Because I Might Need it Some Day
Those of you who attended our August meeting may recall that Bob Robinson noted how he kept shifting selection of his talk’s theme as new ideas came to mind. My situation is a bit similar. Six months ago, I was certain I knew what my theme was for this presentation, triggered by an event last July. When I was in the process of winding up some activities I’d been involved with for more than two decades, I was able to get rid of a lot of hard copy folders—so many in fact, that there were several file drawer sized boxes I no longer needed. It felt so good to see the space cleaned up, and I got to wondering about that feeling and where it comes from. So I thought I wanted to talk about organizing our lives in general. At the same time, cable TV A&E’s show Hoarders, and TLC's Buried Alive had become popular and both had caught my attention. Why would I even want to watch people living in chaos? Part of it may be voyeurism, I suppose. How many chances do we get to really see inside someone else's life? It is so dramatic to look at someone's home, see it this way, and then imagine how in the world someone could live there. While I knew my home in no way was that of a hoarder—no really, it isn’t!―as I watched some of those programs, I had to face the fact that in my own family there are two members who I believe are hoarders. Over the years, I had come to accept the situation unhappily, but circumstances late this summer brought me back to focusing on it again. So I decided I needed to learn more about this phenomenon. And that shifted my thinking about what to talk to you about tonight—hoarding.
Let’s understand that there are collectors—for example, those with many bookshelves full of books, or those with walls full of art work, books of stamps. And then there are clutterers who accumulate things almost unintentionally; and finally there are hoarders. How are hoarders differentiated from collectors or clutterers? Have causes of hoarding been identified? What’s it like to grow up in a hoarder’s house? Who cares what you do with your stuff even if you are a hoarder? Have treatments been found? These are the questions I am attempting to answer this evening.
Hoarding has been identified in some other countries besides the
Indeed, references to hoarding are found in world literature, for example in
Dante’s Divine Comedy, the Inferno, where his guide explained that there were
the hoarders and wasters in life, the Avaricious and Prodigal. The term returns in Gogol’s 1842 Dead Souls, Dickens’ 1862 Bleak House, and even Conan Doyle’s Watson
describing Sherlock Holmes as having a “horror of destroying documents”
resulting in stacks of papers in every corner of the room. Even with such
history, psychologists are just beginning to understand what motivates hoarders
and how to help them. U.S.
1. How Hoarding is differentiated from Collecting and Cluttering
These distinctions have been analyzed by a number of researchers. Briefly, collectors are discerning and display their treasures proudly. Those referred to as clutterers are chronically disorganized people who are willing and able to clean up, even welcoming assistance. And then there are hoarders, whose lives have become overwhelmed by stuff—those who strenuously resist help and turn a blind eye to the chaos.
There has been an effort to quantify and qualify the problem of hoarding to appreciate how serious the problem is or could be. How many hoarders are there in the
? I could find no reliable
number. The lowest was from 700,000 to 1.4 million. Another reference stated
between 6 and 15 million. Apparently, it is difficult to identify all
hoarders—I don’t believe that is one of the identifiers in census forms! And
even if that question was asked, many hoarders don’t view themselves that way. In
an effort to qualify the problem, a group called the Institute for Challenging
Disorganization developed the Clutter Hoarding Scale, an organizational
assessment tool for use by professionals. It has five levels of ranking. However,
since the scale doesn’t take into account the physical health of the individual
or the person’s mental state, a version of the scale was developed by Matt
Paxton’s company Clutter Cleaner. As an aside, some of the hoarders Paxton and
his company have worked with have been on the A&E Hoarders show. This 5-level scale takes into account the social
factors of American society, in which we have more leisure time, and the
pressure that everyone—not just hoarders—is under to consume. The Clutter
Cleaner scale isn’t intended for use by psychiatric professionals or
therapists. It’s just used as a guideline—but let’s take a look at it anyway
with the caveat before I begin that none of these stages is clear-cut. U.S.
Stage One. The individual isn’t usually recognizable as a hoarder. At this stage, the problem isn’t about volume of collected stuff; it’s more about the habits hoarders are developing as they try to handle clutter. Early-stage hoarders have trouble parting with items and are beginning to build collections. They may be starting a shopping habit or a hobby that lends itself to acquiring things. The clutter will grow and hoarding will develop if these behaviors aren’t curbed.
Stage 2. Coping with stuff like filing, particularly before “paperless” communication came into vogue: You leave it for a few days, you can cope. After a week, it becomes a pain but manageable. In a month or two, you’re ready to give up and stuff the whole lot under your desk. After all, if you didn’t need the papers for a month or however long they’d been piled up, how important could they be anyway? And this thinking—this inaction—is what leads to Stage 2. Surely, most folks have a junk drawer that holds odds and ends. Certainly, I have a kitchen drawer dedicated to pens, stamps, phone books, etc. But when a junk drawer becomes a junk room, it’s a signal that you are moving up to another stage! The Stage 2 hoarder pays less attention to housekeeping. Dishes pile up in the sink and spill over onto the counter. If there are indoor cats, the litter box remains dirty. Hoarders at this stage are starting to focus more on clutter than on life. They tend to invite fewer people over from a sense of embarrassment. Emotionally, there is some anxiety and mild depression at this stage. The hoarder may begin to withdraw from friends and family, substituting acquiring more things to fill that void. The cycle continues in earnest. As the hoarder brings homes more items, managing those takes priority over personal relationships. At this point, the hoarder begins to shift from embarrassment to justification, explaining why those possessions are needed; why they must be kept, as my title notes—because I might need it some day.
Stage 3. It’s at this point that signs of hoarding become evident to the outside world. There may be a little structural damage to the house, e.g., a sagging porch. Some items which would be expected to be stored inside are stored or just tossed outside. Inside, paths through rooms and stairs are cluttered and difficult to navigate. Outside storage—such as a shed or garage—overflows. Stage 3 hoarders are losing track of their personal care. Bathing and hair cuts aren’t a priority. Stage 3 hoarders will sit for hours in front of the TV or computer. Bad food and lack of exercise may contribute to weight gain, and the classic stereotypical picture of the hoarder emerges. Job performance suffers. At this stage the hoarder is often depressed and claims to want to be left alone. If family members or even friends have tried to clean the house, they’ve been rejected in the efforts and so withdraw.
Stage 4. Here there’s structural damage to the house such as floors and ceilings sagging, or unrepaired water damage. There may be mold, spider webs, bugs, rotten food in the kitchen. If major appliances break down, they can’t be accessed for repair. Things are stored in odd places: clothes hang from the bathtub curtain rod; documents are in the oven. The house is truly dangerous, with blocked entrances/exits, and mounds of paper creating a true fire hazard. The Stage 4 hoarder begins to retreat to a small area of livable space in the house. The hoarder may not launder clothes; rather more are purchased to replace them. Hoarders at this stage have stopped following societal rules. They struggle to get to work on time, or they may quit working and then be unable to pay their bills, or even if there’s enough money, aren’t paying bills because they’re lost amid piles of newspapers and clothing. Stage 4 hoarders talk mostly about past memories or unrealistic plans for the future.
Stage 5. Not only is the house’s structural damage more severe, entire parts of the house may be blocked off with walls of clothing or other items such as piles of newspapers and magazines. The hoarder spends the entire day struggling to complete simple tasks like eating, sleeping, going to the bathroom. If any family or friends are still in contact with the hoarder, they may have tried intervention. City or county authorities have become aware. Depression is often so severe that the hoarder struggles to even get up each day.
Please remember as I noted before listing the 5 stages, none of these stages is clear-cut. The scale shows a continuum. The initial assessment of what is being hoarded and where the hoarder is on this scale provides a sense of the problem’s severity. Hoarding isn’t just about dirt and trash; it’s about hanging on to things that seem important for one reason or another. The rest is garbage and accumulates because everything else has gotten out of hand.
Another way to express the road from cluttering to hoarding: Hoarding is an issue when the clutter begins to affect the activities of everyday life: moving freely about the house cooking, cleaning, entertaining—being willing to permit others to enter your space. Someone who shuffles pile of junk mail around the kitchen counter or who is too embarrassed by the surroundings to invite people over might just be on the slippery slope to hoarding—or not. If the clutter gets progressively worse instead of better, it’s probably hoarding.
Many people might claim that, at least at one point in their lives, they could be classified as a “pack rat” or a “closet clutterer.” However, compulsive hoarding is an anxiety disorder that involves much more than keeping extra papers and magazines around, or collecting CDs and DVDs under your desk. Severe compulsive hoarding can interfere with a person’s activities–such as cooking, cleaning, showering, and sleeping–because piles of newspapers or clothes are found in the sink, in the shower, on the bed, and in every corner of a home. That is, while most people can at least in due time make decisions about what to keep, what to toss, or what to donate—and then follow through on their decisions, a hoarder can’t. There appears to be something different in the hoarder’s brain that isn’t fully understood yet. It starts small, and then it gets out of hand.
Frost and his colleague Steketee have written several books on this topic following years of research: 2006’sTreatment of Compulsive Hoarding: Therapist Guide, and more recently 2010’s Stuff: Compulsive Hoarding and the Meaning of Things. Frost and Steketee noted that all of us have special relationships with some things and those relationships in some ways seem magical. We get carried away with those attachments and—while that could get more of us into trouble with our possessions—most of us are able to decide when an object begins to interfere with our life. We do something about it at that point. That's the thing that's so troublesome for people who hoard: When objects begin to interfere, hoarders simply put up with them rather than deal with the items. Many hoarders have trouble making decisions about objects because they fear they'll later regret discarding something. Their possessions are often extremely disorganized. A subset of hoarders house large numbers of animals. Experts at the Center for Animals and Public Policy at
School for Veterinary Medicine reported seeing cases with many dozens of animals
in a single home. Hoarders are usually oblivious to the fact that the animals
are malnourished and filthy, convinced the animals are being rescued from a
worse fate. Tufts University
There are some myths about hoarding—that these people are just lazy or messy or forgetful—and it's really much different than that. It's layered and it's complex. It covers not only attachments to possessions, but the inability to process information in a way that's efficient. The first systematic study and definition of hoarding was published in 1993 by Frost and Gross. Here hoarding was defined for the first time as “the acquisition of, and failure to discard, possessions which appear to be useless or of limited value” [p. 367], a definition which is commonly used today, although it’s been found that the hoarded objects may be more than worthless. Researchers talk to many people with hoarding problems who say, “I don't really have a hoarding problem; it's just that I don't have enough time to get rid of this stuff.” In fact what's happening, because of the way these individuals process information, is that it takes them so much time to decide to throw something out that they can't keep up with the in-flow.
2. Identifying Possible Causes of Hoarding
While scientists and medical professionals are still figuring out exactly what hoarding is and what causes it, most agree that it is a glitch in the brain that manifests itself by making a person want to hang on to things. For some, hoarding may begin as the result of material deprivation at an earlier time of life, but that isn’t the only cause. Hoarding isn’t a character flaw. It’s not laziness or forgetfulness. Harsh as this may sound, it’s a mental disorder. Borchard noted that Nestadt and Samuels, two researchers at John Hopkins University, reported that compulsive hoarding is often considered a form of Obsessive-Compulsive Disorder (OCD) because between 18 and 42 percent of people with OCD experience some compulsion to hoard. The avoidance of and difficulties with discarding seem to be driven, at least in part, by fears of losing something significant (either information or emotional attachment) or being responsible for a bad outcome (e.g., behaving wastefully). These could be thought of as obsessional fears. Yet, hoarding appears distinct from OCD in a number of ways. For example, few hoarders experience negative, intrusive, or unwanted thoughts about hoarding, whereas this is the defining feature of OCD. [Also, parts of the hoarding syndrome are experienced as pleasurable (e.g., acquisition), something that almost never happens in people with OCD. Another reason to question the link between hoarding and OCD is that most people who suffer from hoarding (80% or more) do not have any other OCD symptoms, and hoarding shows the smallest correlation with other OCD symptoms of any of the OCD subtypes.]
Hoarding often runs in families and can frequently accompany other mental health disorders, like depression, social anxiety, bipolar disorder, and impulse control problems. A majority of people with compulsive hoarding can identify another family member who has the problem. However, no firm evidence has been reported yet.
To add to the challenge of categorizing hoarding, neuroimaging studies, although still preliminary, suggest that different areas of the brain are involved for hoarding than for OCD.
researchers compared brain-damaged patients who began abnormally collecting
things following injuries/ to brain damaged patients who didn’t show those behaviors. All the abnormal collectors had damage
in the middle of the front portion of the frontal lobes—called the prefrontal
area, while the non-collecting patients’ damage was scattered throughout the
brain. The prefrontal region of the brain is responsible for goal-directed
behavior, planned organization and decision-making—all activities that
represent challenges for people who hoard. There have been some other studies
comparing brain patterns in hoarders to control groups, with no dramatic
results. At this point,
geneticists are betting that hoarding has at least some significant genetic
cause, but exactly what is inherited
isn’t clear. One possibility is that hoarders inherit deficits or different
ways of processing information. Perhaps they inherit an intense perceptual
sensitivity to visual details, which give objects special meaning and value. Or
perhaps hoarders inherit a tendency for the brain to store and retrieve
memories differently. If visual cues are necessary for hoarders’ retrieval of
memories, for example, then getting rid of those cues would be the same as
losing their memories. Whatever might be
inherited, it is likely that some kind of emotional vulnerability must
accompany this tendency for full-blown hoarding to develop. University of Iowa
[How the Hoarder’s Decision-making might occur]
Here is a hypothetical or maybe not example of what a hoarder might deal with in a given situation. Most people who go to a fast-food restaurant and get a cold soda, throw away that big plastic cup when they’re done. Or they recycle it. But a hoarder has issues with that cup. The cup is useful. It’s a sturdy cup, after all, not a flimsy little paper thing. Or maybe a church feeding program or a homeless shelter could use it. Tossing the cup away would be a waste when there are so many people in this world who can use a good cup. So the hoarder keeps it, intending to get it to that church or shelter. It just never gets there. Or that cup—decorated with colorful cartoon characters—is meaningful because the hoarder went to the fast-food place with her toddler daughter as a special treat years before. The moment was an important emotional memory for the mother, and looking at the cup brings back that joyful experience. Throwing away the critical link to such an important occasion is unthinkable.
Hard-core hoarders go through this internal debate with every single item that crosses their path: plastic bags, junk mail, fast-food relish packets. At some point, hoarders lose the self-management battle and get overwhelmed. The piles grow, the trash overflows, embarrassment builds, and they long ago stopped letting people into their homes. Without help, they have no idea where to even begin to clean up.
Once possessions start to take over, hoarders tend to get attached to items no matter what they are. Being surrounded by piles of stuff can be strangely comforting. The stuff is there, day in and day out. It doesn’t change, it doesn’t leave, it doesn’t even move unless the hoarder wants it to.
3. What it’s like Growing up in a Home of a Hoarder
One research thread is to look at children who grow up in the homes of hoarders. Such children are dramatically affected. Their childhoods are markedly different from those of their peers, and their adult lives can be shaped by the experience. Among their research endeavors, Frost, Steketee, and others conducted a study of relatives of hoarders that revealed the harmful consequences of growing up in a hoarded home. They found that the effects varied depending on the age of the child when the parent’s hoarding began. Children who lived in a hoarded home before age 10 were more embarrassed and less happy, had fewer friends and had more strained relations with their parents while growing up than did those whose parent’s hoarding began later. As adults, they were more likely to experience social anxiety and stress, and continued to have more strained relationships with their parents. Children who spent their early years in a hoarder’s home held more hostile and rejecting views of their parents than did children whose parents’ hoarding wasn’t apparent at that time. But even the latter group of adult children expressed a very high level of hostility toward their parents, higher even than that expressed by relatives of individuals with other forms of serious mental illness. Children with hoarding parents find ways of coping with the situation. It’s clear that the negative effects of hoarding stay with many of these children into their adulthood. The impact of growing up in a hoarder’s home can be substantial, so the researchers were not surprised to learn that internet groups have been formed to provide information, comfort, and support. One group called Overcoming Hoarding Together [O-H-T] was created by the leaders of a hoarding self-help group to provide a place for hoarders and family members to interact with one another in a supportive way. Another, Children of Hoarders [C-O-H] was started by adult children of hoarders who recognized a need to share their experiences of growing up in a hoarded home. In March 2012, ABC’s 20/20’s program focused on grown children from hoarded homes. Children of hoarders say it’s difficult for others to understand the weirdness of growing up this way, with parents who seem to love their ‘junk’ more than their children. And, strangely, the children often feel that they’re to blame. Holmberg reported that a recent survey by psychologist Suzanne Chabaud—founder of the Obsessive Compulsive Disorder Institute in New Orleans, almost half of the adult children of hoarders suffer from feelings of guilt and shame and are frequently depressed.
4. Even if you are a hoarder, who cares what you do with your stuff?
In theory, it shouldn’t be anyone’s concern, if you don’t care. However, there are some basic needs of survival that can be affected. Children of hoarders bear responsibility for figuring out what do with an aging parent who is living in such unsafe and unhealthy conditions. Most children are frustrated and angry after years of unsuccessful attempts to get their parents to do something about the problem. At the same time, they love their parents and are worried about them. Conflicted feelings of love and resentment put the children in an impossible position. One woman on the
web site wrote about how her mother died in squalor, leaving the daughter full
of shame, guilt, embarrassment and anger. She wrote: “I don’t care what the
cost for the rest of you whose parent is still alive and living [in squalor]:
WHATEVER IT TAKES have an intervention.” In addition to comments I made earlier
about the hoarder’s home becoming one of filth, with issues of hygiene, other
conditions such as noted in Stages 4 and 5 where the house has blocked
entrances/exits, the turmoil can result in
firefighters not being able to get into the home; or medical support can’t get
in to reach the hoarder. Further, threats of eviction add to the hoarder’s
confusion and defensiveness, as well as to family duress.
5. Treatment Efforts
As noted earlier, those who hoard often don't see it as a problem, making treatment challenging. But intensive treatment can help people who hoard understand their compulsions and live safer, more enjoyable lives.
Professional organizers. One option is to hire a professional organizer, particularly one experienced with compulsive hoarding. The Web site of the Institute for Challenging Disorganization has a list of organizers who have had training. Ideally, they can help the hoarder learn to prioritize the possessions—and, even if an eviction or health citation is imminent, they still will often give the client as much say as possible over their things. According to Deb Stanley, a professional organizer in
a person is never the answer. If you want the opportunity to effect change, you
have to respect the person's dignity." I went to that web site’s link and
found the closest certified member to live in Clinton
Township, Michigan . Cedar Rapids
Other team members. Who needs to be involved will depend on many factors. The most effective teams will include a range of participants. Depending on the circumstances, many of the services may be available at no charge or underwritten by an agency. Whatever the case, knowing whom to call upon and what to expect is essential. So, listing some of the possible team members:
The family. Supportive family members will be invaluable as emotional support for the hoarder. However, family members who have been drained by failed efforts to help in the past, or those who nag and cast blame shouldn’t be part of the team. Any cleanup will be viewed as deeply personal for the hoarder. So the best team members will be close family members but only if there already is a strong relationship.
Friends, neighbors, and/or co-workers. If others than family members are brought into the circle, it needs to be understood that this will usually add to the hoarder’s anxiety level. The hoarder is already worried about being judged by family and doesn’t usually respond well to opening up this secret life to others. During the process of cleaning up, if the hoarder picks up something and someone else asks, “Will you throw this away?” all the attachments to that thing overwhelm any thoughts of being without it. What experts and hoarders alike agree on is that anger and resentment don't work. Therapy. Medications do not seem to be a successful route for hoarding as compared to other obsessive compulsive disorders. There even is some disagreement about the merits of Cognitive Behavioral Therapy. However, Cognitive Behavioral Therapy may be more effective for compulsive hoarding, especially when it involves a therapist going into the home of the hoarder and to help develop habits and a consistent behavioral program to try to de-clutter the hoarder’s home, car, and life. I have located a local group of licensed psychologists who work with hoarders; if you are interested, I’ll be happy to pass the information along to you afterward. There may be other groups as well.
I want to close my formal remarks by turning back to those family members who stimulated the impetus for this presentation. From what I have learned, I believe that one member is a full-blown Stages 4 and 5 hoarder. On those rare occasions when he has had to get rid of some of his stuff due to total flood damage or as a result of city warnings of eviction, more stuff fills those cleared spaces. The other member’s hoarding has various elements of Stages 2 through 4: using a bathtub as storage, rooms stacked with journals and magazines, embarrassed to have people over, with comments like “I just don’t have time to clean it up.” Yet, when arrangements were made to assist him with clean-up this fall, even though he does care for the person who was there to provide assistance, he was defensive, insisting that he had to keep all those publications because he intends to live to 114 and has a lot of research yet to do. He was only willing to let go of junk mail that had piled up over time.
My formal remarks now being concluded, it’s time for discussion. Thank you.
Belk, R. W., Wallendorf, M., Sherry, Jr., J. F., & Holbrook, M. B. (1991). Collecting in a consumer culture. Highways and Buyways: Naturalistic Research from the Consumer Behavior Odyssey, pp. 1778-215.
Frost, R. O., & Gross, R. C. (1993). The hoarding of possessions. Behaviour Research and Therapy, 31(4), 367-381.
Frost, R. O. & Steketee, G. (2010). Compulsive Hoarding and the Meaning of Things.
Books (Houghton Mifflin). Boston
Holmberg, S. Nearly half of children of hoarders fight guilt, depression. ABC News,
March 10, 2012.
Retrieved on January 2, 2013
Paxton, M. (2011).The Secret Lives of Hoarders.
Penguin Group. New York
Tolin, D. F., Frost, R. O., Steketee, G., & Fitch, K. E. (2008). Family burden of compulsive hoarding: Results of an Internet survey. Behavior Research and Therapy, 46, 334-344.
Webley, K. (
26, 2010). Hoarding: How collecting stuff can destroy your life. Time U.S.
[The listed contacts and Self-Help groups were mentioned in the paper. They are not all-inclusive.]
Covenant Clinic Psychology: Dan Ekstrom, PsyS; Ronelle Langley, Ph.D.
St. Francis Dr.,
2802 Orchard Drive, Cedar Falls 268-9700
Institute for Challenging Disorganization. www.challengingdisorganization.org
1693 S. Hanley
Road, St. Louis, MO. Phone: 314-416-2236.
Margaret M. Jackson, the Organized Life. Certified Member, Institute for Challenging Disorganization. email@example.com
Links to Adult Children’s Support Groups
Children of Hoarders (
COH) Support Groups.
Overcoming Hoarding Together (O-H-T) Support Groups. www.ocfoundation.org/yahoo.aspx
Additional Notes referring to page 2
1. Regarding Gogol’s Dead Souls: A wealthy landowner named Plyushkin displayed all the characteristics of hoarding. The local peasants called him the fisherman for his habit of “fishing” the neighborhood for “an old sole, a bit of a peasant woman’s rag, an iron nail, a piece of broken earthenware.” He collected them all in his cluttered manor. Not long after that, “Plyushkin” became slang in Russian for anyone collecting discarded, useless, or broken objects. “Plyushkin syndrome” is still used in Russian psychiatry to refer to someone with a hoarding disorder. 2. Early in the 20th century, ownership and acquisitiveness received some attention from psychologists. William James (1918) described acquisitiveness as something instinctual that contributed to one’s sense of identity. For James, one’s sense of self fused “me” and “mine.” In the mid 20th century, Erich Fromm suggested that acquisition was one way for people to relate to the world around them and was core to one’s character. In his theory, a “hoarding orientation” was one of four types of dysfunctional character. This orientation corresponded with a fundamental orientation to existence – “having.” The destructive orientation of “having” or avarice contrasted with the more healthy “being” orientation.
3. At about the same time as Fromm was writing about the “hoarding orientation,” the
newspapers were filled with stories about the Collyer brothers who died among
the junk in their New York City Harlem brownstone. The
Collyer brothers not only affected a generation of New Yorkers whose mothers
admonished them to clean their rooms or end up like the unfortunate brothers,
but they also inspired several novels, Marcia Davenport’s My Brother’s
Keeper published in 1954, and the recent E.L. Doctorow’s Homer
and Langley. It has been the stuff of theatre, and even now among firemen, a
hoarded home is referred to as a Collyer house. New York City