The impulse is to get a dump truck in the house and toss everything.真有股冲动把垃圾车开进家里，将囤积的东西全扔出去。

I watched the “hoarding show” when it was still on Discovery Health (when Discovery Health still existed!), but in visiting the homes of patients as an LCSW1＝Licensed Clinical Social Worker，即有执照的临床社会工作者。I have seen the effects of reallife hoarding. Hoarding is a disease that acts, in many ways, like an addiction. As such, it affects the family much like addiction affects the family. Everyone needs help but, most often, the patient—the hoarder—is identified as the sick one, the “identified patient2identified patient在某些机能不全的家庭中，尽管家庭成员各有问题，但是某一个成员会不自觉地成为家庭矛盾的集中点，被认为是造成所有矛盾和困境的原因。其实真正有病的是整个家庭，只是该病人被辨认出来，为维护一个病态家庭的平衡而做出了牺牲。治疗的对象不应是个体，而是各家庭成员间的互动本身。.” Once that happens, it seems, the “judging” begins.

2 The show, with its cameras and varying views of the accumulation, can lead you to believe that hoarding is always messy, dirty, disgusting. That if a person is a hoarder they are completely disorganized. I learned over the years that, while those things are true, that some who hoard are in fact quite anal3anal 挑剔的，专注细节的。about it. And proud. And maybe a little arrogant. For example, I once visited a patient who saved decades worth of daily newspapers. Like, five decades worth. He kept them stacked in meticulous4meticulous 过分注意细节的，一丝不苟的。, edge-to-edge order against the walls, and when he was out of wall space (which appeared to have happened a good decade or so before I met him) he constructed little pathways that traversed the living room and dining room. Each winding path was bordered by newspapers that stood waist or shoulder high, but every single one was very neat and tidy and a fire hazard5fire hazard 火灾隐患。. The house smelled musty and stale. But the patient liked it and had no intention of changing a thing, which is why the fire department had been called in.

3 In the current issue of the Diagnostic and Statistical Manual of Mental Disorders6《精神障碍诊断与统计手册》，英文简称DSM，是由美国精神医学学会出版、被国际学界广泛认可和使用的用于诊断精神疾病的指导手册。该手册第四版（DSM-IV）于1994 年出版，而目前以2013 年出版的第五版（DSM-V）为最新版本。(DSM-IV), hoarding is listed under Obsessive-Compulsive Personality Disorder, as one of 8 criteria for diagnosis. It’s described as: “The inability to discard worn-out or worthless objects even when they have no sentimental value.”

It seems as though it deserves its own 在DSM-V 中，囤积行为被单独列为一种精神疾病，称为hoarding disorder，即囤积障碍。

4 In 2018 National Public Radio aired a story about how researchers are realizing that hoarding behaviors begin in the mind. At the University of California, San Diego Department of Psychiatry, psychologist Catherine Ayers, a specialist in anxiety disorders and late-life hoarding, is researching treatment for older adults who hoard. Currently, she’s using a form of behavior therapy and cognitive remediation8remediation 纠正，矫正。that focuses on building concrete skills.

That’s a good thing.

5 As I mention above, hoarding resembles an addiction, progressing in severity over time. If a parent is hoarding in older age, he or she may have always been a hoarder or, perhaps, that behavior has taken the place of another compulsive behavior that, for whatever reason, has been abandoned. A loved one’s hoarding can make their caregiver—son, daughter, spouse, lover, caregiver—feel as out of control as the person who hoards feels deep down. For some people the worsening of symptoms is slow and steady, for others it’s rapid and frantic9frantic 狂乱的，疯狂的。.

6 For family members who are ashamed or saddened or overwhelmed or disgusted, the impulse is to get a dump truck in the house and toss everything. Of course, this would never work in the long run. If a big clean-up is imposed to rid the house of clutter but no follow-up treatment is offered to treat the underlying disease process, the person will typically replenish the clutter and then some10and then some 而且还远不止于此。, much to the dismay11dismay 沮丧，灰心。of the interveners. That’s the pathological part. Remember that if you care about someone who hoards, so you don’t find yourself too angry that your efforts to clean up once and for all failed, over and over again. Be gentle with them—and yourself. In fact, seek help for yourself. Admit, to yourself, that you need it and that you cannot control the hoarder in your life.

当“ 囤积秀” 还在《探索健康》栏目中播出的时候（当时《探索健康》还没停播呢），我曾经看过这个节目，但是当我以临床社工的身份亲身拜访这些病人的家时，才感受到现实生活中囤积行为的影响。囤积行为是一种疾病，它在许多方面都和成瘾行为相似。正因如此，它对于家庭的影响也跟成瘾的影响多有类似。所有人都需要帮助，但最常见的是这些病人——也就是囤积者——被认定为病态个体，也即“被认定患者”。这一旦发生，就意味着一场“批判”开始了。

文章来源：《环境与健康杂志》 网址: http://www.hjyjkzz.cn/qikandaodu/2021/0416/1042.html

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