Roxanne, who had kept all of her grown daughter’s stuff from the time she was an infant, is a not uncommon case. As Roxanne and I worked through cleaning out her spare rooms, she shared with me that she had been abused as a child. Roxanne realized that by saving her daughter’s things, she felt like she was preserving and protecting her daughter’s childhood. She was really trying to find a childhood that she never had. She didn’t understand that hoarding her daughter’s possessions had actually pushed her daughter out of her life.
I’ve seen hoarders whose habit was triggered by events as wide-ranging as a cheating boyfriend or a diagnosis of cancer. One client had lost a child in a car accident and then two weeks later her husband died. Another started hoarding after her husband shot himself in the backyard. Sometimes a hoarder is so deep in depression that the story takes on facets that probably never even happened, but the hoarder believes that they did. I call those “false triggers.” True or false, the triggers are real in the hoarder’s mind.
There always seems to be an emotional event that triggers the behavior. Finding that is the job of the therapist and the hoarder. But family members and those who work with a hoarder need to understand that collecting things is what hoarders frequently do to comfort themselves after trauma. Anyone coming in to clean is coming in to take away those comfort items. That makes the cleanup person a real threat, even if the hoarder is asking for help.
Almost every hoarder I’ve worked with has experienced tragedy. They are sad and feel alone and isolated. Hoarders do not consciously choose to live the way they do; it’s a defensive reaction to what happened or what they believe happened. Family members and professionals can help by remembering that there is a cause, instead of focusing solely on getting rid of the trash.
The triggers never go away: They are life-changing traumas that will always cause some pain. The memories come up often, unexpectedly, and usually when someone is already under stress. Or a hoarder may not even be aware of the trigger, and so it happens in the subconscious. In response, hoarders turn to their possessions, maybe shopping to add to the hoard, or retreating to be with their pets, or creating more piles.
Becoming a hoarder is not unlike becoming a workaholic or an exercise fanatic as a way to escape a difficult life or event. People can turn to these activities just like hoarders rely on acquiring and holding on to their stuff. Work can be a place where someone can feel safe and confident. Exercise can be an activity that makes someone feel better. But anything taken to extremes will inevitably become a problem. In an ideal world, the hoarder would learn to recognize triggers and then respond with a healthier, more balanced behavior that’s equally comforting. But that’s usually a task best undertaken with a counselor, not a cleaner.
Not all hoarders figure out their triggers, but Marcie, the shopaholic, was able to do so. As we worked on cleaning her house, Marcie started talking about why she shopped so much and saved it all, and she confessed that she wanted to figure out what had made her become this person.
In our time together, I had noticed that her husband was a big, angry guy. He yelled at her a lot during the cleanup, and I wondered if it went further than yelling. I mentioned the yelling to Marcie, and she was pretty frank in asking me if it was obvious that he hit her. She kept talking about it, wondering if she was hanging on to things to comfort herself, to feel safe and protected.
I’ve witnessed cases like Marcie’s repeatedly. Hoarders aren’t slobs who don’t care about being clean. They are people struggling with overwhelming emotional issues. A pile in a hoarder house isn’t a pile of stuff; it can be many things: a pile of sadness, a pile of quitting, or sometimes even a pile of hope. It’s never really about the stuff, hoarders are just confusing their possessions with their emotions.
BOUNDARIES
Regardless of what triggers a person to turn to hoarding, there is one characteristic that I have found to be pretty common to all of the people with whom I’ve worked: They struggle with limits and boundaries. Margaret, for example, loved her animals because they made her happy. One dog, or maybe even three, would have been manageable for her. But she wasn’t able to put that limit on herself. In Margaret’s mind, if one dog made her happy, a hundred dogs would make her a hundred times happier. Putting a limit on how many dogs she could accept into her household would be like putting a limit on her happiness, and she wasn’t willing to do that.
For hoarders who shop (or Dumpster dive), it’s the same issue. Purchasing an item gives them a rush of temporary joy, so purchasing more items seems like it should give them an even bigger rush. The collecting gets out of hand when hoarders become so compulsive that they can’t limit it. It’s also a problem when hoarding is the only thing that brings the person happiness, instead of family, friendships, hobbies, work, exercise, or other pastimes.
Dr. Suzanne Chabaud, who works with OCD patients and hoarders at her clinic in New Orleans, points out that hoarders need to learn to have appropriate boundaries. A shopping hoarder may be buying lots of items ostensibly for her husband and her children, but in actuality they don’t want them. The shopaholic isn’t respecting their boundaries. She is focused on what she wants for them instead of what they actually want—or need from her.
Conversely, hoarders may put limits into place that aren’t appropriate, such as when they don’t let people come into their lives to help or simply to form friendships. These limits, like the hoarding itself, may be in response to the imagined and unnamed fears and threats that plague the hoarder’s life.
AVOIDING REALITY
Whatever the triggers that set off the hoarding may be, or whatever boundaries and limits with which the hoarders wrestle, almost every person I’ve worked with has been fixated either on the future or the past. It’s so much easier than living in the present, because the present can be awfully depressing. Since the present is clouded by strained family relationships, financial and personal challenges as well as the clutter, it’s very tempting for hoarders to avoid the realities completely and focus instead on a fantasy. Hoarders also look for an escape into what I call “easy love,” and this is particularly true with animal hoarders. Whatever they are collecting, hoarders turn to their things or pets for positive reinforcement, because that’s a lot less complicated than trying to have a rewarding relationship with another person.
▶ Fake Future
Ben, who we introduced earlier in the book as the “pizza man,” had a house and car crammed with old pizza boxes. In addition, he had a basement full of bits and pieces of mechanical airplane parts, which Ben claimed were enough to build three complete airplanes. To hear him tell it, these would be vintage, collectible airplanes from the golden age of aviation, and he just knew that he was going to build those airplanes and sell them to a museum. In his mind’s eye, he saw himself becoming a sought-after expert on clothwing biplanes. He would write a book and appear on television, giving commentary on aircraft building and restoration. Maybe he would even get a job at the Smithsonian Air and Space Museum, which was near where he lived.
The dream was all Ben talked about. It was so much more appealing than the reality of living in a dangerously full, Stage 5 hoarded house that was getting worse day by day. Ben saw only the fantasy of his completed airplanes, not the thousands of unassembled parts or the putrid rotting pizza that was decaying on top of them. Ben didn’t see himself as an out-of-control hoarder—he was a man with a plan. Unfortunately, Ben wasn’t taking any steps toward implementing that plan. His brain had completely skipped over the phase of picking up the tools, clearing a work space, and starting to assemble the parts of the plane. Instead, Ben was living entirely in the “reward” phase, giving himself lots of praise for being an aviation expert in the making. In his mind, he was happily on his way toward that inevitable, wonderful future.
The reality for Ben was that getting rid of his clutter might have cleared enough space for him to start a few actual projects. But in his mind, throwing anything away was tantamount to
throwing away that glittering future. In his mind he simply couldn’t separate the junk from the valuables—or wasn’t prepared to cope with the task of separating one from the other.
For hoarders, the fake future is the place where they will be successful and happy, and everyone will love them. They can’t think about what others close to them may want—or need—such as a clean house or more quality time together. To make a significant change in their lives, hoarders like Ben or Lucy, the crafter, have to reject their fantasies and learn to accept whatever rewards of reality they can.
▶ Perfect Past
Roxanne was hoarding her daughter’s baby items to hold on to a past that never really existed. Her relationship with her daughter had always been strained, and since the daughter had moved out she had broken off all contact with Roxanne. That separation was too painful for Roxanne, so she spent ten years building an alternative reality.
Roxanne’s thoughts of the past were colored with nostalgia for a time when there were no arguments, no blame, and no hoarding. Each doll or teddy bear conjured up feel-good memories. As long as she had the mementos, she could visit that fantasyland anytime she wanted to escape the bleak reality of her trailer park home, her isolation, and her deteriorating health.
It has been my experience that many hoarders, like Roxanne, are trying to cope with a tragic childhood. And they have to take a huge and very painful leap into reality each time they agree to part with a possession.
▶ Easy Love
For a hoarder like Margaret, animals are a source of unconditional love. They are always around for a pat or a hug, they are always happy to see her, and they won’t voluntarily leave. It’s an easy relationship for her to maintain—she feeds and pets them, and they love her unconditionally. They don’t demand anything, they don’t offer any challenges, and most importantly, they don’t complain about the hoarding.
I have worked with many hoarders who have had failed relationships, often through no fault of their own. Many were abused as children or have been in abusive marriages. Someone who has been hurt that badly has trouble trusting again. Instead, attaching to animals or possessions is much safer and easier. When given the opportunity to get another pet, animal hoarders focus on that easy love and not the reality of whether or not they can actually take care of the animal.
Ironically, the hoarding also keeps people at bay—people hoarders see as threatening. Safe behind the piles, where nobody will reach out and try to engage them in a healthy relationship, hoarders don’t run the risk of being hurt again. Taking hoarders’ stuff makes them feel vulnerable; they lose their safety net, and that’s a terrifying prospect.
THE HOARDER’S STATE OF MIND
To the outsider, the hoarder may appear to be lazy, hostile, or irrational. But really, it’s about deep-seated sadness or anger that may mask or be exacerbated by other mental disorders.
I didn’t set out to write a medical textbook but rather to dispel some of the myths that surround hoarding and give those who are trying to help a sense of the underlying causes of this condition. For family, friends, and professionals whose response may go quickly from sympathy to exasperation and resentment, it is helpful to have an understanding of the psychology of the hoarder—and all the factors that play into this pathology.
Over the years on the front lines, I’ve worked closely with mental health professionals and read whatever I could find on the clinical research. (For a good overview of what’s been published, see the resources listed at the end of the book.)
However, even research psychologists aren’t sure exactly what’s going on. They do know that hoarding is not simply laziness. It is not confined to the poor and undereducated. It is most definitely a psychological disorder. But, like so many disorders, it may be described as a syndrome that is manifested in any number of behaviors.
Researchers also know that hoarders often have other identifiable medical issues, including dementia, obsessive-compulsive disorder, and depression. But they’re still figuring out if the other diseases lead to hoarding or if hoarding triggers them. And it’s not clear whether hoarding is its own mental disorder or a subset of some other category.
Dr. Suzanne Chabaud explains that researchers are discovering that although hoarding is being recognized as a symptom of certain disorders, like dementia and schizophrenia, there are other cases in which they are questioning the connection. For example, do hoarders with depression, anxiety, or attention deficit/hyperactivity disorder (ADHD) hoard because of those disorders, or do they develop those disorders separate from hoarding? Called “co-morbid disorders,” they often develop in tandem, but without clear proof showing that one causes the other.
In my work, I have almost always found there to be another definable mental disorder in evidence. When therapists or counselors like Dr. Chabaud work with hoarders, they try to find out what that other disorder (or disorders) might be, since simply getting a hoarder’s place cleaned up doesn’t address the underlying causes that led to the problem in the first place. The work doesn’t end when the dump truck pulls away from the house. The real work is just getting started.
I don’t play therapist with my clients. I am more of a coach, who also gets involved in the heavy lifting and logistics. But once my part of the job is complete, I want to know that I’ve done everything I can to set these folks on the path to recovery. Understanding the range of conditions that drive or accompany hoarding helps me to do that—and will be invaluable to anyone in this situation.
▶ Obsessive-Compulsive Disorder
Candace, whose story opened this chapter, had been in therapy and was diagnosed with obsessive-compulsive disorder (OCD). She’s not unusual—hoarding has traditionally been linked to OCD. One research study at Johns Hopkins found that up to 42 percent of patients with OCD were also hoarders.
At first glance this doesn’t make much sense. People with OCD are stereotyped as being off-the-charts clean and tidy, with all kinds of rules about items not touching each other and everything being in its special place. That doesn’t sound like hoarding.
Ironically, that obsession is actually the root of the problem. Candace frequently got bogged down while she was trying to get control of her stuff because she couldn’t make the perfect decision about what to do with her things. This dilemma created a constant internal struggle.
Candace would look at a stack of books and want to line them up neatly on a shelf. But of course there was no empty shelf in her house. Based on her behavior during the initial stages of the cleanup, I can only imagine her internal dialogue: “You’re doing this all wrong, you need an empty shelf. Don’t listen to those people trying to help you; they don’t know how to do it correctly. You can do the job way better by yourself. There’s just so much to do besides these books, and wait, you are doing it all wrong!”
So instead of cleaning off a shelf, or maybe deciding to donate the books, Candace became overwhelmed and exhausted and would then just toss the books onto a growing pile. She truly believed she would get to the mess later, but later never came.
Obsessive people can also become overwhelmed by fears: of losing an important item or information; of others touching or moving their possessions; of missing out on a special sale purchase. The sum of these fears can contribute to hoarding. Just as a person with classic OCD finds relief in repetitious actions or rituals, some OCD hoarders collect things not only to feel good but also to fight off discomfort and pain. Dr. Chabaud has worked with OCD hoarders who are driven by a need to protect their families—they feel if they don’t buy a spare set of sheets then their entire family will be in peril because a hurricane might come one day and level the house, and leave them with no bedding.
There are a few other classic yet rarer OCD symptoms that can lead to hoarding. A person with an obsession for cleanliness won’t touch anything that has touched the floor. So whatever falls there remains there—and accumulates exponentially. Some people develop a compulsion to save hair or nail clippings, fec
es, or anything they may have touched, and they won’t get rid of it. There can be process compulsions—the need to go through a long mental checklist before an item can be thrown away. Rather than go through this ritual, the hoarder will postpone the decision and the stuff piles up. I’ve also heard of OCD hoarders who become obsessed with buying sets of things, or buying things in even numbers.
When hoarding is driven by OCD, it’s all about perfectionism, indecision, and procrastination. You will see the hoarder get bogged down in making decisions about which items to donate, throw away, or keep. He or she will probably have to touch every item as it leaves the house, checking things off on a “mental inventory.” A hoarder with OCD can often handle the items leaving a home, but not knowing if the item is there or not messes up the inventory in his or her head and creates constant mental violence.
Children Who Hoard
DR. SUZANNE CHABAUD, who works with clients with OCD and hoarding issues, says a significant number of children with OCD are also hoarders and their hoarding is sometimes a very early symptom. Kids who hoard have a lower response to medication than OCD kids who don’t hoard.
Hoarder children exhibit pronounced tendencies of indecision, procrastination, and perfectionism. They don’t want to let things go, they can’t make a choice about what toys to keep and what to donate. Or the children get fixated on “just right.” For instance, they find the exactly perfect place for a stuffed bear, and then the bear can’t be moved. Moving the bear would upset the perfect order of things.
Not all children who become hoarders have OCD, of course.Their behavior may be learned if they are growing up in a hoarder house. Some children of hoarders never learn to set limits on their possessions, or basic cleaning and organizing techniques. On the other hand, children with OCD may react in exactly the opposite way, and always try to carve out a neat little space for themselves in a cluttered household.
The Secret Lives of Hoarders: True Stories of Tackling Extreme Clutter Page 5