsive hoarding. But around 2010, research began to emerge suggesting that it was a different disorder (Becerra García & Robles Jurado, 2010; Mataiz-Cols, Frost, Pertusa, Clark, Saxena, Leckman, Stein, Matunga & Wilhelm, 2010). Thus, in 2013, when the DSM V was published, it appeared as a hoarding disorder.
It is estimated that between 2 and 5% of American adults meet the criteria for the disorder. It often begins in adolescence and becomes a lifelong struggle (Frost & Gross, 1993). As it worsens, hoarding can become a health and safety threat due to poor sanitary conditions and/or blocked emergency exits, or piles of paper near the kitchen (stove). It can eventually become a reason for quarrels with family and neighbors.In some cases certain community agencies (such as firefighters) have had to intervene dramatically.
> Hoarding disorder was considered part of obsessive-compulsive personality disorder
What do these people collect? Anything, everything (newspapers, propaganda, anything that is free or cheap); whatever they think might be useful, things they think they can repair and even animals.
There is so much accumulated stuff that it can fill the house and leave doors and windows without access, as was the case of the Collyer brothers. It can also make it impossible to find important papers, money, or accounts.
Frequently there is no awareness of illness, nor of the amount of things accumulated, nor of how this interferes with one’s life. What the patient usually experiences is pleasure, relief and excitement when collecting or buying things; and fear or guilt simply when considering that he should get rid of something.
Frequently there is no awareness of illness, nor of the amount of things accumulated, nor of how this interferes with one’s life.
Accumulation has been associated with the perception of responsibility to be prepared and take care of the well-being of possession (Frost, Hartl, Christian & Williams, 1995).
Theoretical explanations of the disorder
For Shaw, Timpano, Steketee, Tolin & Frost (2015), there is some evidence that having to throw something away or not acquiring things is closely linked to strong negative emotions. Difficulties in making decisions could lead the patient to keep things just to avoid facing the uncomfortable situation of having to decide what to get rid of and what not to. The authors also mention that many of these patients report memory problems, and this is often an indicator of hoarding. Having to throw objects produces negative emotions (fear, sadness, worry) since they are considered triggers of memories or reminders of loved ones. In summary, the authors believe that the intensity of negative feelings that appear directly or indirectly when getting rid of something can exacerbate tendencies to save or acquire.
The explanation of the cognitive-behavioral model, formulated by Frost (cited in Díaz Ocampo, Freiria and Jardim, 2016) on this disorder postulates that there would be 4 elements that determine it: a) Deficits in memory, information processing, decision-making decisions, organization and categorization and poor discrimination of what is important and what is not. b) The emotional bond formed with the objects would indicate emotional bonding problems and would have the function of remembering important events. c) Belief that things will be needed in the future. d) It is important to evaluate the cognitive area since it could have a significant influence on the clinical characteristics of the disorder.
lThe intensity of negative feelings that appear directly or indirectly when getting rid of something can exacerbate tendencies to save or acquire.
Comorbidity
One study observed high comorbidity with major depressive disorder and impulse control disorder (acquisition-related). Social phobia was also more common in men with hoarding disorder. Finally, 28% of the participants had ADHD, which was significantly more common than in people with OCD, where only 3% had this diagnosis (Frost, Steketee & Tolin, 2011).
Bettmann/Contributor/Getty Images/ Police reach the roof leaning on newspapers
Differential diagnosis
Dr. Randy Frost, who has done a lot of research on hoarding disorder, makes a distinction between it and Obsessive Compulsive Disorder (OCD). They share some characteristics, such as the fear of making a mistake regarding what to keep and what to throw away; Also the fear of losing something considered valuable could seem like an obsession. In turn, the urge to save or acquire new things is similar to compulsions.
However, there are important differences. The first has to do with illness awareness: people with OCD recognize at some level that the behavior is problematic. People with hoarding disorder have no rituals, and the experience of hoarding is often experienced with pleasure. In fact, what does cause stress is making any effort to get rid of what they have accumulated. What’s more, stress usually comes in relation to the intervention of others and not due to internal worry or discomfort.
One final important difference is that while OCD symptoms come and go over time, hoarding disorder symptoms get worse over the years.
How to help?
First of all, don’t try to clean up or help him throw things. Although it is usually done with good intentions, it will not be successful since the person will fill the space again as soon as possible to reduce the feeling of fear and emptiness.
Insight-oriented psychodynamic therapy, which seeks the client’s response to their family of origin, has also not been shown to be of much help. Perhaps family therapy can help family members be more patient and compassionate toward the person. However, direct help is necessary for this.
Medications and psychological treatments used for OCD are often not effective (Steketee & Frost, 2003; Bloch, Bartley, Zipperer, Jacubovski, Landeros-Weisenberger, Pittenger, & Leckman, 2014). SSRIs are sometimes prescribed to treat anxiety and/or depression.
In cases where the hoarding is due to dementia, the focus is on empathic management of the hoarding, not therapy.
Some therapies that have been shown to be effective are:
Cognitive Behavioral Therapy (CBT): It focuses on exposure with response prevention to address anxiety caused by interventions to reduce hoarding. This is used in conjunction with the cognitive restructuring of beliefs related to hoarding. CBT programs that include homework have proven to be more successful than those that do not (Tolin, Frost, Steketee, Muroff, 2015).
Specific TCC Protocol for Accumulators: Developed by the aforementioned Dr. Frost and his colleagues. It consists of involving the patient so that they gradually decide what to keep and what to throw away. The exercises are intended for the patient to develop tolerance to stress and acquire better decision-making skills. It also usually includes home visits and individual and group therapy (Tolin, Frost & Steketee, 2007).
Motivational Interview: This technique can be useful…