Nov 3, 2009
Everybody accumulates stuff, and many of us have cluttered closets and drawers. But when seemingly useless possessions and even rotten food pile up, blocking exits and filling beds, sofas, sinks and bathtubs, it’s evidence of a psychiatric condition called compulsive hoarding.
Hoarding has spilled into the spotlight in recent years, thanks to ‘Oprah,’ ‘Dr. Phil’ and the A&E series ‘Hoarders.’ E.L. Doctorow’s new novel, ‘Homer and Langely,’ offers fictional insight into the reclusive Collyer brothers, found dead in their Fifth Avenue mansion in 1947 amid 130 tons of trash, including 14 pianos, 25,000 books, decades worth of newspapers and the chassis of a Model T Ford.
Yet most hoarders remain a family secret. Experts estimate that as much as 2% of the population meets the criteria, a group that spans all education and income levels. ‘Attorneys, surgeons, business executives — some very bright and successful people that you’d never suspect have this problem,’ says San Francisco psychologist Michael A. Tompkins, author of a new book, ‘Digging Out,’ aimed at helping families of hoarders. ‘Sometimes they’re the life of the party, but nobody’s ever been invited to their home.’
Hoarders probably existed in other times and cultures, but psychologists are just beginning to understand what motivates them and how to help them. Experts draw distinctions between hoarding and other forms of mess. Collectors are discerning and display their treasures proudly; clutterers and chronically disorganized people are willing and able to clean up, and they welcome assistance. Hoarders often strenuously resist help and turn a blind eye to the chaos.
Psychologically, hoarding defies easy categorization. It’s often seen as a form of obsessive-compulsive disorder, but some aspects don’t fit the OCD pattern. Nearly 90% of hoarders also acquire things excessively and experience a rush that’s not typical of OCD. ‘It’s as if they go into a dissociative state where they forget that they don’t have money to buy this or space to keep it,’ says Randy O. Frost, professor of psychology and an expert on hoarding at Smith College in Northampton, Mass.
Some hoarders show signs of dementia, depression, post-traumatic stress disorder and attention-deficit disorder. Many have trouble making decisions about objects and fear they’ll later regret discarding something. Their possessions are often extremely disorganized; bills often go unpaid because they are lost amid piles of videos and clothing. Services get cut off, which compounds the squalor.
At the same time, some hoarders are extremely frugal, loath to waste anything that could be repaired or given to someone. Some have lost jobs or loved ones and are holding onto physical reminders. Some are highly imaginative: That empty toilet-paper roll could be covered with yarn and made into a doll . . . .
‘I’ve seen many people who have an image of themselves as an expert cook or crafts person, and they collect all the objects that represent that craft until they are overwhelmed,’ says Gail Steketee, dean of the Boston University School of Social Work and another hoarding expert. ‘It’s a dream gone haywire.’
A subset of hoarders house large numbers of animals. Experts at the school of veterinary medicine at Tufts University report seeing cases with as many as 1,000 animals in a single home. Hoarders are usually oblivious to the fact that the animals are malnourished or filthy, and they are convinced they’re rescuing them from a worse fate.
Indeed, most hoarders don’t consider their living conditions to be a problem. The squalor bothers family members far more, particularly if they share the same home.
How can family members and friends help a hoarder? As tempting as it may be, experts say forcibly cleaning out a hoarder’s home is bound to backfire — and in some cases, cause severe psychological trauma. Hoarders tend to feel violated and simply repeat the process in a new location.
Instead, experts counsel patience and understanding, and letting the hoarder make his or her own decisions as much as possible.
One option is to hire a professional organizer, particularly one experienced with compulsive hoarding.
‘Shaming a person is never the answer,’ says Deb Stanley, a professional organizer in Clinton Township, Mich., who is also training to become a mental-health counselor. ‘If you want the opportunity to effect change, you have to respect the person’s dignity.’
Some hoarders willing to seek treatment have found that antidepressants — specifically selective serotonin reuptake inhibitors (SSRIs) — can help manage emotions. Cognitive behavioral therapy can also help change hoarders’ thinking about their possessions.