Family Almanac
Hoarding Could Mean OCD
Special to The Washington Post
Friday, December 15, 2006; Page C08
Q. Our son, almost 9, sometimes falls to pieces when we throw away toothpaste tubes, old clothes and plastic wrappers. The episodes make him intensely sad and now occur about three times a week, which is more frequent than they used to be.
When he has them, we comfort him, rub his back and let him have a good cry. Afterward, he says that he feels terribly bad for the things that are discarded and for himself, because he will miss them so much. And recently he said that he has been retrieving straws and wrappers from the trash and hiding them around the house. I told him that we needn't throw away these things but that they were just objects and had no feelings or brains or hearts.
Aside from these episodes -- and a dramatic, tearful reaction when we told him the truth about Santa -- our son is a happy, smart, funny, confident fellow, a wonderful artist and a good student who is active in church, likes to swim, dive and play skill-based video games. He has a nice group of friends, but he wants to attend the birthday parties of only his three or four close friends and he likes to stay home with us and his 6-year-old brother more than anything else.
Is he having this problem because he has experienced a fair number of losses? My father died before he was born; my mother -- whom he loved -- died when he was 5; a close family friend died and so did a neighbor.
Effectively our sons have no grandparents, since my husband has no contact with his parents. They sexually, physically and emotionally abused him and his siblings as children, so we told our boys that they were mean to Daddy and it isn't safe for children to be around them. The boys do see their loving godparents regularly, however, and have special outings with them.
My husband and I have been in 12-step programs since long before we married and had children, but what can we do for our son?
A.Your 8-year-old needs special help and he needs it soon, because he is a hoarder, and hoarding, if untreated, can get worse.
Most specialists think that hoarding is an obsessive-compulsive disorder, that it's an expression of anxiety, that it may be genetic and that it is caused by wiring in the brain gone a bit askew. This glitch, which can show up at any age, makes the brain send out the same silly, irrational command again and again and again. Your son may never be able to resist these commands, no matter what you say, unless he gets professional help.
First, get a firm diagnosis from an experienced child psychiatrist or a child psychologist, perhaps at a children's hospital. If he says that your son has OCD, he's almost sure to refer you to a therapist who uses cognitive behavior therapy (CBT). Studies find that this type of therapy, which usually takes about 12 weeks, is the most effective, although still not as effective with hoarders as it is with those who have other OCD symptoms.
A CBT practitioner would be particularly good for your son, because she would teach him how to discard his treasures, one by one, which would briefly heighten his anxiety each time but in the process, desensitize his need to hoard. He might have to take an antidepressant, too -- as young as he is -- so his brain would calm down and let him learn the techniques he needs to control his life.
If your son is diagnosed with OCD, you'll want to read everything you can on the subject, beginning with the Obsessive-Compulsive Foundation Web site, http:/
Although OCD is born in the brain, anxiety can be encouraged. You'd be wise to limit your talk about loss, death and abusive grandparents for a while. There is plenty of time for that when your boys are older.
Questions? Send them toadvice@margueritekelly.comor to Box 15310, Washington, D.C. 20003.
