Question: Doctor, I have an aunt on my mother's side who is very strange. She cannot throw out anything. She keeps all her newspapers, magazines, cardboard boxes, and even plastic wrappings from item she buys. She puts these in bundles all over her apartment. Two weeks ago when I was visiting her, she spent all the time I was there checking these bundles and moving them around. Her apartment, in addition to being very crowded, is also very dirty. She spends so much time with the things she collects that she doesn't have time to clean her place. Can you tell me what is wrong with her?
Answer: Without a complete assessment I cannot be perfectly sure, but from what you described I would speculate that she has a form of Obsessive-Compulsive Disorder (OCD). When we usually think of OCD, we think about people who fear being contaminated by things like germs. Often these people engage in elaborate cleaning rituals to get rid of their feared contamination. But there are other forms of OCD. One form is referred to as hoarding. People who hoard things, possibly like your aunt, become very uncomfortable getting rid of things. For some hoarders it is only specific things, such as bottles, that they hoard. Others hoard many things. OCD is usually composed of two elements: obsessions (thoughts) and compulsions (ritualistic activities). Many hoarders have thoughts (obsessions) that if they throw out something something bad will happen. They often justify these thoughts by saying, "Well you never know when you will need a box." The ritual for many hoarders is the act of checking to see that the items they hoard are intact. They may also spend a lot of time ordering their "collection" in piles.
These types of problems often can be treated using appropriate medications and/or cognitive behaviour therapy which let the person lead a more normal life. The trick is getting treatment for them. Many are reluctant to see that they have a problem and may refuse treatment even when it is available. I hope this helps answer your question.
