Paper short abstract:

We examine the medicalization of households using the lens of Hoarding Disorder (HD). Using interviews with patients/clinicians, and representations of HD in the media, we analyze contested beliefs about pathological household practices to both critique and better understand models of the household.

Paper long abstract:

Households of patients diagnosed with Hoarding Disorder (HD) have become contested as sites for domestic, psychological, bureaucratic, media, and professional management interventions. Since 2013, HD has been formally included in the DSM-V, a manual for diagnosis used by American Psychiatry, and is defined as a persistent difficulty associated with discarding possessions. In order to diagnose HD, clinicians often consider not only the patient, but also their home space. This paper uses a careful examination of the ways that clinicians, professional organizers, and individuals with hoarding problems come to understand households as “sick” or “well,” “normal” or “abnormal” and “homey” or “uninhabitable,” to critically unpack these binary concepts. We further seek to apply this critique of normative household practices beyond HD to better understand models of households and homes.Using 30 semi-structured interviews with clinical experts, we examine the process of HD diagnosis. We combine this analysis with talk of domesticity and homes within several long-running reality television shows featuring individuals with HD. Finally, we draw from 30 interviews with individuals diagnosed with HD, in which they describe their notions of space and household. In the encounter of these different groups and interventions, “households” and “hoarding disorders” become mutually shaped and constituted through practices, ideas, and evaluations of hygienic standards, household management, mental diagnoses, waste disposal, and food and storage practices, and family socialities. These fraught dialogues provide a lens through which normative models of domesticity, homes, and household become visible, as well as suggesting productive avenues for critique and reimaginings.