By Brian Goslow
Irene’s compulsive hoarding problem had pushed her family to the brink of leaving.
They no longer ate together: A wide collection of items covered the kitchen table, leaving only a small corner that was barely large enough to hold a plate. Sit down as a group? Forget it. All but one chair was stacked with Irene’s things. More frightening was the counter space covered with papers that sat dangerously close to the stove.
The adjoining dining room was a worse disaster, with only a one-foot wide path open to move around. The pile of things on the dining table nearly touched the chandelier and the outside exit was unreachable.
At 55, Irene (not her real name) was forced to recognize she was one of an estimated 5 percent of the population with a severe hoarding problem that threatens their and their family’s safety due to unsanitary living conditions, maneuverability problems and the fire hazard caused by blocked exits. Desolate conditions can also lead to evictions and/or the home condemned.
Smith College psychology professor Randy Frost, co-author of Buried in Treasures: Help for Compulsive Acquiring, Saving and Hoarding, has spent the past two decades studying and attempting to understand those controlled by the urge to accumulate “stuff.” A member of the New England Hoarding Consortium, a group of clinicians and researchers at Smith, Boston University and the Institute of Living in Hartford, Frost recently gave a lecture at the Worcester Senior Center on understanding and treating compulsive hoarding.
Irene was his first case study. “She spent three hours a day, sitting on the bare part of the table, trying to sort out her papers,” Frost said. The items included large numbers of clipped newspaper coupons for expired sales, yellowing articles on Vermont, which she always wanted to visit, and brochures on talking about drugs to her kids, who were nearing their teens. “Each day, she just churned the material — but threw nothing away,” Frost said.
He described Irene as a delightful and smart person with a master’s degree and a wide circle of friends. “Very few of whom had been in her home, which is a characteristic of hoarders,” he said. Her entire house was eventually cleaned after 40 behavioral modification sessions over an 18-month span.
Hoarders are compulsive collectors who save almost anything that they convince themselves have some value: clothing, newspapers, books, containers of things; some collect animals, trash and body parts. “Our world has become dominated by possessions,” Frost said. “Some are for convenience, some are for pleasure. If you lose control of them, it can be a living hell.”
They shouldn’t be confused with collectors, say, of model cars, salt and pepper shakers or sports memorabilia. “Collectors acquire things to show them off; with hoarders, they’re not collecting to have that collection be part of their persona; it’s a private experience,” Frost said. That amassing of objects becomes a problem when the collection becomes a source of stress or impairment to normal living.
Those who work with hoarders utilize a hoarding rating scale of five major issues to determine the severity of the problem: difficulty using rooms in the home; difficulty discarding items regardless of their true value; problem collecting or buying; emotional distress; and impairment. Many hoarders are found to suffer from varying degrees of attention-deficit hyperactivity disorder (ADHD) and/or obsessive-compulsive disorder (OCD).
With patience, some obsessive collecting tendencies can be reversed; those who’ve worked with hoarders have had positive results when they can get them to evaluate why they’ve held onto an item and why they’re considering buying new ones. A study of 700 people identified as having significant acquisition problems in 2008 found 75 percent kept buying items for which they had no clear use, 60 percent took free items for which they had no use, and half did both.
Many older residents’ homes have safety issues caused by clutter that doesn’t allow the safe use of large appliances. Or non-working appliances have become hazards to people’s ability to maneuver around easily. A 2001 study of elderly hoarders found almost 60 percent owned a non-working stove or oven while 40 percent had at least a non-usable fridge/freezer, kitchen sink or bathtub.
“With elder hoarders, over time, their ability to use appliances declines because of clutter,” Frost said. “There is a pattern: Something goes wrong with an appliance and the person is afraid to have someone come into the home to fix it because of their potential reaction to the clutter; it’s a secondary effect.”
Well-meaning family members and friends, seeing only piles of junk, want to help and will go to a hoarder’s house intending to try to toss out whatever they can. In most instances, Frost said, this can cause conflict and hostility that leads to a separation of the parties. “If you’re caught (throwing something away), you’re never trusted by that person again,” Frost said. “They like being in a position of control with their saving behavior.”
Any long-term solution is personal. Frost has found showing hoarders a picture of their home when they’re outside the house can inspire action; most don’t recognize it as theirs. “It’s as if we’re giving them a different lens on their home,” he said. “They don’t see the clutter when they’re in the house. When we visit them in their homes, they tell us, ‘When you’re here, I see it. When you’re not, I don’t.’”
Many Americans have become aware of hoarding and the problems it can cause in a person’s life through the A & E Network program, Hoarders. Laura Moore, M.Ed., owner of ClutterClarity at Home, based in Concord, finds the program is pure voyeurism and distorts the complexity of the problem and solution. “It teaches people that it has to be that bad before you need help,” she said. Moore, a therapist and professional organizer with a master’s degree from the Harvard Graduate School of Education, believes that people prone to cluttering may not always be suffering from a mental illness, rather they are engaging in “unclear thinking.”
“Everyone’s overwhelmed in one capacity or another and doesn’t have the time to take care of their home the way they did 25 years ago,” she said. “We’re overworked; we’re overscheduled; we’re over stuffed,” she said, estimating 50 to 70 percent of the population suffer from having “too much stuff” and haven’t learned to take care of their home in today’s go-go-go-work-till-you-drop culture.
“Your life changes,” Moore said. “When you get married, and at every major life change, your needs and the items you require change. You have to clean up and make room for the new. Every life transition — losing your job or having a pending divorce, for instance, is an opportunity to clean out (your home).”
She suggests that if people spent 10 less hours per week at the workplace and applied that time towards taking care of their home, the payoff would be greater than the salary lost. “It’s actually their key to freedom,” Moore said. “Almost everyone I deal with, I’m dealing with a calendar. Their calendar reflects their priorities. I try to get them to make their feeling better their number one priority.”
The thought of getting rid of things can be as much of a roadblock as actually starting the decluttering process. “When I work with someone, we determine a strategy,” Moore said. “I ask them, ‘How are you going to let go?’ You have to put effort into finding a solution.”
There are different levels to that end solution: emotional (whether a person truly needs to hold onto an item), economic (is it worth the person’s time to sell the item) and charitable (do they want to donate their items and if so, to whom?). “It takes money, time and energy to make those decisions,” Moore said. “Only you can decide what’s best for you.”
Not only are many overtaken by possessions, but paperwork. If all those bills, bank and loan statements and documents essential to your life aren’t in one place, you can end up wasting and suffering stressful hours gathering them together, especially at tax time. Moore compiled Paper Clarity at-a-glance: What to Keep and When to Let Go, a booklet on managing personal documents, to assist with the problem; it’s available through Amazon.com.
While solving a clutter problem can be part of a mid-life inventory for baby boomers, when it comes to cleaning up their parents’ house, other issues come into play. “A family can be terrified, not just about the person, but what happens after that person dies,” Moore said. “When they die, they’re responsible for cleaning up the house. They barely have time for cleaning their own house and they resent it.”
Whatever it’s a loved one’s home or their own, everyone will feel much better getting the job done, first through seeing the gradual signs of progress and then, when most, if not all of the clutter has disappeared.
Deciding if you or a loved-one has a compulsive hoarding problem
The Anxiety Disorders Center at the Institute for Living at Hartford Hospital in Hartford, Conn. shared these questions to consider in deciding whether you have a compulsive hoarding problem and tips on how to overcome it, some of which are adapted from the book Buried in Treasures: Help for Compulsive Acquiring, Saving and Hoarding (Oxford University Press).
A problem with hoarding may exist if you or a loved-one:
•Regularly hangs onto a large number of possessions that most other people would not consider to be very useful or valuable; for example: junk mail, old newspapers and catalogs, broken things you might want to fix some day.
•The home is so cluttered that individuals can no longer use those parts of the home for the intended purpose. For example: beds that can’t be slept in; kitchens that can’t be cooked in; chairs, sofas or tables that are unusable;
•The clutter is so bad that it causes significant distress or impairment. For example, many people with compulsive hoarding problems report that they: cannot have friends or family over because they are so embarrassed; cannot let maintenance professions in because of the clutter, thus leaving items unfixed; are at risk of fire, falling, infestation or eviction.
Some tips for overcoming compulsive hoarding:
Just because you have a use for an object, doesn’t mean you need to keep it; a good rule of thumb is if you haven’t used an object in over a year, you can probably live without it.
More is not necessarily better; there really is no need for most of us to have two microwave ovens or three bicycles. Try to get rid of the extras.
Categorize items into piles: items you want to keep, items to give to charity, items to sell and items to throw away.
Don’t over-think: Most decisions are not that complicated; if you find the decision takes more than a few minutes, you are probably making it too complicated.
Follow the “OHIO” rule: Only handle it once. If you find yourself handling things again and again, moving things from one pile to the other, stop yourself. Refocus and move on.
Know when to ask for help. Compulsive hoarding is a potentially serious mental health issue. Serious mental health issues require serious treatment.
For more information: www.instituteofliving.org/adc. —BRIAN GOSLOW
