I know that this may be very difficult to understand for people who are not familiar with OCD hoarding, but I guess that's one reason why the associated behaviors qualify as symptoms of a disorder -- they do not make sense; they are not rational behaviors. In this case, a person with more than adequate financial resources, with far above average intelligence, with a high degree of social functioning outside of the home, seems utterly incapable of distinguishing between "important" things and "trash" -- leading eventually to living conditions of abject squalor. Attempts by others to help to clean up or at least to manage the clutter can be traumatic, with the hoarder refusing to allow the removal of almost anything that most people would regard as trash, insisting that things will somehow get "squared away" eventually.
Many health care professionals advocate taking a slow, non-judgmental, low-pressure approach to resolving such cases. While they are almost certainly correct that different methods may be too traumatic or may prove unsuccessful at providing permanent solutions, I believe that other factors should also be weighed when considering treatment or assistance strategies:
- What is the impact of "go-slow" approaches on other family members, particularly on juveniles who are raised in squalor?
- Even if there is significant relapse after more aggressive intervention, what happens when a "go-slow" approach fails to generate adequate progress before the hoarder becomes elderly or infirm, when the likelihood of progress is dramatically reduced and the likelihood of injury drastically heightened? (See The Hallway for the result of "too much patience".)
I am not saying that a "go-slow" approach is necessarily wrong; indeed, it probably should be the first thing to try. However, it must be balanced against the impact of hoarding on the entire family and the prospects for the long-term safety and well-being of the hoarder.