There's another important issue that comes up with this definition. In many cases, family members, friends, or outside agencies have tried to help by clearing out things from the person's home. Sometimes this is done with the person's permission and sometimes not. We think that these kinds of interventions miss the point. When we focus all of our efforts on the person's house—for example, if we send the person on vacation and then clean out the house while he or she is away, we're treating hoarding as a house problem . But hoarding is not just a house problem; it's also a person problem . Unless the person makes fundamental, sustainable changes in how he or she thinks, feels, and acts—that is, alters the way he or she relates to possessions—the problem is likely to return. This is exactly what research tells us: When someone else takes over the discarding process, the person with the hoarding problem usually continues to acquire and save items, and the house fills up again— sometimes more so than before the clean-out.
So throughout this book, you'll notice that we spend a lot less time talking about your house and a lot more time talking about you—how you feel, how you think, and what you do. From our research and our experience talking with people with compulsive hoarding, we think that much of the problem can be attributed to personal factors such as: