I generally have mixed feelings about TV shows that deal with organization, as they tend to present a slightly (and sometimes radically) inaccurate picture of what it takes to get and stay organized. So I was a bit skeptical about "Hoarders", a new hour-long show on A&E about compulsive hoarders, who struggle much more with disorganization than others do. I'm happy to report, though, that based on the first episode of the show, it seems committed to presenting a realistic portrait of what's behind hoarders' behavior, and what it takes to overcome hoarding.

Inspired by the show, this week I want to share with you some facts about hoarding, dispel some myths, and offer some resources if you or someone you know is struggling with hoarding.

What Is Hoarding?
In my experience, there's quite a bit of confusion about what hoarding is (and isn't) and who qualifies as a hoarder. I've had potential clients describe themselves to me as hoarders because they had a handful of unpacked boxes from a move a few years back, for example, or because they had a few particularly crammed and disorganized closets.

The most important thing to know about hoarding is that it goes above and beyond disorganization. According to Dr. Randy Frost, a professor of Psychology at Smith College and a hoarding expert, "Compulsive hoarding is the acquisition of and failure to discard possessions that appear to be either useless or of limited value. This behavior is quite common, and only becomes a clinical disorder when the behavior or resulting clutter presents problems in living."

Hoarders aren't just packrats or folks who have a few too many things; they're people, often with some sort of mental health issues, who feel the need (or compulsion) to gather and hold onto things that have little to no value, from bottlecaps to old newspapers to empty toothpaste tubes to clothing. The thought of getting rid of their things, or of not bringing in more things, can be physically painful to hoarders.

How Is Hoarding Different from Disorganization?
Generally, when I work with a client, we go through a series of questions during the sorting and weeding phase of our project to determine what the client truly wants to hold onto and what she's ready to let go of. While some of these decisions can be very challenging, most clients are able to come to logical conclusions about why they do or don't opt to keep something. They might realize, for example, that the information in the stack of newspapers they've been keeping is out-of-date, and that they can go online if they want to research past articles. Or perhaps they'll decide that there's no good reason to hold onto the extra set of dishes they haven't used in several years (and never actually liked in the first place).

This logic chain isn't effective for hoarders, who are very adept at coming up with excuses (for themselves and others) for why they need to keep much of what they've collected and who can find it truly agonizing to even contemplate getting rid of any of their possessions, no matter how useless or valueless they might be.

Furthermore, for many hoarders, compulsive acquisition and keeping are long-term struggles with deep psychological roots, whereas more common "situational" disorganization often stems from a specific event or life change, such as moving, changing jobs, getting married or divorced, or having a child. Situational disorganization can often be conquered by clearing out what's not needed, putting new systems in place, and developing habits to support those systems. Hoarding requires more intensive treatment.

What's the Treatment for Hoarding?
Because of the mental health component of compulsive hoarding, it's critical that the treatment of hoarding involve some sort of mental health work, generally involving therapy and, depending on the severity of the psychological issues each hoarder faces, possibly also including medication. Many mental health professionals who work with hoarders collaborate with Professional Organizers, giving the client both psychological support and the assistance of an organizer who can help with the hands-on work. This is known as collaborative therapy.

In the first episode of A&E's "Hoarders," both of the subjects featured--a young couple from Louisville who are in danger of having their children taken away due to the condition of their home, and a woman in Milwaukee who hoards food and is at risk of eviction--receive mental health support in addition to two days of intensive work with teams of organizers. This is one of the things I like best about the show: it doesn't shy away from showing just how involved the process of helping people overcome hoarding can be.

Where Can I Find Help?
The Treatment page on the Hoarders site offers links to organizations that offer hoarding treatment programs. The NSGCD (National Study Group on Chronic Disorganization) has a directory of Professional Organizers and related professionals who have training in working with hoarders. In addition, many cities and communities have mental health associations that offer treatment programs and support groups for hoarders.

I encourage you to check out an episode of "Hoarders" (you can watch online). I hope the show continues to offer a balanced portrayal of the challenges hoarders face, and I hope it inspires folks who struggle with hoarding--or who know others who do--to seek help.