If there's a hoarder in your life, it may help to know that you're not alone. The disorder affects up to 5 percent of the population.

Hoarding is a complex disorder with multiple roots, and very difficult to address without the help of professionals.

When it comes down to it, hoarders like the way they live, and don't understand why others think it's a problem, said Hunterdon Behavioral Health psychotherapist Cynthia Comparato on April 3.

Right now in Hunterdon County, four women face animal cruelty charges in what authorities say were two separate cases of hoarding animals. One was the director of the county animal shelter. The others were a mother and two daughters sharing a home.

In October, a home burned in Bethlehem Township. Firefighters later said their efforts were hampered by what they said was hoarding, and it wasn't the first time.

Hunterdon County's Public Health Services division leader remembers his first call to a home infested with bed bugs. A 94-year-old woman lived alone, Tadhgh Rainey said on April 4, but there were narrow walkways instead of open floors, "like taking a trail in the woods."

Once bed bugs got to the house, there was "plenty of harborage," he said, starting with "every church bulletin from the last 50 years on the living room floor."

Hoarding is a clinical term, a mental health disorder that may or may not co-exist with other disorders such as depression, anxiety or obsessive-compulsive disorder, said Comparato.

"It's a really complex disorder," is her refrain when talking about hoarding.

The psychotherapist and Rainey both point to an issue that frustrates friends and families when faced with a hoarder: free will.

"You can't just barge into people's places and clean them up," said Rainey, whose office has gotten involved when there is a public health risk, such as the spread of bed bugs.

Comparato said, "We have the right to self determination, until it gets to the point of safety."

Dan Van Fossen has been Pattenburg Fire Company chief for 15 years and is also a volunteer EMT. He said hoarding leads to safety issues for not just the person afflicted with the disorder, but emergency responders, particularly firefighters.

Tadhgh Rainey's office has gotten involved when there is a public health risk, such as the spread of bed bugs.

More materials means there is more fuel for a fire, he said. It doesn't end there. He remembers two fires, one on Henderson Road in Union Township and a second in October on Fox Farm Road in Bethlehem Township, in which firefighters struggled to reach the source of fires.

In the first case, he said, "there was so much stuff on the first floor" that firemen had trouble getting at the floorboards that needed to come up to get to the fire.

In the second case, he said, "we had to move dressers and clothes that were piled up. You couldn't get to the wall."

As a rescue squad volunteer, he has been in other homes where he hopes there's never a fire because "you're going to be hesitant to send somebody in there, unless somebody's trapped. And then you put the firefighter's life in danger."

The risk is greater amid hoarding, he explained, because a firefighter in a smoky room can't reach a wall to use it to help guide him or her, and because the clutter snags fire hoses.

It all adds up to a situation in which it's more difficult to get ahead of a fire.

Unfortunately, Comparato said, sharing such information with a hoarder is unlikely to have any impact. "Hoarders have very poor insight and judgment, " she said. "Their intention is never to harm anybody" or anything — in the case of animal hoarding. "The danger is secondary."

She listed four "major" aspects that "play into why a person hoards." The first is trouble processing information,which factors into our ability to make decisions and sort and organize our lives.

The second is emotional attachment to things, even those that non-hoarders don't understand, such as that 50-year supply of church bulletins or hundreds of plastic food containers in an elderly relative's small kitchen.

Hearing "I need that" about items that clearly aren't needed — commercial VHS tapes when there's only a DVD player hooked up to the TV — from a hoarder signals "the irrational, illogical emotional attachment."

Third, Comparato said, hoarding for some people "provides avoidance of situations or life." If someone is collecting things constantly, she explained, "you're not thinking about your life, you're just thinking about acquiring. If you've had an emotional upset, it's one way to avoid" working it through.

Finally, she said, more recent research has shown there might be a genetic link.

Perhaps the best counseling for hoarders is held in their homes, called in vivo exposure therapy, but it's hard to find such therapists, she said.

Unlike mental health disorders that produce anxiety, she added, hoarding is one in which those who are afflicted get pleasure from the practice, and won't seek out treatment unless highly motivated.

"All of their things feel right to them," Comparato said, although sometimes help is started because of another disorder, and the hoarding is discovered.

There are a few common threads among hoarders. Comparato said the disorder cuts across socioeconomic levels and is found around the world. When it comes to animal hoarders, however, about three-quarters are women, usually over the age of 60.

Hoarding does tend to appear more often in the elderly. That may be, Comparato said, because younger people usually have more people living with them and keeping the disorder at bay.

Hoarders tend to live alone, but usually have friends and family who have tried to help them clean up. "Taking something away isn't going to help," said the psychotherapist, because it produces anxiety and resentment in the hoarder, who will then turn around and re-fill the cleared space.

"it's a really complex disorder," Comparato said again. "The problem is the motivation to change."

Often, she added, friends and family are powerless to act until there is a safety issue. It may seem harsh to say that the intervention of authorities is the only way to remove to many animals, or insect-harboring items, from a residence, but she said that's usually the case.

In Hunterdon recently that has meant the SPCA, although it also happens when landlords threaten tenants with eviction.

An in-between step, said Comparato, is the local adult protective services agency. Don't look for a hoarders anonymous group. As Comparato pointed out, hoarders "wouldn't go. They don't see the problem."

Loved ones frustrated by a hoarder may benefit from counseling, she said, and need to realize that they're not alone, and they're not failing their loved ones.

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