Hoarding Disorder 101 2026 IOCDF Conference

I’ve attended so many Hoarding Disorder 101s, from so many presenters in soooooooo many forums, I don’t always claim the continuing ed credit anymore. But I never leave a presentation without learning something new. This version, Hoarding Disorder 101 at the 2026 IOCDF Conference, a panel of Kiara R. Timpano, PhD, Marnie Cooper, Kayley Hyman, Msc, Holistic Hoarding, and Randy O. Frost, PhD, surprised me.

There’s research which indicates that people with hoarding disorder may have clinically significant difficulty focusing, above-and-beyond what might be indicative of co-occurring ADHD (I may NOT be expressing this well, I took frantic notes). To my mind, that means that people with hoarding disorder really really really need to experiment with body-doubling techniques. Ancedotally, widely-recognized in the neurodiverse/ADHD-abled community, body-doubling is a phenomena in which people are more effective, more productive, more focused, in the presence of other people. There are numerous mechanisms to get body-doubles. I refer to it as The Phone Calls Club. My training grounds me in the ideas that decision-making and categorizing are difficult for people with hoarding disorder. But focus????? WHO KNEW.

The other surprise is that there isn’t an agreed-upon universal definition of hoarding disorder, which the clinicians in the room noted. I’m very familiar with the American Psychiatric Association‘s DSM-5- TR (Diagnostic and Statistical Manual 5th Edition – Text Revised), a reference work used to standardize the language and criteria for diagnosing brain-based health conditions so all clinicians can try to reliably diagnose, treat and discuss patients. The World Health Organization‘s ICD-11 (International Classification of Diseases 11th Revision) also classifies hoarding behaviors as a potential mental health condition. I’m not a clinician, but there are fascinating differences between the two bodies of knowledge. The ICD-11 includes references about when symptoms may show up, the ways people accumulate stuff, and subtleties about how people may understand their illness. It seems to this layperson to be a much more comprehensive guideline. But Drs. Frost and Timpano pointed out that the ICD-11 gives equal weight (maybe more weight? AAARRGH these notes), during diagnosis, to whether a person accumulates stuff and to whether a person can discard stuff. Clinicians using the DSM criteria consider a person’s inability to discard stuff to be more signficant. Maybe what this difference emphasizes is that there is still a great deal to learn about this awful problem.

Marnie Cooper’s heartbreaking, heartwarming, poignant message left me breathless. I’m paraphrasing, and doing her a miserable injustice – she taught that “behind the lie, there’s the truth” about the sentiment a hoarding-disorded brain creates. She told a story about struggling to let go of her daughter’s violin, a thing which her daughter had touched and was precious. The truth about the instrument was that her daughter had hated playing and wasn’t very good. It didn’t represent her daughter at all. Marnie let it go. Not surprising, given Marnie’s determined campaign. It was good to end on that note.