Supper
Club
Because
I Might Need it Some Day
Judith Harrington
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 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 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 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. 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 COH
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 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.
References
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.
www.acrwebsite.org/volumes/display.asp?id=12102
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.
Boston
Holmberg, S.
Nearly half of children of hoarders fight guilt, depression. ABC News,
March 10, 2012 .
Retrieved on January 2, 2013
from
http://abcnews.go.com/blogs/health/2012/03/10/nearly-half-of-children-of- hoarders-fight-guilt-depression
Paxton, M. (2011).The Secret
Lives of Hoarders. 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. (April
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.]
Contacts
Covenant Clinic Psychology: Dan Ekstrom, PsyS; Ronelle Langley,
Ph.D.
2750 St. Francis Dr., Waterloo
2802 Orchard Drive,
Cedar Falls 268-9700
Address: ICD, 1693 S. Hanley
Road , St. Louis , MO.
Margaret M. Jackson, the Organized
Life. Certified Member, Institute for Challenging
Disorganization. organizedlife@msn.com
Links to Adult Children’s Support
Groups
Children of Hoarders (COH ) Support Groups.
www.childrenofhoarders.com
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 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 New York City
1 comment:
Ever hear of the Collyer Brothers of Harlem? http://en.wikipedia.org/wiki/Collyer_brothers
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