Q My 15-year-old daughter is a wonderful girl who seems to have one big problem. It's always been a struggle to get her to clean her room. She simply will not do it, even for something she, herself, has set as a goal. She's been not feeling well (she's been to the doctor lately a couple of times for non-specific tiredness, allergic type reactions, etc) and I thought it might be because of all the trash in her room. I repeatedly asked her to clean her room and she eventually did—she filled 2 garbage bags with trash and one bag with plastic bottles. While she was taking a nap I figured I'd finish up. .Her bed was against the wall at one point but had slowly been moving to the center of the room as trash and clothes and papers accumulated around. I pulled out 3 more bags of trash. The trash was a lot of papers, magazines, clothing tags, wrappers, empty deodorant containers, etc. As I was finishing, she woke up and started yelling at me that I was invading her privacy. Everyone in the family is a bit messy and has hoarder tendencies but she takes it to a new level. The house is not so bad that we can't have people over, but just the amount of stuff we have is astounding to me. I'm not sure how my daughter would feel about counseling—it would probably be difficult to get her to go.
It does sound like your daughter might have hoarding disorder. As you say, you and your wife don’t have great organizational skills, so her hoarding could be partly a learned behavior or genetic. But while you and your wife might have hoarding tendencies, it sounds like your daughter has a full-blown disorder.
The kinds of things that she is keeping are very typical of hoarding—plastic bags, magazines, wrappers, garbage. Most people would look at that and think it’s trash and not understand why she’s holding onto it. But for her it likely has some sentimental meaning, or she sees it as part of her identity, and throwing it away would be like throwing away part of herself. The things she’s keeping have value to her, so from her point of view it really did feel like a privacy violation when you went into her room to throw things away.
Also, your concerns about how the trash accumulating in her room might be affecting her health certainly make sense. Kids with hoarding disorder can be more prone to having dust and mold allergies, migraines, and respiratory problems because of their surroundings.
Your goal should be for her to come into treatment so that she can start understanding her hoarding and then learning strategies to overcome it. Look for a psychologist who does cognitive behavioral therapy (CBT) and who has experience in OCD and hoarding. I say OCD and hoarding because they are very related. It would also be good to have her CBT therapist evaluate her to see if she has any other related disorders (like OCD) that might be going unnoticed.
You say that you think your daughter will be resistant to getting treatment, and that is pretty common for kids with hoarding disorder. She might be more open to it if it is framed differently. You can say that you as a family need to learn better ways of organizing things. This way she isn’t the identified patient—the whole family is.
If she still is resistant, then a lot of families decide to come in first to learn about hoarding and some of the dos and don’ts. Having her family learn to make changes within themselves first can facilitate her coming in in the future. She might not be ready now, but she can get there.