We can see hoarding — being out of control with accumulated stuff — as the reverse image of being rich in what matters.

Chaos, lack of usable living space, sky-high storage costs, rodent infestations, shame and social isolation are some of the ways that compulsive hoarders suffer. The families and friends of compulsive hoarders suffer too, from stress, anger and depression. It’s a problem that needs our compassion, and some skills and tips for addressing it.

I’ve used my M.S. in counseling psychology to write a 2 part series on compulsive hoarding. Part I was about understanding hoarding and today’s post (2 of 2) offers ways to help the hoarder. Update on March 17: Mike V. has pointed out that many of these tips can apply to helping anyone with anything.

1. Find a relatively unstressed time to talk with the compulsive hoarder about the problem. The beginning of a move is not a good time, because moving is stressful for everyone, and much more so for a hoarder. The person won’t hear your words. Three months before a move would be better, or any time when the person has free attention, rather than being tense or distracted.

2. Make factual observations to the hoarder, not judgmental ones. Factual observations describe what you have seen or witnessed. “This mail says the electricity’s about to be shut off.” “I noticed that you tripped and almost fell twice today over the stacks of books in the hallway.” “The rent on that storage unit has totaled $3,450 over the last four years.”

3. Make “I” statements, not “you” statements in discussing the hoarding. Sentences that start with “you” will get a poor response, because they come across as criticism and blame. “You’ve got a problem”; “You’re living in a filthy, dangerous situation”; “You need help” will trigger defensiveness, and make future conversations about hoarding unlikely.

Try statements like these, instead: “I feel worried that the rotting garbage will attract insects and rodents.” “I’m concerned for your safety because those mountains of objects could fall on top of you.”

3. Focus first on the safety problems the hoarding is causing. Cleaning up mice feces would be one example, or clearing pathways to crucial rooms, and to the fire extinguisher. Addressing the house’s poor appearance in general is not a good place to start (unless that is what the hoarder initiates).

4. Consider getting the hoarder into a different environment for awhile. A landlord who had had several tenants who were hoarders reported to me that this helped. Even a week-long vacation helped the hoarders realize that their lives proceeded fine without access to their mountains of accumulated objects.

5. Invite the hoarder to come out of his/her living space for outings. of isolation. Invite the person for an outing, whether a walk, a movie, a social gathering, a cup of coffee.

6. Suggest the hoarder see a therapist with experience in hoarding. I don’t suggest standard run-of-the-mill counseling for compulsive hoarding.

To clarify, the reflective listening of standard counseling does often help a person feel better, because everyone needs to be heard, validated and accepted.

But feeling better is not the same thing as a tangibly improved situation, and a tangibly improved situation is what’s needed with compulsive hoarding. Find a therapist who specializes in obsessive-compulsive disorder (OCD), or a cognitive-behavioral therapist. Ask the potential therapist if he/she has experience in hoarding. Some therapists who do will go into a person’s home to help the compulsive hoarder deal with their possessions. This can be a very time-consuming process.

7. The only organization system that will succeed is one the hoarder helped to create. The temptation will be strong, especially for a concerned family member, to set up a system for the hoarder. “Look here, leftovers get labeled with this sharpie and they get thrown out after five days. You’ll stop buying any more costume jewelry, and you’ll recycle the ding-dang newspapers every week into this yellow container, and . . . “. The hoarder might nod along to get you out of the house, but he/she will sooner or later revert to the earlier compulsive habits.

8. Get support for yourself in dealing with the situation. Research shows that families and friends of compulsive hoarders experience stress, anger and depression. It’s very hard to be around compulsive hoarding, especially when your own quality of life is affected by it. Talk about your feelings and frustrations with trusted friends or a counselor. If you are going to be the executor of the estate of someone who hoards, you’re in a particularly challenging situation. Find out how other people have coped with similar situations. You’re not alone.

9. Accept that the hoarder may refuse to change or get help. That is not a fun fact to read, or for me to write. But it’s true of problematic behaviors in general. In a free country like the U.S., it is only when people are at concrete risk of harming self or others that it’s legal to actively intervene in their lives. Even then, the kinds of low-grade, chronic risk that hoarding tends to create don’t necessarily trigger the “harm to self “ threshold of legal intervention. But if you think the person who hoards is in danger, talk with Adult Protective Services of your county or state.

10. Focus on the whole person, not just his/her hoarding. What can you appreciate about the person? Remember that many other things are also true about him/her besides the fact of hoarding. For example, he/she may have a vibrant connection to the past, and be keeping family memories alive, or have deep expertise in certain areas. Find at least one positive way to connect consistently (away from his/her living quarters if possible), and don’t define the person merely by his/her hoarding.