Petra Kottsieper, Ph.D
If you have been following the regular Philadelphia evening
news you may have come across one of the biggest recent animal hoarding cases
in Philadelphia, which also made it into some international newspapers. On March 26, some 239 cats were removed from
a double row house in the Frankford section of
Philadelphia, after the same person had previously surrendered about 40 of her
cats voluntarily. The woman who lived
with and took care of the cats also officially ran an animal rescue group, a
situation that very clearly got out of hand.
Hoarding has become popular in recent years with TV shows such as the
now cancelled “Hoarders” on A&E, and “Hoarding: Buried Alive” on TLC. I assume, and I am assuming because I have
never watched them, most people watch these shows with a mixture of curiosity
and disgust. It seems, however, that
animal hoarding presents its own unique challenges that, until very recently,
have not been explored at all.
Hoarding is finally gaining its own entry as a diagnosis in
the Diagnostic and Statistical Manual of the American Psychiatric Association,
5th Edition (DSM-5; 2013). Hoarding
disorder, as it is now called, appears to affect between 2-5% of the
population. It furthermore appears to be
a distinct disorder and not just a symptom of Obsessive Compulsive Personality
Disorder (OCPD) , or Obsessive Compulsive Disorder (OCD). Hoarding has been referenced in the
literature going back all the way to Dante, and was first discussed by
psychoanalysts as one of the determinants of having an "anal personality." In the 1980’s the anal personality construct
(also containing orderliness and obstinacy) developed into Obsessive compulsive
Personality Disorder. To make things
more difficult hoarding has also been thought and is still thought to be a part
of Obsessive Compulsive Disorder.[i]
So now in essence we have 2 types of hoarding
categorization. Hoarding disorder in itself and OCD with hoarding
behaviors. Differences between these two
manifestations are that in hoarding disorder the accumulation and refusal to
discard things (or animals) is often thought to be “normal” by the person and
may even be associated with positive experiences. Whereas individuals with OCD
who engage in hoarding are more likely to experience their behavior as
distressing and not really part of their self-identity. Individuals who clutter
are not necessarily hoarders, but individuals who hoard have excessively cluttered and largely unusable work and living
spaces, often resulting in serious health and safety concerns.
Why do people hoard compulsively? Many reasons have been put
forth. One example is the belief that individuals who have grown up in poverty
or serious deprivation may grow into someone who engages in hoarding. This theory has not been substantiated by
research. Hoarding has been thought of as a pathological excess of capitalism,
and several psychoanalytic theories have conceptualized hoarding as a drive to
acquire in one’s self-development for a variety of functions. More recent research has begun to outline
psychological and cognitive processes closely related to or may even causally
related to some hoarding behavior. For
example, one recent study used functional magnetic resonance imaging to compare
neural activity and self-reports in individuals with HD, OCD and individuals
with no mental health diagnosis. It was found that individuals who compulsively
hoard exhibited very distinct neural activity in specific brain regions that
mapped onto their self-reported and observable psychological states in response
to specific stimuli. Compared to the
other two groups, the individuals with HD reported significantly more
difficulty with decision making around personal objects they had brought to the
study, especially around the emotional value they assign to the objects in
question. In addition these same individuals reported experiencing
significantly more sadness and anger when thinking about discarding any of these
items.[ii]
Other emerging theoretical approaches have pointed out the
importance of a dysfunctional attachment style in individuals who hoard animals.[iii] Even
“normal” animal rescue behavior probably function as a means of deriving
meaning and a sense of self as a “good” person. Additionally, rescuing an
animal from a "kill shelter" or the streets, which may otherwise mean
“death” for the animal, can afford the person a special feeling of control, a
sense that individuals who develop hoarding behaviors may not experience in
other areas of their lives. These individuals may have disrupted or
dysfunctional attachments to other humans, and their attachment to the animals develops
into their primary means to build and maintain a sense of self. The control
experienced often becomes so extreme (and some have argued delusional) that
these individuals believe that no one else can take care of the animals as well
as they do, despite evidence of death , disease and squalor all around them.
What does this mean for the woman in our recent local animal
hoarding case? Animal hoarding has been described as significantly more
difficult to deal with for public health departments as compared to complaints
about individuals with non-animal hoarding behaviors. Individuals who hoard animals are much less
willing to cooperate with authorities during the resolution of hoarding
complaints leveled against them. In a
very comprehensive overview of animal hoarding, it was noted that animal
hoarding largely overlaps with object focused hoarding, but it may constitute
even more severe cases , especially as it is often associated with extremely
squalid living conditions .
Individuals who hoard animals often develop the hoarding
behavior in middle or older age, as opposed to a younger age as seen in
individuals who hoard objects, and they seem to be more often women. Animal hoarding seems to also be associated
with more dysfunctional beliefs and attachments to the animals they hoard as
compared to other hoarding situations. Individuals are often unable to bury
them or discard the animals even when they are deceased. Furthermore the
extreme distress experienced when having to give up the hoarded animal might be
greater in individuals who hoard animals as compared to object hoarding. [iv]
Hoarding in general , but animal hoarding specifically, is
in significant need of more research. Very little is known about animal
hoarding and the etiology of this possible subtype of hoarding disorder (it is
not mentioned as such in the DSM-V). However, animal hoarding is not an infrequent occurrence, carries not
only significant risks to the person and the animals involved but also the nearby
community, and can be an expensive and frustrating problem to deal with. Additionally, animal hoarding has an
extremely high relapse rate, reportedly as much as 100% . Historically it has
been left to be dealt with by predominantly animal control and law
enforcement. This is clearly an area in
dire need of interdisciplinary collaborative efforts and attention from human
welfare and mental health agencies. Maybe the inclusion of hoarding disorder as
a separate category into the DSM-V will be one important step in this direction.
In the future I hope to see not only the rescue
of the animals from these terribly sad and awful situations, but also envision
the provision of (either voluntary or court mandated) help and assistance to
the people who very clearly are in need of treatment and relapse prevention.
[i]
Mataix-Cols, D. et al. (2010). Hoarding Disorder: A new disordered for DMS-V?.
Depression and Anxiety, 27, 556–572.
[ii]
Tolin D.F., Stevens M.C., Villavicencio A.L., et al. (2012). Neural Mechanisms
of Decision Making in Hoarding Disorder. Archives of General
Psychiatry, 69, 832-841.
[iii]
Nathanson, J.N. & Patronek, G.J. (2009). A theoretical perspective to
inform assessment and treatment strategies for animal hoarders. Clinical Psychology Review, 29, 274–281.
[iv]
Frost, R.O., Patronek, G. , and Rosenfield, E. (2011). Comparison of
object and animal hoarding. Depression and Anxiety, 28, 885–891.
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